II. Indications

  1. Acute Myocardial Ischemia (Angina Pectoris)
    1. Exertional or rest Angina

III. Precautions

  1. Do not take more than 3 Nitroglycerin doses in 15 minutes
  2. Seek immediate attention (call 911):
    1. Anginal pain not improved after the first Nitroglycerin after 5 minutes

IV. Preparations

  1. Nitroglycerin Sublingual (0.15 to 0.6 mg)
    1. Sublingual 0.4 mg prn Angina up to 3 in 15 minutes
    2. Costs roughly 40 cents per tablet
    3. Sublingual tablets are now good until expiration bottle (even after opening)
      1. Formulation lasts 2 years from manufacture date
      2. Assumes the bottle is kept capped, at room Temperature
      3. Older formulations in the distant past needed replacement every 6 months
  2. Nitroglycerin Spray (0.4 mg/spray)
    1. Spray 1 prn Angina up to 3 sprays in 15 minutes
    2. Expensive ($1.50 to $4.50 per spray in 2016)
  3. Nitroglycerin Powder (single dose packet)
    1. Open packet and pour under Tongue up to 3 in 15 minutes
    2. Expensive ($7 per packet in 2016)

V. References

  1. (2016) Presc Lett 23(11)

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Cost: Medications

nitrostat (on 6/1/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
NITROSTAT 0.3 MG TABLET SL Generic $0.30 each
NITROSTAT 0.4 MG TABLET SL Generic $0.57 each
NITROSTAT 0.6 MG TABLET SL $0.50 each

Ontology: Oral form glyceryl trinitrate (C0358597)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
SnomedCT 346460001
English Oral glyceryl trinitrate, Oral form glyceryl trinitrate (product), Oral form glyceryl trinitrate, Oral glyceryl trinitrate (product), Oral glyceryl trinitrate (substance)
Spanish trinitrato de glicerilo oral, trinitrato de glicerilo oral (producto), trinitrato de glicerilo, forma farmacéutica oral (producto), trinitrato de glicerilo, forma farmacéutica oral

Ontology: Glyceryl trinitrate spray (C0358692)

Concepts Clinical Drug (T200)
SnomedCT 346463004
English Glyceryl trinitrate spray, Glyceryl trinitrate spray (product), Glyceryl trinitrate spray (substance)
Spanish trinitrato de glicerilo en aerosol (producto), trinitrato de glicerilo en aerosol, trinitrato de glicerilo en spray (producto), trinitrato de glicerilo en spray