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80 tab. Nitroglycerin tablets. 0.5mg N40 * 2 pack. Free shipping

80 tab. Nitroglycerin tablets. 0.5mg N40 * 2 pack. Free shipping
 
 
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INSTRUCTIONS
on medical use of the drug
NITROGLYCERINE-HEALTH

tradename
NITROGLYCERINE-HEALTH


International Nonproprietary Name:
Nitroglycerol

Latin name
NITROGLYCERIN-ZDOROVYE

general characteristics
Composition of the medicinal product:
active substance:
1 tablet contains nitroglycerin diluted in terms of nitroglycerin 0.5 mg
Excipients:
microcrystalline cellulose, potato starch, colloidal silicon dioxide, magnesium stearate, aspartame (E 951), crospovidone, lactose.

form of issue
Form of issue:
Tablets of 0.5 mg of No. 40 in cans or containers

Farmgroup
Pharmacological group.
Vasodilators used in cardiology. organic nitrates
. ATS code C01D A02.

Pharmacological properties
Nitroglycerin-Health - antianginal, vasodilating, coronary degluticide. The mechanism of action is due to the action of the free radical of nitric oxide (NO), which is released from nitroglycerin. NO - an endothelial relaxing factor that activates guanylate cyclase and increases the content of cyclic guanosine-3'5'-monophosphate (cGMP) in the smooth muscle cells of the vessels, which leads to relaxation of the smooth muscles of the vessel walls.
It affects the processes of central regulation of vascular tone and heart activity. Promotes the release of catecholamines in the brain and heart, has an indirect sympathomimetic effect on the myocardium, changes the conformation of the troponin-tropomyosin complex. It exhibits a central inhibitory effect on sympathetic vascular tone, inhibiting the vascular component of the pain syndrome. In patients with heart failure and in patients with angina pectoris increases cardiac output, tolerance to physical exertion, reduces the severity and frequency of seizures. With sublingual use, the attack of angina pauses after 1.5 minutes, hemodynamic and antianginal effects persist for 30 minutes.
Causes the deposition of blood in the venous system, reduces the venous return of blood to the heart (preload) and the final diastolic filling of the left ventricle. Systemic arterial vasodilation is accompanied by a decrease in total peripheral vascular resistance and arterial pressure (i.e., decreased afterload). Decrease in pre- and post-loading on the heart leads to a decrease in myocardial oxygen demand. Reduces the wedging pressure in the pulmonary capillaries; slightly increases the heart rate (reflex tachycardia in response to a decrease in systemic arterial pressure and stroke volume is more pronounced in the vertical position of the body) weakens the resistance of the coronary arteries and improves coronary blood flow (except for cases of excessive reduction in systemic blood pressure or increased heart rate when possible worsening coronary blood flow).
Expands large epicardial coronary arteries to redistribute coronary blood flow in favor of ischemic sites. With ischemic hypokinesia of certain parts of the myocardium contributes to the restoration of local contractility. Relieves postinfarction remodeling of the left ventricle. Inhibits the aggregation of platelets and their adhesion to the vascular endothelium. Increases the threshold of occurrence of myocardial ischemia.
Promotes the transition of hemoglobin to methemoglobin and can worsen the transport of oxygen. Causes the expansion of meningeal vessels, often accompanied by the appearance of a headache. Relaxes the smooth muscles of the bronchi, bile ducts, esophagus, stomach, intestines, genito-urinary tract.
With sublingual application, it is quickly and completely absorbed from the surface of the mucous membranes, immediately enters the systemic circulation. At sublingual application (in a dose of 0,5 mg) bioavailability - practically 100%; the maximum concentration of the main metabolites in the blood (0.2-0.3 ng / ml) is achieved after 2-3 min; the half-life of nitroglycerin is 1-4.4 min, metabolites - 7 min.
When ingested, it is largely destroyed in the liver (the effect of "first passage", is eliminated with sublingual administration), and then metabolized to form NO in smooth muscle cells. The primary metabolites are di- and mononitrates, the final - glycerin. When administered, the maximum concentration in the blood of metabolites (0.1-0.2 ng / ml) is achieved after 20-60 min; relative bioavailability - 10-15%; the half-life of metabolites is 4:00. Connection with plasma proteins - 60%. Metabolised in the liver with the participation of nitrate reductase. Metabolites are excreted mainly by the kidneys.


