What you need to know about drugs

Nitro-Bid

Nitro-Bid(nitroglycerin) – Fougera

THERAPEUTIC CLASS

Nitrate vasodilator

INDICATIONS

Prevention of angina pectoris due to coronary artery disease.

ADULT DOSAGE

Adults: Initial: Apply 0.5 inch bid (once in the am and 6 hrs later). Titrate: May increase to 1 inch bid, then to 2 inches bid. Should have 10-12 hr nitrate-free period.

HOW SUPPLIED

Oint: 2% (15mg/inch) [1g (48s), 30g, 60g]

WARNINGS/PRECAUTIONS

Monitor with acute MI or CHF. Severe hypotension and tachycardia may occur; caution with volume depletion and hypotension. May aggravate angina caused by hypertrophic cardiomyopathy. Tolerance to other forms of nitrates may decrease effects. Chest pains, acute myocardial infarction, and death may occur during temporary withdrawal. Not useful in aborting an acute anginal episodes.

ADVERSE REACTIONS

Headache, lightheadedness, hypotension.

DRUG INTERACTIONS

Additive vasodilating effects with other vasodilators (eg, alcohol). Severe hypotension with sildenafil. Marked orthostatic hypotension reported with CCBs, possibly requiring dose adjustment.

PREGNANCY

Category C, caution in nursing.

MECHANISM OF ACTION

Nitrate vasodilator; relaxes vascular smooth muscle, and consequent dilatation of peripheral arteries and veins, especially the latter. Dilatation of veins leads to reduced left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). It also dilates the coronary artery.

PHARMACOKINETICS

Distribution: Vd=3L/kg. Metabolism: Extrahepatic metabolism (RBC and vascular walls), inorganic nitrate and 1,2-and 1,3-dinitrogylcerin (metabolites). Dinitrates are metabolized to mononitrates, gycerol and CO2. Elimination: T1/2 =3 mins.

ASSESSMENT

Assess for severe hypotension or volume-depletion in patients, angina caused by hypertrophic cardiomyopathy, alcohol intake, and possible drug interactions.

MONITORING

Careful clinical or hemodynamic monitoring for hypotension and tachycardia. Monitor for paradoxical bradycardia and increased angina pectoris, rebound and decreased exercise tolerance, headaches and lightheadedness on standing, manifestation of true physical dependence (chest pain, acute MI after withdrawal), and methemoglobinemia.

PATIENT COUNSELING

Counsel to carefully follow dosing regimen, including a 10-12 hr nitrate-free period. Inform about headaches (markers of drug activity). Furthermore, inform patients to contact MD if patient experiences lightheadedness on standing. Avoid alcohol consumption. Topical use only.

ADMINISTRATION/STORAGE

Administration: Topical route. Place applicator on flat surface, printed side down. Squeeze necessary amount from tube onto applicator. Place applicator on desired area of skin, spread ointment, and tape into place. Storage: 20o-25°C (68°-77oF).


  • Post a Comment

    Your email is kept private. Required fields are marked *

    You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

    Nitro-Bid

    Nitro-Bid

    Generic Name: nitroglycerin

    Dosage Form: ointment

    For ProfessionalsSide EffectsInteractionsMore…

    Nitro-Bid®

    (Nitroglycerin Ointment USP, 2%)

    FOR TOPICAL USE ONLY

    Rx Only

    Nitro-Bid Description

    Nitroglycerin is 1,2,3-propanetriol trinitrate, an organic nitrate whose structural formula is:

    and whose molecular weight is 227.09. The organic nitrates are vasodilators, active on both arteries and veins.

    Nitro-Bid® for topical use contains lactose and 2% nitroglycerin in a base of lanolin, white petrolatum and purified water. Each inch (2.5 cm), as squeezed from the tube, contains approximately 15 mg of nitroglycerin.

    Nitro-Bid – Clinical Pharmacology

    The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle and consequent dilatation of peripheral arteries and veins, especially the latter. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Dilatation of the coronary arteries also occurs. The relative importance of preload reduction, afterload reduction, and coronary dilatation remains undefined.

    Dosing regimens for most chronically used drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective concentration. This strategy is inappropriate for organic nitrates. Several well-controlled clinical trials have used exercise testing to assess the anti-anginal efficacy of continuously-delivered nitrates. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Attempts to overcome nitrate tolerance by dose escalation, even to doses far in excess of those used acutely, have consistently failed. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored.

    Pharmacokinetics: The volume of distribution of nitroglycerin is about 3 L/kg, and nitroglycerin is cleared from this volume at extremely rapid rates, with a resulting serum half-life of about three minutes. The observed clearance rates (close to 1 L/kg/min) greatly exceed hepatic blood flow; known sites of extrahepatic metabolism include red blood cells and vascular walls.

