Pactorin 400 mcg/spray (Topical Spray)

Indications

• Relief of angina pectoris
• Prophylaxis of angina pectoris

Dosage

• 1-2 metered sprays at onset of attack
• No more than 3 metered sprays in 15 minutes
• Prophylactic use 5-10 minutes prior to activities precipitating an attack

Mode of Action

• Relaxation of vascular smooth muscle
• Vasodilator effect on arteries and veins
• Decreases left ventricular enddiastolic pressure
• Reduces systemic vascular resistance
• Reduces arterial pressure

Administration

• Carry at all times for angina patients
• Not for routine use, only at onset of chest pain
• Administer 5-10 minutes prior to activities precipitating an attack
• Avoid alcoholic beverages after administration
• Avoid taking sildenafil, vardenafil or tadalafil concurrently
• Keep away from children
• Sit down when feeling angina attack, remove plastic cap, hold container upright, spray under tongue, avoid swallowing immediately, may require second administration for relief

Interaction

• Severe hypotension and collapse with alcohol
• Enhanced bioavailability of dihydroergotamine with oral Pactorin
• Risk of orthostatic hypotension with calcium channel blocker, phenothiazines, and tricyclic antidepressants

Contraindications

• Hypersensitivity to nitrates
• Hypotension, hypovolaemia, severe anaemia
• Cerebral haemorrhage and brain trauma
• Mitral stenosis and angina caused by hypertrophic obstructive cardiomyopathy
• Concomitant administration of phosphodiesterase inhibitors used for erectile dysfunction

Side Effects

• Headache
• Facial flushing
• Dizziness
• Nausea
• Vomiting
• Feelings of weakness
• Postural hypotension
• Reflex tachycardia

Pregnancy & Lactation

• Pregnancy Category C
• Administer to pregnant women only if clearly needed
• Caution in nursing women

Precautions & Warnings

• Use during early days of acute myocardial infarction requires monitoring
• Caution in patients with impaired renal or hepatic function, hypothyroidism, malnutrition, or hypothermia

Use in Special Populations

• Safety and effectiveness in pediatric patients not established

Overdose Effects

• Severe hypotension
• Headache
• Vertigo
• Palpitation
• Visual disturbance
• Flushing and perspiring skin
• Nausea and vomiting
• Syncope
• Methemoglobinemia
• Circulatory collapse

Therapeutic Class

• Nitrates: Coronary vasodilators

Storage Conditions

• Store in cool and dry place
• Away from light and heat
• Keep out of reach of children

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