Nitroglicerina Eg (Glyceryl Trinitrate)

• Nitroglicerina Eg, an organic nitrate, is used in the management of cardiovascular conditions that involve myocardial oxygen demand.
• Angina pectoris: provides prophylactic relief of chest pain by dilating coronary vessels.
• Chronic heart failure: improves exercise tolerance and reduces symptoms through decreased cardiac workload.
• Exercise‑induced angina: prevents episodes during physical activity by maintaining coronary blood flow.

• Glyceryl trinitrate releases nitric oxide within vascular smooth muscle cells. The nitric oxide activates guanylate cyclase, increasing cyclic GMP levels, which leads to relaxation of smooth muscle in veins and arteries. Venous dilation reduces preload, while arterial dilation lowers afterload, collectively decreasing myocardial oxygen consumption and alleviating ischemic chest pain. The effect is rapid, peaking within minutes and lasting for several hours, which makes it suitable for both acute and prophylactic therapy.

Glyceryl trinitrate may cause a range of adverse reactions, classified as common or serious.

Common Side Effects

• Headache: throbbing pain often occurring shortly after application.
• Flushing: warmth and redness of the skin, especially on the face.
• Dizziness: light‑headed sensation due to blood pressure reduction.
• Skin irritation: redness or itching at the patch site.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure requiring medical attention.
• Methemoglobinemia: abnormal hemoglobin that impairs oxygen delivery.
• Reflex tachycardia: rapid heart rate as a compensatory response.

When prescribing or using Nitroglicerina Eg, several safety considerations should be observed.

• Blood pressure monitoring: check for hypotension before initiating therapy and during dose adjustments.
• Concomitant phosphodiesterase‑5 inhibitors: avoid co‑administration because of risk of profound hypotension.
• Cardiac surgery: discontinue the patch at least 24 hours before any operative procedure.
• Pregnancy and lactation: use only if the potential benefit justifies the potential risk to the fetus or infant.
• Store at room temperature: keep in the original packaging, protect from moisture and light.

Nitroglicerina Eg can interact with other medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Sildenafil, tadalafil, vardenafil and other PDE5 inhibitors: may cause severe hypotension.
• Other nitrates (e.g., isosorbide dinitrate): additive vasodilatory effect leading to dangerous blood pressure fall.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may enhance hypotensive response.
• Diuretics: can increase the risk of low blood pressure.
• Antihypertensive agents: may require dose adjustment to avoid excessive hypotension.