    The first products in the metabolism of nitroglycerin are inorganic nitrate and the 1,2- and 1,3-dinitroglycerols. The dinitrates are less effective vasodilators than nitroglycerin, but they are longer-lived in the serum, and their net contribution to the overall effect of chronic nitroglycerin regimens is not known. The dinitrates are further metabolized to (non-vasoactive) mononitrates and, ultimately, to glycerol and carbon dioxide.

    To avoid development of tolerance to nitroglycerin, drug-free intervals of 10 – 12 hours are known to be sufficient; shorter intervals have not been well studied. In one well-controlled clinical trial, subjects receiving nitroglycerin appeared to exhibit a rebound or withdrawal effect, so that their exercise tolerance at the end of the daily drug-free interval was less than that exhibited by the parallel group receiving placebo.

    Reliable assay techniques for plasma nitroglycerin levels have only recently become available, and studies using these techniques to define the pharmacokinetics of nitroglycerin ointment have not been reported. Published studies using older techniques provide results that often differ, in similar experimental settings, by an order of magnitude. The data are consistent, however, in suggesting that nitroglycerin levels rise to steady state within an hour or so of application of ointment, and that after removal of nitroglycerin ointment, levels wane with a half-life of about half an hour.

    The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.

    The maximal achievable daily duration of anti-anginal activity provided by nitroglycerin ointment therapy has not been studied. Recent studies of other formulations of nitroglycerin suggest that the maximal achievable daily duration of anti-anginal effect from nitroglycerin ointment will be about 12 hours.

    It is reasonable to believe that the rate and extent of nitroglycerin absorption from ointment may vary with the site and square measure of the skin over which a given dose of ointment is spread, but these relationships have not been adequately studied.

    Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Doses used in clinical trials have ranged from 1/2 inch (1.3 cm; 7.5 mg) to 2 inches (5.1 cm; 30 mg), typically applied to 36 square inches (232 square centimeters) of truncal skin.

    In some controlled trials of other organic nitrate formulations, efficacy has declined with time. Because controlled, long-term trials of nitroglycerin ointment have not been reported, it is not known how the efficacy of nitroglycerin ointment may vary during extended therapy.

    Indications and Usage for Nitro-Bid

    Nitroglycerin ointment is indicated for the prevention of angina pectoris due to coronary artery disease. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.

    Contraindications

    Allergic reactions to organic nitrates are extremely rare, but they do occur. Nitroglycerin is contraindicated in patients who are allergic to it.

    Warnings

    Amplification of the vasodilatory effects of nitroglycerin by sildenafil can result in severe hypotension. The time course and dose dependence of this interaction have not been studied. Appropriate supportive care has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion.

    The benefits of transdermal nitroglycerin in patients with acute myocardial infarction or congestive heart failure have not been established. If one elects to use nitroglycerin in these conditions, careful clinical or hemodynamic monitoring must be used to avoid the hazards of hypotension and tachycardia.

    Precautions

    General: Severe hypotension, particularly with upright posture, may occur with even small doses of nitroglycerin. This drug should therefore be used with caution in patients who may be volume depleted or who, for whatever reason, are already hypotensive. Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris.

    Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy.

    As tolerance to other forms of nitroglycerin develops, the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is somewhat blunted. In industrial workers who have had long-term exposure to unknown (presumably high) doses of organic nitrates, tolerance clearly occurs. Chest pains, acute myocardial infarction, and even sudden death have occurred during temporary withdrawal of nitrates from these workers, demonstrating the existence of true physical dependence.

    Some clinical trials in angina patients have provided nitroglycerin for about 12 continuous hours of every 24-hour day. During the nitrate-free intervals in some of these trials, anginal attacks have been more easily provoked than before treatment, and patients have demonstrated hemodynamic rebound and decreased exercise tolerance. The importance of these observations to the routine, clinical use of transdermal nitroglycerin is not known.

    Information for Patients: Daily headaches sometimes accompany treatment with nitroglycerin. In patients who get these headaches, the headaches are a marker of the activity of the drug. Patients should resist the temptation to avoid headaches by altering the schedule of their treatment with nitroglycerin, since loss of headache is likely to be associated with simultaneous loss of antianginal efficacy.

    Treatment with nitroglycerin may be associated with lightheadedness on standing, especially just after rising from a recumbent or seated position. This effect may be more frequent in patients who have also consumed alcohol. Patient instruction leaflet is included.

    Drug Interactions: The vasodilating effects of nitroglycerin may be additive with those of other vasodilators. Alcohol, in particular, has been found to exhibit additive effects of this variety.

    Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. Dose adjustments of either class of agents may be necessary.

    Carcinogenesis, Mutagenesis, and Impairment of Fertility: Studies to evaluate the carcinogenic or mutagenic potential of nitroglycerin have not been performed. Nitroglycerin’s effect upon reproductive capacity is similarly unknown.

