Nitroglycerin (Sublingual Tablet)

Generic Details

Generic Name

Nitroglycerin Sublingual Tablet

Other Names

  • Nitroglycerin Sublingual Spray
  • Nitrostat

Drug Class

  • Antianginal
  • Vasodilator

Chemical Formula

C3H5N3O9

Molecular Weight

227.09 g/mol

Mechanism of Action

  • Nitroglycerin is a prodrug that is metabolized to nitric oxide (NO) in smooth muscle cells. NO activates guanylate cyclase, leading to an increase in cyclic guanosine monophosphate (cGMP), which causes vasodilation of venous and arterial smooth muscles.

Indications

  • Angina pectoris (chest pain)

Common Dosage Forms

  • 0.3 mg
  • 0.4 mg
  • 0.6 mg

Typical Dosage

  • One tablet under the tongue as soon as chest pain starts. May repeat every 5 minutes for a maximum of 3 doses if needed. If pain persists, seek medical attention.

Pediatric Dosage

  • Dosage should be determined by a healthcare provider based on the child's weight and condition.

Geriatric Dosage

  • May require lower doses due to age-related changes in drug metabolism and sensitivity.

Side Effects

  • Headache
  • Dizziness
  • Flushing
  • Hypotension
  • Tachycardia

Contraindications

  • Severe hypotension
  • Hypovolemia
  • Concomitant use with phosphodiesterase-5 inhibitors (e.g., sildenafil)
  • Increased intracranial pressure

Pregnancy Category

  • Category C - Risk cannot be ruled out

Lactation Safety

  • Caution advised, excretion in breast milk unknown

Drug Interactions

  • Hypotensive effects potentiated by alcohol, antihypertensives, and other vasodilators. Contraindicated with phosphodiesterase-5 inhibitors.

Overdose Symptoms

  • Severe hypotension
  • Cyanide toxicity

Antidote for Overdose

  • Methylene blue for cyanide poisoning

Storage Conditions

  • Store at room temperature away from moisture and heat.

Pharmacokinetics

  • Absorption: Rapidly absorbed through the oral mucosa
  • Distribution: Widely distributed in the body
  • Metabolism: Primarily hepatic
  • Excretion: Excreted renally

Precautions

  • Caution in patients with closed-angle glaucoma, hypothyroidism, or severe anemia.

Warnings

  • May cause severe hypotension, especially in the elderly or those with volume depletion.