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Coro-Nitro Pump Spray
c
(Ayrton Saunders)
Aerosol spray
,
glyceryl trinitrate 400 micrograms/
metered dose,
net price 200-dose unit = £3.13
Dose
treatment or prophylaxis of angina, spray 1–2 doses under
tongue and then close mouth
Glytrin Spray
c
(Sanofi-Aventis)
Aerosol spray
,
glyceryl trinitrate 400 micrograms/
metered dose,
net price 200-dose unit = £3.29
Dose
treatment or prophylaxis of angina, spray 1–2 doses under
tongue and then close mouth
Cautions
flammable
GTN 300 mcg
(Martindale)
Sublingual tablets
,
glyceryl trinitrate 300 micr-
ograms,
net price 100 = £2.71.
Label:
16
Nitrolingual Pumpspray
c
(Merck Serono)
Aerosol spray
,
glyceryl trinitrate 400 micrograms/
metered dose,
net price 200-dose unit = £3.44
Dose
treatment or prophylaxis of angina, spray 1–2 doses under
tongue and then close mouth
Nitromin
c
(Egis)
Aerosol spray,
glyceryl trinitrate 400 micrograms/
metered dose,
net price 180-dose unit = £2.63,
200-
dose unit = £2.71
Dose
treatment or prophylaxis of angina, spray 1–2 doses under
tongue and then close mouth
Longer-acting tablets
Suscard
c
(Forest)
Buccal tablets
, m/r, glyceryl trinitrate 2 mg, net price
100-tab pack = £12.70;
3 mg,
100-tab pack = £18.33;
5 mg,
100-tab pack = £24.96.
Counselling,
see below
Dose
treatment of angina, 2 mg as required, increased to 3 mg if
necessary;
prophylaxis 2–3 mg 3 times daily;
5 mg in severe
angina
Unstable angina (adjunct),
up to 5 mg with ECG monitoring
Congestive heart failure, 5 mg 3 times daily, increased to 10 mg 3
times daily in severe cases
Acute heart failure, 5 mg repeated until symptoms abate
Counselling
Tablets have rapid onset of
effect;
they are placed
between upper lip and gum,
and left to dissolve;
vary site to
reduce risk of dental
caries
Parenteral preparations
Note
Glass or
polyethylene apparatus is preferable;
loss of
potency will occur if PVC is used
Glyceryl Trinitrate
(Non-proprietary) A
Injection
,
glyceryl trinitrate 1 mg/mL.
To be diluted
before use or given undiluted with syringe pump. Net
price 50-mL vial = £15.90
Injection
,
glyceryl trinitrate 5 mg/mL.
To be diluted
before use. Net price 5-mL amp = £6.49; 10-mL amp =
£12.98
Excipients
may include ethanol,
propylene glycol (see Excipients, p.
2)
Nitrocine
c
(UCB Pharma) A
Injection
,
glyceryl trinitrate 1 mg/mL.
To be diluted
before use or given undiluted with syringe pump. Net
price 10-mL amp = £5.88;
50-mL bottle = £13.77
Excipients
include propylene glycol (see Excipients, p.
2)
Nitronal
c
(Merck Serono) A
Injection
,
glyceryl trinitrate 1 mg/mL.
To be diluted
before use or given undiluted with syringe pump. Net
price 5-mL vial = £1.80;
50-mL vial = £14.76
Transdermal preparations
Deponit
c
(UCB Pharma)
Patches
, self-adhesive, transparent, glyceryl trinitrate,
‘5’ patch
(releasing approx.
5 mg/24 hours when in
contact with skin), net price 28 = £12.77;
‘10’ patch
(releasing approx.10 mg/24 hours),
28 = £14.06
Dose
prophylaxis of angina,
apply one ‘5’
or one ‘10’
patch to
lateral
chest wall, upper arm,
thigh,
abdomen,
or shoulder;
increase to two ‘10’
patches every 24 hours if necessary; replace
every 24 hours, siting replacement patch on different area;
see
also notes above (Tolerance)
Minitran
c
(Meda)
Patches
, self-adhesive, transparent, glyceryl trinitrate,
‘5’ patch
(releasing approx.
5 mg/24 hours when in
contact with skin), net price 30 = £11.62;
‘10’ patch
(releasing approx. 10 mg/24 hours), 30 = £12.87;
‘15’
patch
(releasing approx. 15 mg/24 hours),
30 =
£14.19
Dose
prophylaxis of angina, apply one ‘5’ patch to chest or upper
arm; replace every 24 hours, siting replacement patch on different
area;
adjust dose according to response;
see also notes above
(Tolerance)
Maintenance of venous patency (‘5’
patch only),
consult product
literature
Nitro-Dur
c
(Schering-Plough)
Patches
,
self-adhesive, buff, glyceryl trinitrate,
‘0.2 mg/h’ patch
(releasing approx. 5 mg/24 hours
when in contact with skin),
net price 28 = £10.59;
‘0.4 mg/h’ patch
(releasing approx. 10 mg/24 hours),
28 = £11.72;
‘0.6 mg/h’ patch
(releasing
approx.15 mg/24 hours),
28 = £12.90
Dose
prophylaxis of angina, apply one ‘0.2 mg/h’ patch to chest
or outer upper arm;
replace every 24 hours, siting replacement
patch on different area:
adjust dose according to response;
max.
15 mg in 24 hours;
see also notes above (Tolerance)
Percutol
c
(Aspire)
Ointment
,
glyceryl trinitrate 2%,
net price 60 g =
£59.65.
Counselling,
see administration below
Excipients
include wool fat
Dose
prophylaxis of angina,
usual dose 1–2 inches of ointment
measured on to
Applirule
c
, and applied (usually to chest, arm, or
thigh) without rubbing in and secured with surgical tape, every 3–
4 hours as required;
to determine dose, ½ inch on first day then
increased by ½ inch/day until headache occurs, then reduced by
½ inch
Note
Approx.
800 micrograms/hour
absorbed from 1 inch of
ointment
Transiderm-Nitro
c
(Novartis)
Patches
,
self-adhesive, pink,
glyceryl trinitrate,
‘5’
patch
(releasing approx. 5 mg/24 hours when in
contact with skin), net price 28 = £17.05;
‘10’ patch
(releasing approx.
10 mg/24 hours),
28 = £18.74
Dose
prophylaxis of angina,
apply one ‘5’
or one ‘10’
patch to
lateral
chest wall; replace every 24 hours, siting replacement
patch on different area; max. two ‘10’ patches daily; see also notes
above (Tolerance)
Prophylaxis of phlebitis and extravasation (‘5’ patch only), consult
product literature
ISOSORBIDE DINITRATE
Indications
prophylaxis and treatment of angina;
left
ventricular failure
Cautions
see under Glyceryl Trinitrate
Contra-indications
see under Glyceryl Trinitrate
Hepatic impairment
see under Glyceryl Trinitrate
Renal impairment
see under Glyceryl Trinitrate
Pregnancy
may cross placenta—manufacturers
advise avoid unless potential benefit outweighs risk
Breast-feeding
see under Glyceryl Trinitrate
126
2.6.1 Nitrates
BNF 61
2
Cardiovascular system