Nitroglycerina Teva (Glyceryl Trinitrate)

Nitroglycerina Teva, a nitrate vasodilator, is indicated for the management of angina pectoris and related ischemic heart conditions, acting to improve myocardial oxygen supply and reduce pain episodes.

• Angina pectoris (stable): improves exercise tolerance by lowering cardiac workload.
• Acute angina attacks: provides rapid relief of chest pain within minutes.
• Variant (Prinzmetal) angina: alleviates coronary‑spasm‑related chest discomfort.
• Prophylaxis before exertion: prevents angina onset during physical activity.

• Glyceryl trinitrate is metabolized to nitric oxide, which activates soluble guanylate cyclase in vascular smooth‑muscle cells. The resulting increase in cyclic guanosine monophosphate (cGMP) leads to relaxation of both venous and arterial smooth muscle, producing venodilation and modest arterial dilation that lower preload and afterload, thereby reducing myocardial oxygen demand.

Common side effects are generally mild and related to vasodilation.

Common Side Effects

• Headache: throbbing pain often occurring shortly after application.
• Flushing: warmth and redness of the skin, especially on the face.
• Dizziness or light‑headedness: due to transient blood pressure reduction.
• Hypotension: mild drop in blood pressure, usually orthostatic.
• Tachycardia: compensatory increase in heart rate.
• Nausea: occasional gastrointestinal upset.

Serious or Rare Side Effects

• Severe hypotension: marked blood pressure fall leading to syncope.
• Reflex tachyarrhythmias: potentially dangerous rapid heart rhythms.
• Myocardial infarction: rare but reported in susceptible patients.
• Allergic reactions: rash, itching, or anaphylaxis.
• Methemoglobinemia: rare disorder affecting oxygen transport.
• Vision disturbances: blurred vision or visual field changes.

Nitroglycerina Teva requires careful patient assessment and monitoring.

• Blood pressure monitoring: check for orthostatic hypotension before and after use.
• Concomitant PDE5 inhibitors: avoid co‑administration due to risk of severe hypotension.
• Anemia or hypovolemia: use with caution as vasodilation may exacerbate symptoms.
• Severe aortic stenosis: contraindicated because fixed outflow obstruction limits compensation.
• Abrupt discontinuation: may precipitate rebound angina; taper if long‑term therapy.
• Store at room temperature: keep in original container, protect from moisture and direct sunlight.

Nitroglycerina Teva can interact with several drug classes, requiring clinician awareness.

Major Interactions (Avoid)

• Phosphodiesterase‑5 inhibitors (e.g., sildenafil, tadalafil): may cause profound hypotension.
• Other nitrates (e.g., isosorbide dinitrate): additive vasodilatory effect leading to dangerous blood pressure drops.

Moderate Interactions (Monitor Closely)

• Antihypertensives (beta‑blockers, ACE inhibitors, calcium‑channel blockers): may enhance blood‑pressure‑lowering effect.
• Diuretics: increase risk of volume depletion and hypotension.
• Alcohol: potentiates vasodilatory response and dizziness.
• Antiplatelet agents: monitor for bleeding tendencies.
• Certain anti‑arrhythmic drugs: may affect heart rate response.