    Pregnancy Category C: Animal reproduction studies have not been conducted with nitroglycerin. It is also not known whether nitroglycerin can cause fetal harm when administered to a pregnant woman or whether it can affect reproductive capacity. Nitroglycerin should be given to a pregnant woman only if clearly needed.

    Nursing Mothers: It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nitroglycerin is administered to a nursing woman.

    Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

    Adverse Reactions

    Adverse reactions to nitroglycerin are generally dose-related, and almost all of these reactions are the result of nitroglycerin’s activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose, especially at higher doses. Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur. Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy. Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon.

    Allergic reactions to nitroglycerin are also uncommon, and the great majority of those reported have been cases of contact dermatitis or fixed drug eruptions in patients receiving nitroglycerin in ointments or patches. There have been a few reports of genuine anaphylactoid reactions, and these reactions can probably occur in patients receiving nitroglycerin by any route.

    Extremely rarely, ordinary doses of organic nitrates have caused methemoglobinemia in normal-seeming patients; for further discussion of its diagnosis and treatment see OVERDOSAGE.

    Data are not available to allow estimation of the frequency of adverse reactions during treatment with nitroglycerin ointment.

    Overdosage

    Hemodynamic Effects: The ill effects of nitroglycerin overdose are generally the results of nitroglycerin’s capacity to induce vasodilation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure, with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitations; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); air hunger and dyspnea, later followed by reduced ventilatory effort; diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death.

    Laboratory determinations of serum levels of nitroglycerin and its metabolites are not widely available, and such determinations have, in any event, no established role in the management of nitroglycerin overdose.

    No data are available to suggest physiological maneuvers (e.g., maneuvers to change the pH of the urine) that might accelerate elimination of nitroglycerin and its active metabolites. Similarly, it is not known which—if any—of these substances can usefully be removed from the body by hemodialysis.

    No specific antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of nitroglycerin overdose. Because the hypotension associated with nitroglycerin overdose is the result of venodilatation and arterial hypovolemia, prudent therapy in this situation should be directed toward increase in central fluid volume. Passive elevation of the patient’s legs may be sufficient, but intravenous infusion of normal saline or similar fluid may also be necessary.

    The use of epinephrine or the arterial vasoconstrictors in this setting is likely to do more harm than good.

    In patients with renal disease or congestive heart failure, therapy resulting in central volume expansion is not without hazard. Treatment of nitroglycerin overdose in these patients may be subtle and difficult, and invasive monitoring may be required.

    Methemoglobinemia: Nitrate ions liberated during metabolism of nitroglycerin can oxidize hemoglobin into methemoglobin. Even in patients totally without cytochrome b5 reductase activity, however, and even assuming that the nitrate moieties of nitroglycerin are quantitatively applied to oxidation of hemoglobin, about 1 mg/kg of nitroglycerin should be required before any of these patients manifests clinically significant (> 10%) methemoglobinemia. In patients with normal reductase function, significant production of methemoglobin should require even larger doses of nitroglycerin. In one study in which 36 patients received 2 to 4 weeks of continuous nitroglycerin therapy at 3.1 to 4.4 mg/hr, the average methemoglobin level measured was 0.2%; this was comparable to that observed in parallel patients who received placebo.

    Notwithstanding these observations, there are case reports of significant methemoglobinemia in association with moderate overdoses of organic nitrates. None of the affected patients had been thought to be unusually susceptible.

    Methemoglobin levels are available from most clinical laboratories. The diagnosis should be suspected in patients who exhibit signs of impaired oxygen delivery despite adequate cardiac output and adequate arterial pO2. Classically, methemoglobinemic blood is described as chocolate brown, without color change on exposure to air.

    When methemoglobinemia is diagnosed, the treatment of choice is methylene blue, 1-2 mg/kg intravenously.

    Nitro-Bid Dosage and Administration

    As noted above (CLINICAL PHARMACOLOGY), controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Doses used in clinical trials have ranged from 1/2 inch (1.3 cm; 7.5 mg) to 2 inches (5.1 cm; 30 mg), typically applied to 36 square inches (232 square centimeters) of truncal skin.

    It is reasonable to believe that the rate and extent of nitroglycerin absorption from ointment may vary with the site and square measure of the skin over which a given dose of ointment is spread, but these relationships have not been adequately studied.

    Controlled trials with other formulations of nitroglycerin have demonstrated that if plasma levels are maintained continuously, all anti-anginal efficacy is lost within 24 hours. This tolerance cannot be overcome by increasing the dose of nitroglycerin. As a result, any regimen of Nitro-Bid® administration should include a daily nitrate-free interval. The minimum necessary length of such an interval has not been defined, but studies with other nitroglycerin formulations have shown that 10 to 12 hours is sufficient.

