GTN FORTE OINTMENT 25G

Glyceryl Trinitrate (GTN) ointment exerts its therapeutic effects primarily through the release of nitric oxide (NO) after penetrating the skin. When applied topically, GTN undergoes enzymatic conversion to nitric oxide, a potent vasodilator. Nitric oxide released from GTN diffuses into the underlying vasculature, leading to smooth muscle relaxation in blood vessels. This relaxation results in peripheral vasodilation, particularly in the venous system, which reduces venous return, preload, and subsequently, cardiac output. By dilating the veins, GTN ointment decreases systemic vascular resistance, lowers blood pressure, and reduces the workload on the heart. This mechanism is particularly beneficial in conditions where reducing cardiac preload and afterload is desirable, such as in the management of angina pectoris and congestive heart failure. The localized release of nitric oxide from the ointment allows for targeted vasodilation, making it a valuable treatment option with minimal systemic side effects.

Glyceryl Trinitrate

Nitrate vasodilator

Ointment

The following are the uses of Glyceryl Trinitrate Ointment:

• Used for treating Angina, a type of chest pain caused by reduced blood flow to the heart.
• Used for improving blood flow to the heart by relaxing and widening blood vessels.
• Used for preventing and managing symptoms of angina attacks.
• Used for relieving chest pain and discomfort associated with physical exertion or stress.
• Used for long-term management of chronic angina conditions.
• Used for pre-operative application to reduce the risk of heart complications during surgery.
• Used for treating Coronary Artery Disease to improve blood circulation.
• Used for emergency treatment during acute angina episodes.

In the case of an overdose of Glyceryl Trinitrate Ointment, the individual may experience symptoms such as severe headaches, dizziness, and a sudden drop in blood pressure. The skin may also show signs of irritation, redness, and warmth at the application site. It is important to remove any remaining ointment and wash the affected area with mild soap and water. Seek medical advice promptly to ensure appropriate management and prevent potential complications.

In the case of a missed dose of Glyceryl Trinitrate Ointment, it is important to apply the ointment as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not apply extra ointment to make up for the missed dose, as this may increase the risk of side effects. If you miss multiple doses, consult your healthcare provider for advice on how to safely resume your treatment.

To apply Glyceryl Trinitrate Ointment, clean and dry the affected area, then use the provided applicator or your fingertip to apply a thin layer of the ointment to the skin, gently massaging it in, following the dosage instructions provided by your healthcare professional.

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

• Must not be used in patients with a known allergy or hypersensitivity to Glyceryl Trinitrate or other nitrates.
• Not suitable for individuals with severe anemia, as it may worsen oxygen supply to vital organs.
• Contraindicated in patients with head injuries or increased intracranial pressure.
• Should not be used in patients with severe aortic stenosis (narrowing of the aortic valve in the heart).
• Avoid using in patients with glaucoma, as it may increase intraocular pressure.
• Not recommended for individuals with hypotension (low blood pressure) or those who have recently suffered a heart attack.
• Discontinue use if the patient experiences severe headaches or dizziness.
• Must not be used in patients with conditions that may be aggravated by increased blood flow, such as acute myocardial infarction or pericarditis.

The side effects of Glyceryl Trinitrate Ointment may include:

• Headache
• Dizziness
• Lightheadedness
• Flushing or redness of the skin
• Skin irritation or rash at the application site
• Low blood pressure, which can lead to fainting or weakness
• Rapid or pounding heartbeat (palpitations)
• Nausea and vomiting

Here are the precautions and warnings for Glyceryl Trinitrate Ointment:

• Avoid using this ointment if you have a known allergy to glyceryl trinitrate or any other ingredients in the formulation.
• Exercise caution if you have a history of severe headaches or migraines, as this medication may aggravate these conditions.
• Do not apply the ointment on irritated, broken, or damaged skin.
• Wash your hands thoroughly after applying the ointment to avoid accidental contact with eyes or other sensitive areas.
• If you experience severe or persistent headaches, dizziness, or lightheadedness, discontinue use and seek medical advice immediately.
• Keep out of reach of children and pets. Store in a cool, dry place, away from direct sunlight.
• Consult a healthcare professional if you are pregnant, planning to become pregnant, or breastfeeding, as they can advise on the potential risks and benefits.
• Do not use this ointment for conditions other than those prescribed by your doctor.

