Skip to content

Nitroglycerin

    Brands

    nitroglycerin IV (Rx)

    Brand and Other Names: glyceryl trinitrate IV, IV Nitroglycerin, NitroBid IV, NTG, Tridil
    • Classes: Nitrates, Angina

    nitroglycerin transdermal (Rx)

    Brand and Other Names: NitroDur, Minitran, Deponit, Transdermal Nitroglycerin, Nitrocine, glyceryl trinitrate transdermal
    • Classes: Nitrates, Angina; 
    • Vasodilators; 
    • Antianginal Agents

    nitroglycerin topical (Rx)

    Brand and Other Names: Nitrol, Nitro Bid, NitroBid Topical, glyceryl trinitrate topical, Topical Nitroglycerin
    • Classes: Nitrates, Angina

    nitroglycerin PO (Rx)

    Brand and Other Names: glyceryl trinitrate PO
    • Classes: Nitrates, Angina

    nitroglycerin rectal (Rx)

    Brand and Other Names:Rectiv
    • Classes: Gastrointestinal Agents, Other

    nitroglycerin sublingual (Rx)

    Brand and Other Names: Nitrostat, Nitrolingual Pumpspray, GoNitro, NitroQuick, glyceryl trinitrate sublingual, Sublingual Nitroglycerin
    • Classes: Nitrates, Angina

    nitroglycerin translingual (Rx)

    Brand and Other Names: Nitrolingual, glyceryl trinitrate translingual spray, NitroMist
    • Classes: Nitrates, Angina; 
    • Antianginal Agents
    Organic nitrate vasodilator; available in many dosage forms.
    Used for angina, HTN, CHF, AMI, hypertensive emergency, hypotension induction during surgery, and used in a rectal ointment for pain associated with chronic anal fissures.
    Chronic use may be associated with nitrate tolerance.
    Indicated for the treatment of angina pectoris due to coronary artery disease.

    Indicated for treatment of moderate-to-severe pain associated with chronic anal fissures; consider use if conservative treatment for acute symptoms of anal fissure fails

     
    For the treatment of moderate to severe pain associated with chronic anal fissures.
    For controlled hypotension induction during anesthesia; for the treatment of acute congestive heart failure or pulmonary edema, acute angina pectoris or unstable angina, acute myocardial infarction, or acute pulmonary hypertension; or for treatment of severe hypertension, postoperative hypertension, perioperative hypertension (e.g., during cardiac surgery), or hypertensive emergency.
    For use as a uterine relaxant to aid in extraction of a retained placenta.
    For the treatment of extravasation of vasoactive medications.

    Recent use (within several days) of PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, or vardenafil) may cause dangerously low hypotension; the time course of the interaction appears to be related to the PDE-5 inhibitor half-life

    Riociguat; coadministration may cause hypotension

    Narrow angle glaucoma (controversial: may not be clinically significant)

    Hypersensitivity

    Symptomatic hypotension, uncorrected hypovolemia, increased intracranial pressure (head trauma, cerebral hemorrhage), severe anemia, constrictive pericarditis, pericardial tamponade, restrictive cardiomyopathy

    Common

    Headache

    Hypotension

    Tachycardia

    Dyspnea

    Dizziness

    Lightheadedness

    Blurred vision

    Flushing

    N/V

    Nervousness

    Xerostomia

    Serious

    Methemoglobinemia (rare)

    Syncope

    Prolonged bleeding time

    Exfoliative dermatitis

    Unstable angina

    Rebound hypertension

    Thrombocytopenia

    Use caution in alcohol use, hyperthyroidism, hypertrophic cardiomyopathy, postural hypotension, severe renal impairment, hepatic impairment

    Gradually decrease dose to avoid withdrawal reaction

    May need 10-12 hr/day nitrate-free interval to avoid tolerance development

    Doses ~ 200 mcg/min

    Some products contain alcohol and propylene glycol

    Remove topical forms when starting IV infusion

    Use glass bottles and non-PVC (polyvinyl chloride) tubing to avoid adsorption of drug to delivery devices; use of PVC tubing in infusion sets may lead to loss of active ingredient due to adsorption of nitroglycerin to PVC tubing; dosage is affected; adsorption by PVC tubing is increased when tubing is long, flow rates are low, and nitroglycerin concentration of solution is high; delivered fraction of solution’s original nitroglycerin content has been 20-60% in published studies; fraction varies with time during single infusion, and no simple correction factor can be used; if intravenous nitroglycerin is administered through non-adsorptive tubing, doses based upon published reports will generally be too high; some in-line intravenous filters also adsorb nitroglycerin and should be avoided

    Solutions containing dextrose without electrolytes should not be administered through the same administration set as blood, as this may result in pseudoagglutination or hemolysis

    Pregnancy Category: C

    Lactation: Developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for nitroglycerin and any potential adverse effects on breastfed child from nitroglycerin or from underlying maternal condition

    Adults

    The maximum dosage is dependent on route of administration and indication for therapy.

    Geriatric

    The maximum dosage is dependent on route of administration and indication for therapy.

    Adolescents

    The maximum dosage is dependent on route of administration and indication for therapy; safety and efficacy of the 0.4% rectal ointment have not been established.

    Children

    The usual maximum rate is 5 mcg/kg/min; however, IV rates up to 20 mcg/kg/min have been used. Safety and efficacy of the 0.4% rectal ointment have not been established.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Nesiritide

    infusion solution

    • 25mg/250mL
    • 50mg/250mL
    • 100mg/250mL

    injectable solution

    • 5mg/mL

    patch

    • 0.1mg/hr
    • 0.2mg/hr
    • 0.3mg/hr
    • 0.4mg/hr
    • 0.6mg/hr
    • 0.8mg/hr

    ointment

    • 2%

    capsule, extended release

    • 2.5mg
    • 6.5mg
    • 9mg

    ointment, intra-anal

    • 0.4% (4mg nitroglycerin/1g of ointment)

    tablet, SL

    • 0.3mg
    • 0.4mg
    • 0.6mg

    powder, SL (GoNitro)

    • 0.4mg

    spray

    • 0.4mg/spray