    Thus, one appropriate dosing schedule for Nitro-Bid® would begin with two daily 1/2- inch (7.5 mg) doses, one applied on rising in the morning and one applied six hours later. The dose could be doubled, and even doubled again, in patients tolerating this dose but failing to respond to it. The foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed from the tube. Use entire contents of foilpac to obtain full dose and discard immediately after use.

    Each tube of ointment and each box of foilpacs is supplied with a pad of ruled, impermeable, paper applicators. These applicators allow ointment to be absorbed through a much smaller area of skin than that used in any of the reported clinical trials, and the significance of this difference is not known. To apply the ointment using one of the applicators, place the applicator on a flat surface, printed side down. Squeeze the necessary amount of ointment from the tube onto the applicator, place the applicator (ointment side down) on the desired area of the skin, and tape the applicator into place.

    How is Nitro-Bid Supplied

    Nitro-Bid® (Nitroglycerin Ointment USP, 2%), is a pale yellow ointment. (Package includes a supply of ruled applicators for convenient application.)

          NDC 0281-0326-08 foilpac® Box of 48 x 1 gram
          NDC 0281-0326-30 30 gram tubes
          NDC 0281-0326-60 60 gram tubes

    Close tightly, immediately after each use.

    Store at 20°-25°C (68°-77°F) [See USP Controlled Room Temperature].

    Nitro-Bid®(Nitroglycerin Ointment USP, 2%)

    SAVAGE LABORATORIES®

    A division of Fougera Pharmaceuticals Inc.

    MELVILLE, NEW YORK 11747

    I7326A/IF7326A

    R09/11

    #274

    PATIENT INSTRUCTIONS FOR APPLICATIONS

    1. Measure desired dosage of Nitroglycerin Ointment 2% by means of the dose measuring applicator supplied with the tube. Place the applicator on a flat surface, printed side down. Squeeze the necessary amount of ointment from the tube onto the applicator, and place the applicator (ointment side down) on the desired area of the skin.
    2. Spread the ointment using the dose measuring applicator lightly onto the chest or other areas of skin if preferred. Do not rub into the skin. Coverage of an area approximately the size of the dose measuring applicator (3 1/2′′ by 2 1/4′′) should be sufficient to obtain the desired clinical effects. A larger area may be used.
    3. Tape the applicator into place.

    NOTE: Nitro-Bid® can stain clothing. Care should be taken to completely cover the dose measuring applicator with a plastic kitchen wrap.

    Dosage Instructions: Dosage instructions should be obtained from your physician. One appropriate dosing schedule for Nitro-Bid® would begin with two daily 1/2 inch (7.5 mg) doses, one applied on rising in the morning and one applied six hours later. The dose could be doubled, and even doubled again, in patients tolerating this dose but failing to respond to it. The foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed from the tube. Use entire contents of foilpac to obtain full dose and discard immediately after use.

    INFORMATION FOR PATIENTS: Your daily regimen of Nitro-Bid® administration should include a nitrate-free period. Studies have shown 10-12 hours is sufficient. The most common side effect which is encountered is headache. Faintness, flushing and dizziness may occur, especially when suddenly arising from the recumbent (lying horizontal) position. If these latter symptoms do occur, it may warrant discontinuation of therapy, and your physician should be notified. For changes in dosage and frequency of application consult your physician.

    TUBE: KEEP TUBE TIGHTLY CLOSED.

    foilpac®: DISCARD IMMEDIATELY AFTER USE.

    Store at 20°-25°C (68°-77°F) [See USP Controlled Room Temperature].

    SAVAGE LABORATORIES®

    A division of Fougera Pharmaceuticals Inc.

    MELVILLE, NEW YORK 11747

    R09/11

    PACKAGE LABEL – PRINCIPAL DISPLAY PANEL – 30 GRAM TUBE

    NDC 0281-0326-30

    SAVAGE LABORATORIES®

    Nitro-Bid®

    (Nitroglycerin Ointment USP, 2%)

    Rx only

    NET WT 30 grams

    PACKAGE LABEL – PRINCIPAL DISPLAY PANEL – 30 GRAM CARTON

    NDC 0281-0326-30

    SAVAGE LABORATORIES®

    Nitro-Bid®

    (Nitroglycerin Ointment USP, 2%)

    Rx only

    NET WT 30 grams

    PACKAGE LABEL – PRINCIPAL DISPLAY PANEL – APPLICATOR SHEET

    Nitro-Bid

    (Nitroglycerin Ointment USP, 2%)

    INCHES ½ 1 1 ½ 2

    CENTIMETERS 1.25 2.5 3.75 5

    the applicator that measures the dose

    SAVAGE LABORATORIES®

    A division of Fougera Pharmaceuticals Inc.