Following are the drug interactions for Glyceryl Trinitrate Ointment:

• Sildenafil and similar phosphodiesterase inhibitors may cause a significant drop in blood pressure when used with glyceryl trinitrate.
• Drugs like alpha-blockers (e.g., prazosin) and certain beta-blockers (e.g., propranolol) can enhance the hypotensive effects, requiring careful monitoring.
• Antihypertensive medications, when combined with glyceryl trinitrate, can lead to excessive blood pressure reduction.
• Nitrates like glyceryl trinitrate can interact with calcium channel blockers (e.g., verapamil), potentially causing hypotension and cardiac issues.
• Alcohol consumption may intensify the vasodilatory effects, leading to low blood pressure.
• The use of glyceryl trinitrate with other vasodilators may result in severe hypotension.
• Certain medications metabolized by the liver, such as erythromycin, can affect the clearance of glyceryl trinitrate, potentially increasing its effects.

Following are the food interactions for Glyceryl Trinitrate Ointment:

• Grapefruit and grapefruit juice consumption should be avoided as they can lead to increased levels of the medication in the blood, potentially causing headaches, dizziness, and a drop in blood pressure.
• Alcohol use may intensify the medication's side effects, including dizziness, lightheadedness, and hypotension. It is advisable to refrain from consuming alcohol while using this medication.
• High-fat meals might affect the absorption rate of the drug, potentially delaying its onset of action. It is recommended to apply the ointment at least 10 minutes before or after a meal.
• Caffeine intake should be monitored as it can constrict blood vessels, reducing the medication's effectiveness. Limit or avoid excessive caffeine consumption while using this ointment.
• Spicy foods may cause skin irritation or increased blood flow to the application site, potentially affecting the absorption of the medication. It is best to avoid applying the ointment on areas with recent exposure to spicy substances.
• Foods rich in nitrates, like processed meats, might interact with the medication, leading to increased vasodilation and potential hypotension. Consider limiting nitrate-rich foods while using Glyceryl Trinitrate Ointment.
• Staying well-hydrated is essential, as dehydration can affect blood volume and pressure, potentially reducing the medication's efficacy. Ensure adequate fluid intake during treatment.
• Certain herbal supplements, such as St. John's Wort, may interact with the medication's metabolism. Consult your healthcare provider about any herbal remedies you are taking.

Glyceryl Trinitrate Ointment should be stored in a secure and controlled environment, preferably in a cool and dry place away from direct sunlight, heat, and moisture. The original container should be tightly sealed to maintain its integrity and prevent contamination. It is crucial not to store the ointment in the bathroom or near heat-emitting appliances, as temperature fluctuations can impact its effectiveness. Always adhere to the expiration date indicated on the packaging, and when disposing of the ointment, avoid flushing it down the toilet or pouring it into drainage systems. Instead, consult your pharmacist or healthcare professional for safe disposal practices to minimize environmental impact. Keep the ointment out of children's reach to prevent accidental exposure.

Following are the quick tips for Glyceryl Trinitrate Ointment:

• Clean and dry the affected skin area before applying the ointment.
• Apply a thin layer as directed, usually 2-3 times daily, or as prescribed.
• Wash your hands after application to avoid accidental contact with eyes or sensitive areas.
• Avoid applying the ointment to broken or irritated skin.
• Do not cover the treated area with bandages or tight clothing.
• Store the ointment at room temperature, away from direct sunlight and moisture.
• Consult your doctor if symptoms persist or worsen despite using the ointment as directed.