Important note: Before prescribing, consult full prescribing information.
Presentation: Transdermal patch. Nitroderm TTS 5, 10, and 15, delivering 5, 10 or 15 mg nitroglycerin/24 hours. Available in 3 sizes: 10, 20 or 30 cm².
Indications: Prevention of attacks of angina pectoris. Supplementary treatment for congestive heart failure. Only Nitroderm TTS 5: prevention of phlebitis and extravasation.
Dosage: Individualised (dosage range per 24 hours: 5-20 mg). Intermittent therapy with daily patch-off period of 8-12 hours; continuous therapy where responsiveness can be judged reliably.
Contraindications: Hypersensitivity to nitroglycerin, related organic nitrates or any excipient of Nitroderm TTS; acute circulatory failure; increased intracranial pressure; myocardial insufficiency due to obstruction; concomitant use of Nitroderm TTS and phosphodiesterase type 5 inhibitors such as sildenafil.
Warnings/Precautions: Caution is recommended in the events of recent myocardial infarction, severe cardiac and/or cerebral ischaemia, acute heart failure. Withdraw gradually when discontinuing treatment. Remove before applying magnetic or electrical fields such as in MRI, cardioversion, DC defibrillation or diathermy treatment. Arterial hypoxaemia due to severe anaemia. Hypertrophic cardiomyopathy. Increased angina. Risk of developing tolerance to sublingual nitroglycerin. Pregnancy and breast-feeding. Ability to drive and use machines (especially at the start of treatment).
Interactions: Caution when used concomitantly with other vasodilators (e.g. PDE5 inhibitors such as sildenafil), calcium antagonists, ACE inhibitors, beta-blockers, diuretics, antihypertensives, tricyclic antidepressants, major tranquillisers, alcohol, dihydroergotamine, acetylsalicylic acid, non-steroidal anti-inflammatory drugs.
Adverse reactions: Very common: nausea, vomiting. Common: headache, which often regresses after a few days. Uncommon: application-site reactions. Rare: postural hypotension, flushing, tachycardia. Very rare: dizziness. Other: palpitations.