    Melville, New York 11747

    Nitro-Bid 

    nitroglycerin ointment

    Product Information
    Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:0281-0326
    Route of Administration TOPICAL DEA Schedule     
    Active Ingredient/Active Moiety
    Ingredient Name Basis of Strength Strength
    nitroglycerin (nitroglycerin) nitroglycerin 20 mg  in 1 g
    Inactive Ingredients
    Ingredient Name Strength
    lactose  
    water  
    petrolatum  
    Packaging
    # Item Code Package Description
    1 NDC:0281-0326-08 48 PACKET in 1 BOX
    1 1 g in 1 PACKET
    2 NDC:0281-0326-30 30 g in 1 TUBE
    3 NDC:0281-0326-60 60 g in 1 TUBE
    Marketing Information
    Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
    ANDA ANDA087355 08/15/2009
    Labeler - SAVAGE LABORATORIES, A division of Fougera Pharmaceuticals Inc. (043838424)
    Establishment
    Name Address ID/FEI Operations
    Fougera Pharmaceuticals Inc. 043838424 MANUFACTURE(0281-0326), ANALYSIS(0281-0326)
    Establishment
    Name Address ID/FEI Operations
    Fougera Pharmaceuticals Inc. 174491316 MANUFACTURE(0281-0326)

    Revised: 06/2012   SAVAGE LABORATORIES, A division of Fougera Pharmaceuticals Inc.

    Post a Comment

    Your email is kept private. Required fields are marked *

    You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

    Nitro-Bid

    Nitro-Bid

    Generic Name: nitroglycerin (Transdermal route)

    nye-troe-GLIS-er-in

    OverviewSide EffectsInteractionsFor ProfessionalsMore…

    Commonly used brand name(s)

    In the U.S.

    • Minitran
    • Nitrek
    • Nitro-Bid
    • Nitro-Dur

    In Canada

    • Nitrodur 0.2
    • Nitro-Dur 0.2
    • Nitro-Dur 0.3
    • Nitrodur 0.4
    • Nitro-Dur 0.4
    • Nitrodur 0.6
    • Nitro-Dur 0.6
    • Nitro-Dur 0.8
    • Transderm-Nitro
    • Trinipatch 0.2
    • Trinipatch 0.4
    • Trinipatch 0.6

    Available Dosage Forms:

    • Ointment
    • Patch, Extended Release

    Therapeutic Class: Antianginal

    Chemical Class: Nitrate

    Uses For Nitro-Bid

    Nitroglycerin transdermal is used to prevent angina (chest pain) caused by coronary artery disease. It does not work fast enough to relieve the pain of an angina attack that has already started.

    Nitroglycerin transdermal belongs to the group of medicines called nitrates. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart while reducing its work load. When used regularly on a long-term basis, this helps prevent angina attacks from occurring.

    This medicine is available only with your doctor’s prescription.

    Before Using Nitro-Bid

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of nitroglycerin transdermal in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of nitroglycerin transdermal in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving nitroglycerin transdermal.

    Pregnancy

    Pregnancy Category Explanation
    All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

    Breast Feeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Interactions with Medicines

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Avanafil
    • Sildenafil
    • Tadalafil
    • Vardenafil

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Alteplase, Recombinant

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Acetylcysteine
    • Aspirin
    • Dihydroergotamine
    • Pancuronium

    Interactions with Food/Tobacco/Alcohol

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Cardioversion (medical heart procedure) or
    • Defibrillation (medical heart procedure)—Use with caution. The patch should be removed before having these procedures.
    • Congestive heart failure or
    • Heart attack, recent or
    • Hypertrophic cardiomyopathy (a heart disease) or
    • Hypotension (low blood pressure) or
    • Hypovolemia (low amount of blood)—Use with caution. May make these conditions worse.

    Proper Use of nitroglycerin

    This section provides information on the proper use of a number of products that contain nitroglycerin. It may not be specific to Nitro-Bid. Please read with care.

    Use this medicine exactly as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered. It will only work if applied correctly.

    This form of nitrate is used to reduce the number of angina attacks over a long time. It will not relieve an attack that has already started because it works too slowly. The ointment and patch forms release medicine gradually to provide an effect for 7 to 10 hours. Check with your doctor if you also need a fast-acting medicine to relieve the pain of an angina attack.

    You should use this medicine first thing in the morning and follow the same schedule each day. This medicine works best if you have a “drug-free” period of time every day when you do not use it. Your doctor will schedule your doses during the day to allow for a drug-free time. Follow the schedule of dosing carefully so the medicine will work properly.

    This medicine comes with a patient information leaflet. Read and follow the instructions in the leaflet carefully. Ask your doctor if you have any questions.

    For patients using the ointment:

    • Before applying a new dose of ointment, remove any ointment remaining on the skin from a previous dose. This will allow the fresh ointment to release the nitroglycerin properly.
    • This medicine comes with papers to help measure the dose. Use them to measure the length of ointment squeezed from the tube and to apply the ointment to the skin. Do not rub or massage the ointment into the skin. Spread it in a thin, even layer, and cover an area of skin that is the same size each time it is applied.
    • Apply the ointment to skin with little or no hair that is free of scars, cuts, or irritation.
    • Apply each dose of ointment to a different area of skin to prevent irritation.
    • If your doctor has ordered an airtight covering or dressing (such as plastic kitchen wrap) be placed over this medicine, make sure you know how to apply it. Airtight dressings will increase the amount of medicine absorbed through the skin and may cause more side effects. Use them only as directed and check with your doctor if you have any questions about this.

