GTN 0.3% 15GM

Glyceryl Trinitrate, commonly known as nitroglycerin, works by releasing nitric oxide (NO) into the body upon metabolism. Nitric oxide has a profound effect on the smooth muscle cells within blood vessels, causing them to relax and dilate. This mechanism of action is primarily responsible for the drug's therapeutic effects. Specifically, when Glyceryl Trinitrate is metabolized, it triggers the activation of soluble guanylate cyclase in vascular smooth muscle cells, leading to an increase in cyclic guanosine monophosphate (cGMP) levels. This rise in cGMP results in the relaxation of smooth muscle, causing vasodilation, particularly in the veins and coronary arteries. Consequently, blood flow is enhanced, reducing the workload on the heart and improving oxygen delivery to the myocardium. This makes Glyceryl Trinitrate particularly effective in treating conditions such as angina pectoris, where improved blood flow to the heart is essential.

Glyceryl Trinitrate

vasodilator

Solution

The following are the uses of Glyceryl Trinitrate Solution:

• Used for treating and preventing chest pain (angina).
• Used for improving blood flow to the heart, especially during physical activities.
• Used for managing and preventing heart attacks.
• Used for rapidly lowering blood pressure in emergency situations.
• Used for treating heart failure, enhancing heart function.
• Used for managing coronary artery disease, widening blood vessels.
• Used for preventing and relieving pain in specific heart conditions.
• Used for reducing the heart's workload, improving oxygen supply.

In the case of an overdose of Glyceryl Trinitrate Solution, the primary symptoms may include severe headaches, dizziness, and a sudden drop in blood pressure. An excessive dose can lead to increased heart rate and palpitations. It is vital to seek medical assistance promptly, as overdoses may result in serious cardiovascular complications, particularly for individuals with pre-existing heart conditions. Emergency treatment aims to stabilize blood pressure and manage heart function.

In the case of a missed dose of Glyceryl Trinitrate Solution, it is important to follow the instructions provided by your healthcare professional. If you realize you've missed a dose, administer it as soon as possible, but if it's almost time for your next scheduled dose, skip the missed one. Do not double the dose to make up for a missed one. Consult your doctor or pharmacist for specific guidance on managing missed doses, especially if you've missed multiple doses or if you're experiencing any symptoms related to the medication.

To use Glyceryl Trinitrate Solution, place the prescribed number of drops under your tongue or on the inside of your cheek, as directed by your healthcare provider, allowing the medication to be absorbed into your bloodstream.

Following are the conditions/situations when Glyceryl Trinitrate Solution should not be used:

• Must not be used in individuals with a known allergy to nitrates or any other components of the solution.
• Contraindicated in patients with severe anemia, as it can worsen oxygen supply to vital organs.
• Should not be used in individuals with recent head injury or increased intracranial pressure.
• Not suitable for patients with hypotension (low blood pressure) or individuals who have experienced a recent heart attack.
• Contraindicated in patients with aortic stenosis, a condition where the aortic valve in the heart is narrowed.
• Should be avoided in individuals with severe hypoxia, where there is insufficient oxygen supply to tissues.
• Not recommended for use during acute myocardial infarction with low filling pressure.
• Must not be used in patients with pericardial tamponade, a condition where fluid accumulates around the heart.
• Contraindicated in patients with cardiac tamponade, a condition where fluid builds up around the heart.

The side effects of Glyceryl Trinitrate Solution may include:

• Severe headaches or migraines, often described as throbbing.
• Dizziness or lightheadedness, which may lead to fainting or feeling faint.
• Flushing or redness of the face and neck.
• Palpitations or the sensation of a rapid or pounding heartbeat.
• Nausea and vomiting, which can sometimes be severe.
• Skin rashes or itching.
• Fatigue or weakness, especially during prolonged use.
• Orthostatic hypotension (a sudden drop in blood pressure upon standing) leading to dizziness.

