Nitroglycerin Aerosol

1. What is and what it is used for?
Nitrosol® Aerosol is a metered dose spray containing Glyceryl Trinitrate BP. Each actuation delivers Glyceryl Trinitrate BP 400 mcg. The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle, producing a vasodilator effect on both peripheral arteries and veins with more prominent effects on the latter. Dilation of the post-capillary vessels, including large veins, promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure (pre-load). Arteriolar relaxation reduces systemic vascular resistance and arterial pressure (after-load). Nitrosol® Aerosol is indicated for acute relief of an attack or prophylaxis of angina pectoris due to coronary artery disease.

2. Before you take Nitrosol
Do not take this medicine and tell your doctor if:

Nitroglycerin is contraindicated in patients who are allergic to it. Nitrosol® Aerosol is contraindicated in patients taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), Hypotensive Shock, Narrow-angle Glucoma, Severe anaemia, Cerebral haemorrhage and brain trauma. Do not take this medicine if the above applies to you. If you are not sure, talk to your doctor before taking Nitrosol.

Take special care with Nitrosol
Severe hypotension, particularly with upright posture, may occur even with small doses of nitroglycerin. The drug, therefore, should be used with caution in subjects who may have volume depletion from diuretic therapy or in patients who have low systolic blood pressure (e.g., below 90 mm Hg). Paradoxical bradycardia and increased angina pectoris may accompany nitroglycerin-induced hypotension. Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy.

Taking other medicines
It should be applied with precaution together with antihypertensive, tricyclic antidepressants (hypotension is enhanced)

Pregnancy and breast-feeding
Pregnancy Category C. It is not known whether nitroglycerin is excreted in human milk.

3. How to take Nitrosol?
At the onset of an attack, one or two metered sprays should be administered under the tongue. No more than three metered sprays are recommended within a 15-minute period. If the chest pain persists, prompt medical attention is recommended. Nitrosol® Aerosol may be used prophylactically five to ten minutes prior to engaging in activities which might precipitate an acute attack.

If you take more Nitrosol than you should
In overdosage, methemoglobinemia and cyanosis may occur.

4. Possible side effects
Like all medicines, Nitrosol can cause side effects, although not everybody gets them.

Transitional, mild burning sensation in the mouth. Pulsation in the head, facial flush, headache, dizziness, palpitation, sensation of heat, nausea, sweating.

Tell your doctor if any of the side effects gets serious or lasts longer than a few days, or if you notice any side effects not listed in this leaflet.

5. How to store Nitrosol?
Do not puncture, break or incinerate even when the canister is empty. Avoid storage in direct sunlight or heat. Store below 25° C. Keep out of reach of children. To be dispensed only on the prescription of a registered doctor.

Nitrosol Prescribing Information

Located in: Cardiovascular