    For patients using the patch system:

    • Wash your hands with soap and water before and after applying a patch. Do not touch your eyes until after you have washed your hands.
    • Do not try to trim or cut the adhesive patch to adjust the dosage. Check with your doctor if you think the medicine is not working as it should.
    • Apply the patch to a clean, dry skin area with little or no hair that is free of scars, cuts, or irritation.
    • Always remove a previous patch before applying a new one.
    • Apply a new patch if the first one becomes loose or falls off.
    • Apply each patch to a different area to prevent skin irritation.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For angina prevention:
      • For transdermal dosage form (ointment):
        • Adults—At first, 7.5 milligrams (mg), one-half inch of ointment, two times a day. Apply the first dose in the morning right after you wake up, and the second dose 6 hours later. Your doctor may increase your dose as needed.
        • Children—Use and dose must be determined by your doctor.
      • For transdermal dosage form (skin patch):
        • Adults—Apply one patch once a day in the morning. Leave the patch in place for a total of 12 to 14 hours.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, apply it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

    If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.

    After removing a used patch, fold it in half with the sticky sides together. Make sure to dispose of it out of the reach of children and pets.

    Precautions While Using Nitro-Bid

    If you will be taking this medicine for a long time, it is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

    Do not take sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) while you are using this medicine. Using these medicines together may cause blurred vision, dizziness, lightheadedness, or fainting. If you are taking these medicines and you experience an angina attack, you must go to the hospital right away.

    This medicine may cause headaches. These headaches are a sign that the medicine is working. Do not stop using the medicine or change the time you use it in order to avoid the headaches. If you have severe pain, talk with your doctor.

    Dizziness, lightheadedness, or faintness may occur, especially when you get up quickly from a lying or sitting position. Getting up slowly may help.

    Dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking this medicine, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time.

    Do not stop using this medicine without checking with your doctor first. Your doctor may want you to gradually reduce the amount you are using before stopping it completely.

    Tell the doctor in charge that you are using this medicine before having a magnetic resonance imaging (MRI) scan. Skin burns may occur at the site where the patch is worn during this procedure. Ask your doctor if the patch should be removed before having an MRI scan. You might need to put on a new patch after the procedure.

    Nitro-Bid Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    More common

    • Lightheadedness

    Less common

    • Arm, back, or jaw pain
    • blurred vision
    • chest pain or discomfort
    • chest tightness or heaviness
    • confusion
    • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
    • fainting
    • fast or irregular heartbeat
    • nausea
    • shortness of breath
    • sweating
    • unusual tiredness or weakness

    Rare

    • Bluish-colored lips, fingernails, or palms
    • dark urine
    • difficulty with breathing
    • fever
    • headache
    • pale skin
    • rapid heart rate
    • sore throat
    • unusual bleeding or bruising

    Incidence not known

    • Blistering, burning, crusting, dryness, or flaking of the skin
    • cough
    • difficulty with swallowing
    • hives
    • itching, scaling, severe redness, soreness, or swelling of the skin
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • skin rash
    • wheezing

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Blurred or loss of vision
    • bulging soft spot on the head of an infant
    • change in consciousness
    • change in the ability to see colors, especially blue or yellow
    • cold, clammy skin
    • disturbed color perception
    • double vision
    • feeling of constant movement of self or surroundings
    • halos around lights
    • headache, severe and throbbing
    • loss of consciousness
    • night blindness
    • overbright appearance of lights
    • paralysis
    • sensation of spinning
    • tunnel vision

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Rare

    • Burning, itching, redness, skin rash, swelling, or soreness at the application site

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

    See also: Nitro-Bid Transdermal side effects (in more detail)

    Post a Comment

    Your email is kept private. Required fields are marked *

    You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

    Nitro-Bid

    Nitro-Bid

    Generic Name: nitroglycerin (Intravenous route)

    nye-troe-GLIS-er-in

    OverviewSide EffectsInteractionsFor ProfessionalsMore…

    Commonly used brand name(s)

    In the U.S.

    • Nitro-Bid

    Available Dosage Forms:

    • Solution
    • Kit
    • Injectable

    Therapeutic Class: Coronary Vasodilator

    Chemical Class: Nitrate

    Uses For Nitro-Bid

    Nitroglycerin injection is used to treat hypertension (high blood pressure) during surgery or to control congestive heart failure in patients who have had a heart attack. It may also be used to produce hypotension (low blood pressure) during surgery. Nitroglycerin injection is sometimes used to treat angina (chest pain) in patients who have been treated with other medicines that did not work well.