Application features
Special instructions.
Be sure to tell your doctor about your previous reaction to taking the drugs of this group.
When there is a headache or migraine, improvement is achieved by the use of Validol or drops of menthol sublingually. Often poorly tolerated only the first dose, then the side effects are weakened.
Use during pregnancy or lactation.
The drug is contraindicated in pregnancy. During the period of treatment, breast-feeding should be stopped.

The ability to influence the reaction rate when driving or working with other machinery.
During the treatment period it is necessary to refrain from practicing potentially dangerous species
activities that require increased attention and speed of psychomotor reactions, since nitroglycerin can reduce the rate of psychomotor reactions.
Children.
The drug is contraindicated in children under the age of 18 years (safety of use is not established).
Appropriate safety measures when used. Use with caution when:
- Severe anemia
- Hypertrophic cardiomyopathy - there may be more frequent and / or heavier angina attacks;
- Acute myocardial infarction - the risk of lowering blood pressure and developing tachycardia, which can increase ischemia. In the acute period of myocardial infarction and with the development of acute heart failure carefully monitored hemodynamics;
- Aortic and mitral stenosis;
- Propensities to arterial hypotension - can worsen a patient's condition, causing a paradoxical bradycardia and attacks of angina pectoris;
- Severe hepatic and / or renal insufficiency - the risk of developing methaemoglobinaemia;
- Expressed atherosclerosis of cerebral vessels, disorders of cerebral circulation
- Hyperthyroidism;
- In the elderly.
The risk of developing methaemoglobinemia, which is manifested by cyanosis and the appearance of a brown shade of blood, increases with prolonged uncontrolled intake of nitroglycerin, taking high doses of the drug in patients with renal insufficiency. In the case of development of methemoglobinemia, nitroglycerin should be urgently discontinued and antidote - methylthioninium chloride (methylene blue) should be applied. If it is necessary to continue using nitrates, it is necessary to control the content of methaemoglobin.
To reduce the risk of side effects, care should be taken when using drugs with pronounced hypotensive and vasodilating properties at the same time; refrain from drinking alcohol, limit stay in rooms with a high ambient temperature (sauna, sauna, hot shower), avoid taking several tablets simultaneously or sequentially in a short time after the first intake.
Tablets can not be chewed, because through the mucous membrane of the oral cavity in the systemic blood flow can enter an excessive amount of active substance.
Uncontrolled use of the drug may lead to the development of tolerance, which is reflected in a decrease in the duration and severity of the effect and the need to increase the dose to achieve a therapeutic effect. After a break in treatment, sensitivity to nitrates is restored. In order to prevent the development of tolerance, it is recommended to maintain the interval between nitrate intake (8-12 hours) daily.
When taking nitroglycerin, it is possible to significantly reduce blood pressure and the appearance of dizziness during a sharp transition to a vertical position from a lying or sitting position, with alcohol, exercise, and hot weather, as well as increased angina with a sharp decrease in blood pressure, ischemia, up to myocardial infarction and sudden death (paradoxical nitrate reactions).
During the period of treatment, alcohol is not allowed.
Before taking the drug for the first time, consult a doctor!

Terms and conditions of storage
Shelf life.
2 years.
Do not use after the expiry date stated on the package
Storage conditions.
Store in the original packaging at a temperature of 2 to 25 ° C.
Keep out of the reach of children.
Manufacturer and its address
Manufacturer, country:

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