Following are the precautions and warnings for Glyceryl Trinitrate Solution:

• It should not be used by individuals with a known allergy to glyceryl trinitrate or nitrates.
• This medication is for sublingual or buccal use only; do not swallow the solution.
• May cause severe headaches, especially during initial therapy, which can be managed with analgesics.
• Avoid using in patients with severe anemia, recent head trauma, increased intracranial pressure, or cardiac tamponade.
• Exercise caution in patients with hypotension, as it may cause a significant drop in blood pressure.
• Should be used with caution in individuals with heart disease, as it may worsen angina or cause irregular heart rhythms.
• Discontinue use and seek medical attention if symptoms worsen or do not improve after taking the medication.

Following are the drug interactions for Glyceryl Trinitrate Solution:

• Alcohol can increase the blood pressure-lowering effect of glyceryl trinitrate, potentially causing excessive hypotension.
• Medications like sildenafil, tadalafil, or vardenafil can significantly interact with glyceryl trinitrate, leading to a sudden drop in blood pressure.
• Beta-blockers, such as metoprolol or atenolol, may reduce the effectiveness of glyceryl trinitrate, as they can blunt its vasodilatory effects.
• ACE inhibitors (e.g., lisinopril, enalapril) or angiotensin II receptor blockers (e.g., losartan) may have additive effects with glyceryl trinitrate, leading to excessive blood pressure drop.
• Combining glyceryl trinitrate with other nitrates or nitric oxide donors can result in severe hypotension and increased risk of side effects.
• Antihypertensive drugs like calcium channel blockers (e.g., amlodipine) may enhance the blood pressure-lowering effect of glyceryl trinitrate.
• Glyceryl trinitrate may interact with certain phosphodiesterase inhibitors, such as riociguat, leading to a decrease in blood pressure.

Following are the food interactions to consider with Glyceryl Trinitrate Solution:

• Alcohol consumption should be avoided as it can lead to a sudden drop in blood pressure, causing dizziness, lightheadedness, or even fainting.
• Grapefruit and grapefruit juice should be consumed with caution as they can increase the effects of Glyceryl Trinitrate, leading to a greater risk of side effects like headache, low blood pressure, and dizziness.
• Caffeine intake may need to be monitored as it can constrict blood vessels, reducing the effectiveness of Glyceryl Trinitrate.
• High-fat meals might slow down the absorption of the medication, delaying its intended effects.
• Spicy foods might increase the risk of headaches, especially when combined with Glyceryl Trinitrate, due to its vasodilating properties.
• Avoid large meals or heavy snacks immediately after taking the dose, as it can interfere with the medication's absorption.
• Be cautious with salt intake, as Glyceryl Trinitrate can interact with high sodium levels, affecting blood pressure control.
• Always follow healthcare advice on dietary restrictions or recommendations tailored to your specific condition.

Glyceryl Trinitrate Solution should be stored in a secure and controlled environment, specifically in a cool and dry place, ensuring it is kept away from direct sunlight, heat, and moisture. Maintain the solution at room temperature, ideally between 15-25°C (59-77°F). Always keep the medication in its original container, tightly sealed, to prevent contamination and maintain its integrity. It is crucial to dispose of any unused or expired solution properly, avoiding improper methods like flushing or pouring it down the drain. Consult your pharmacist or healthcare provider for specific instructions on safe disposal practices, and remember to keep the medication out of children's reach to prevent accidental ingestion. Regularly check the expiration date on the packaging and discard the solution if it has passed its expiry, ensuring safe and responsible handling.

Following are the quick tips for Glyceryl Trinitrate Solution:

• Consult your doctor before use, especially if you have a heart condition.
• Administer the solution under the tongue or inside the cheek as directed.
• Avoid swallowing the solution; it is meant for sublingual or buccal absorption.
• Store the bottle tightly closed and protect it from light and heat.
• Keep a record of your doses to ensure you don't exceed the prescribed limit.
• Inform your doctor if you experience severe headaches or prolonged dizziness.
• Do not use the solution if the color changes or it develops an unusual odor.