    Nitroglycerin injection belongs to the group of medicines called nitrates. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart while reducing its work load.

    This medicine is available only with your doctor’s prescription.

    Before Using Nitro-Bid

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of nitroglycerin injection in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of nitroglycerin injection in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving nitroglycerin injection.

    Pregnancy

    Pregnancy Category Explanation
    All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

    Breast Feeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Interactions with Medicines

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

    • Avanafil
    • Sildenafil
    • Tadalafil
    • Vardenafil

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Alteplase, Recombinant
    • Heparin

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Acetylcysteine
    • Aspirin
    • Dihydroergotamine
    • Pancuronium

    Interactions with Food/Tobacco/Alcohol

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Constrictive pericarditis (a heart disease) or
    • Pericardial tamponade (a heart disease) or
    • Restrictive cardiomyopathy (a heart disease)—Should not be used in patients with these conditions.
    • Hypertrophic cardiomyopathy (a heart disease) or
    • Hypotension (low blood pressure) or
    • Hypovolemia (low amount of blood)—Use with caution. May make these conditions worse.

    Proper Use of Nitro-Bid

    A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.

    Precautions While Using Nitro-Bid

    It is very important that your doctor check your progress closely while you are receiving this medicine to make sure it is working properly.

    Do not take sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) while you are using this medicine. Using these medicines together may cause blurred vision, dizziness, lightheadedness, or fainting. If you are taking these medicines and you experience an angina attack, you must go to the hospital right away.

    Dizziness, lightheadedness, or faintness may occur, especially when you get up quickly from a lying or sitting position. Getting up slowly may help.

    This medicine may cause headaches. These headaches are a sign that the medicine is working. If you have severe pain, talk with your doctor.

    Nitro-Bid Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor or nurse immediately if any of the following side effects occur:

    Rare

    • Bluish-colored lips, fingernails, or palms
    • dark urine
    • difficulty with breathing
    • dizziness or lightheadedness
    • fever
    • headache
    • pale skin
    • rapid heart rate
    • shortness of breath
    • sore throat
    • unusual bleeding or bruising
    • unusual tiredness or weakness

    Incidence not known

    • Arm, back, or jaw pain
    • blurred vision
    • chest pain or discomfort
    • chest tightness or heaviness
    • confusion
    • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
    • fainting
    • fast or irregular heartbeat
    • sweating

    Get emergency help immediately if any of the following symptoms of overdose occur:

    Symptoms of overdose

    • Blurred or loss of vision
    • bulging soft spot on the head of an infant
    • change in consciousness
    • change in the ability to see colors, especially blue or yellow
    • cold, clammy skin
    • convulsions
    • disturbed color perception
    • double vision
    • feeling of constant movement of self or surroundings
    • flushed skin
    • halos around lights
    • headache, severe and throbbing
    • increased sweating
    • loss of appetite
    • loss of consciousness
    • nausea or vomiting
    • night blindness
    • overbright appearance of lights
    • paralysis
    • sensation of spinning
    • slow or irregular heartbeat
    • tunnel vision
    • wheezing

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

    See also: Nitro-Bid side effects (in more detail)

    Post a Comment

    Your email is kept private. Required fields are marked *

    You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

    Nitro-Bid

    Nitro-Bid

    Generic Name: nitroglycerin (topical) (NYE troe GLIS er in)

    Brand Name: Nitro-Bid, Nitrol Appli-Kit

    OverviewSide EffectsInteractionsFor ProfessionalsMore…

    What is Nitro-Bid (nitroglycerin (topical))?

    Nitroglycerin is in a group of drugs called nitrates. Nitroglycerin dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.

    Nitroglycerin topical (for the skin) is used to prevent attacks of chest pain (angina).

    Nitroglycerin topical may also be used for other purposes not listed in this medication guide.

    What is the most important information I should know about Nitro-Bid (nitroglycerin (topical))?

    You should not use this medication if you are allergic to nitroglycerin, isosorbide mononitrate (Imdur), or isosorbide dinitrate (BiDil, Isordil).

    Before using nitroglycerin topical, tell your doctor if you have congestive heart failure, low blood pressure, glaucoma, anemia, or a history of heart attack, stroke, or head injury.

    Do not use this medication to treat an angina attack that has already begun. It will not work fast enough.

    Nitroglycerin topical can cause severe headaches, especially when you first start using it. Do not stop using nitroglycerin, and ask your doctor before using any headache pain medication.

    Nitroglycerin topical can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

    Avoid drinking alcohol. It can increase some of the side effects of nitroglycerin topical.

    Call your doctor at once if you have a serious side effect such as worsening chest pain, pain spreading to the arm or shoulder, nausea, vomiting, sweating, blurred vision and dry mouth, or fainting.

