Precautions and warnings

Take the medication exactly as prescribed by your doctor. Do not take more or less than the prescribed dose.

If you have never taken glyceryl trinitrate before, let your doctor know before taking it. You may have to start with a lower dose.

Keep the medication in its original container and store it at room temperature away from heat and moisture.

Do not crush, chew or break the medication, as this can cause too much of the drug to be released at once.

If you are taking sublingual tablets (tablets that dissolve under the tongue), make sure your mouth is dry before taking them. Place the tablet under your tongue and let it dissolve completely.

Do not drink alcohol while taking glyceryl trinitrate, as this can increase the risk of side effects such as dizziness and headache.

Do not drive or operate heavy machinery until you know how this medication affects you.

If you experience any side effects, such as dizziness or headache, or if your symptoms worsen or do not improve, contact your doctor immediately.

Tell your doctor about any other medications you are taking, as glyceryl trinitrate can interact with other drugs.

If you are pregnant or breastfeeding, talk to your doctor before taking this medication.

It is important to take glyceryl trinitrate exactly as prescribed and follow all of your doctor's instructions carefully. If you have any concerns or questions about taking this medication, be sure to discuss them with your doctor.

Drug Interactions

Glyceryl Trinitrate (nitroglycerin) can interact with other medications, supplements, and foods, which can affect its effectiveness and increase the risk of side effects. Here are some examples of common interactions:

Erectile dysfunction medications: Glyceryl trinitrate should not be taken with medications used to treat erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), as they can cause a dangerous drop in blood pressure.

Blood pressure medications: Other medications used to treat high blood pressure, such as beta-blockers, calcium channel blockers, and ACE inhibitors, can interact with glyceryl trinitrate and cause a drop in blood pressure.

Alcohol: Drinking alcohol while taking glyceryl trinitrate can increase the risk of side effects, such as dizziness and headache.

Nitrate-containing medications: Other medications that contain nitrates, such as isosorbide dinitrate and isosorbide mononitrate, can interact with glyceryl trinitrate and cause a drop in blood pressure.

Diuretics: Some diuretics, also known as water pills, can interact with glyceryl trinitrate and increase the risk of low blood pressure.

Herbal supplements: Certain herbal supplements, such as ginkgo biloba and garlic, can interact with glyceryl trinitrate and increase the risk of bleeding.

Grapefruit juice: Grapefruit juice can increase the absorption of glyceryl trinitrate, which can increase the risk of side effects.

Contraindications

While it can be an effective treatment for this condition, there are certain situations in which it should not be used due to contraindications. Here are some of the main contraindications of glyceryl trinitrate:

Allergy: Do not take glyceryl trinitrate if you are allergic to it or any of its ingredients.

Severe anemia: Glyceryl trinitrate can cause a drop in blood pressure, which can be dangerous for people with severe anemia.

Increased intracranial pressure: Glyceryl trinitrate can increase pressure inside the skull, which can be dangerous for people with conditions that cause increased intracranial pressure.

Head trauma: Glyceryl trinitrate should not be used in people who have recently suffered a head injury.

Glaucoma: Glyceryl trinitrate can increase pressure in the eye, which can be dangerous for people with glaucoma.

Medications: There are several medications that can interact with glyceryl trinitrates, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), which are used to treat erectile dysfunction.

Pregnancy and breast-feeding: The safety of glyceryl trinitrate during pregnancy and breastfeeding is not known, and it should be used with caution in these situations.

Mode of actions

Glyceryl Trinitrate (nitroglycerin) works by relaxing and widening the blood vessels in the body, including the coronary arteries that supply the heart with oxygenated blood. This helps to improve blood flow and relieve the symptoms of angina, which is caused by reduced blood flow to the heart.

Glyceryl trinitrate is converted into nitric oxide (NO) in the body, which activates an enzyme called guanylate cyclase. This enzyme then converts guanosine triphosphate (GTP) into cyclic guanosine monophosphate (cGMP), which causes the smooth muscle cells in the walls of the blood vessels to relax. This relaxation leads to the widening of the blood vessels, which reduces resistance to blood flow and increases blood flow to the heart.

In addition to its effects on blood vessels, glyceryl trinitrate also decreases the amount of work the heart has to do by reducing the heart rate and the force of its contractions. This helps to reduce the oxygen demand of the heart muscle, which can relieve symptoms of angina.

Dosage & Administration

The usual dosage for adults and elderly patients:
PO: 1 capsule/tablet: 2 times a day before meal (e.g. at 8 AM & 2 PM, with a daily nitrate-free interval of 10-12 hours). If necessary the dosage may be raised gradually to 2 or 3 capsules/tablets: 2 times daily. But dosage should be individualized depending on the Nitroglycerin sensitivity of the patient, the severity of the illness and the occurrence of side effects.

Use in Children:
Not recommended for children. Spray: In case of attack 1 or 2 doses should be administered under the tongue to a sitting patient. If necessary, more doses can be given but not more than 3 doses within 15 minutes. For prevention 1 dose should be applied 5-10 minutes before physical exercise.

Use in Children:
Nitroglycerin Spray is not recommended for children.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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