    What should I discuss with my healthcare provider before using Nitro-Bid (nitroglycerin (topical))?

    You should not use this medication if you are allergic to nitroglycerin, isosorbide mononitrate (Imdur), or isosorbide dinitrate (BiDil, Isordil).

    Before using nitroglycerin topical, tell your doctor if you are allergic to any drugs, or if you have:

    • congestive heart failure;

    • a history of heart attack, stroke, or head injury;
    • low blood pressure;
    • glaucoma; or
    • anemia (lack of red blood cells).

    If you have any of these conditions, you may need a dose adjustment or special tests to safely use nitroglycerin topical.

    FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

    It is not known whether nitroglycerin topical passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

    Nitroglycerin topical can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use nitroglycerin topical. Do not stop using the medication. Ask your doctor before using any headache pain medication.

    If you need to have any type of surgery or dental work, tell the surgeon or dentist ahead of time that you are using nitroglycerin topical.

    How should I use Nitro-Bid (nitroglycerin (topical))?

    Use this medication exactly as it was prescribed for you. Do not use the medication in larger amounts, or use it for longer than recommended by your doctor. Follow the directions on your prescription label.

    Do not use nitroglycerin topical to treat an angina attack that has already begun. It will not work fast enough. Your doctor may prescribe an oral form of nitroglycerin (tablet, capsule, spray) to treat an angina attack. Talk with your doctor if any of your medications do not seem to work as well in treating or preventing angina attacks.

    Nitroglycerin ointment is usually applied 3 or 4 times daily. You may also need to wash off the ointment at a certain time each day. Follow your doctor’s instructions carefully.

    Wash your hands after applying nitroglycerin ointment.

    Do not stop using this medication without your doctor’s advice, even if you feel better. You may have increased angina attacks if you stop using the medication suddenly.

    Store this medication at room temperature, away from moisture and heat.

    What happens if I miss a dose?

    Apply the medicine as soon as you remember. If your next dose is less than 2 hours away, wait until then to apply the ointment and skip the missed dose.

    Do not use extra ointment to make up a missed dose.

    What happens if I overdose?

    Seek emergency medical attention if you think you have used too much of this medicine.

    Overdose symptoms may include a severe throbbing headache, confusion, fever, fast or pounding heartbeats, dizziness, vision problems, nausea, vomiting, bloody diarrhea, trouble breathing, cold or clammy skin, feeling light-headed, fainting, seizure (convulsions), or blue-colored skin, lips, or nails.

    What should I avoid while using Nitro-Bid (nitroglycerin (topical))?

    Avoid using nitroglycerin topical on irritated or broken skin.

    Nitroglycerin topical can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

    Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

    Avoid drinking alcohol. It can increase some of the side effects of nitroglycerin topical.

    Nitro-Bid (nitroglycerin (topical)) side effects

    Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

    Call your doctor at once if you have a serious side effect such as:

    • worsening chest pain, slow heart rate;

    • feeling like you might pass out;
    • chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
    • fast or pounding heartbeats; or
    • blurred vision and dry mouth.

    Less serious side effects may include:

    • mild skin rash or itching;

    • warmth, redness, or tingly feeling under your skin;
    • nausea, vomiting, upset stomach; or
    • feeling nervous, weak, or dizzy.

    This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

    See also: Nitro-Bid side effects (in more detail)

    What other drugs will affect Nitro-Bid (nitroglycerin (topical))?

    Tell your doctor about all other medications you use, especially:

    • blood pressure medication or diuretics (water pills);

    • cold or allergy medicines, diet pills, or over-the-counter pain medicine such as ibuprofen (Advil, Motrin) or naproxen (Aleve);
    • an erectile dysfunction medication such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra);
    • migraine headache medication such as ergotamine (Ergomar, Cafergot), or dihydroergotamine (D.H.E. 45, Migranal Nasal Spray);
    • a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), and others; or
    • a calcium channel blocker such as amlodipine (Norvasc), diltiazem (Tiazac, Cartia, Cardizem), felodipine (Plendil), nicardipine (Cardene), nifedipine (Procardia, Adalat), nimodipine (Nimotop), nisoldipine (Sular), or verapamil (Calan, Covera, Isoptin, Verelan).

    This list is not complete and there may be other drugs that can interact with nitroglycerin topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

    Next Page → Side Effects

    More Nitro-Bid resources

    • Side Effects
    • Pregnancy Warnings
    • Drug Images
    • Drug Interactions
    • Support Group
    • 2 Reviews - Add your own review/rating

    Compare Nitro-Bid with other medications

    • Angina
    • Angina Pectoris Prophylaxis
    • Heart Attack
    • Heart Failure
    • High Blood Pressure
    • Raynaud’s Syndrome

    Where can I get more information?

    • Your pharmacist can provide more information about nitroglycerin topical.

    Post a Comment

    Your email is kept private. Required fields are marked *

    You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>