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Nitrocard 400mcg Spray
Nitrocard Spray is a sublingual metered-dose formulation containing 400 mcg of nitroglycerin per spray. Each bottle provides 200 precisely measured doses. Nitroglycerin is an organic nitrate and potent vasodilator that rapidly relieves chest pain by relaxing vascular smooth muscle.
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✅ Description:
Nitrocard is indicated for the immediate relief and prevention of angina pectoris due to coronary artery disease. It is also used in managing acute myocardial infarction, hypertensive crises, and pulmonary edema under specific clinical supervision.
Nitroglycerin promotes vascular smooth muscle relaxation by stimulating nitric oxide-induced activation of guanylate cyclase, increasing cyclic GMP. This causes venous pooling, reduced preload, decreased myocardial oxygen demand, and relief of coronary artery spasm. It also decreases afterload through arteriolar dilation.
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✔️ Side Effects:
Common: Headache, flushing, dizziness, postural hypotension, tachycardia, nausea, vomiting, dry mouth, localized burning.
Serious: Syncope, methemoglobinemia, paradoxical bradycardia, visual changes, exfoliative dermatitis, prolonged bleeding time.
Potentially Fatal: Severe hypotension, respiratory depression, cardiovascular collapse.
✔️ Dosage & Administration
- Acute Angina Relief: Administer 1–2 sprays under or onto the tongue at the onset of pain. Repeat every 3–5 minutes if needed, but do not exceed 3 sprays within 15 minutes. Seek emergency care if symptoms persist.
- Prophylaxis: Use 1–2 sprays 5–10 minutes prior to exertion or known angina triggers.
Renal Dosing
CrCl 10–50 mL/min: Extend dosing interval to every 24–72 hours.
CrCl <10 mL/min: Dose every 72–96 hours with close monitoring.
Special Instructions:
- Sit down when using the spray to reduce the risk of fainting.
- Do not inhale, rinse, or swallow immediately after use.
- Do not drink water for at least 5–10 minutes post-administration.
- Keep the spray accessible at all times and store away from heat or direct sunlight.
- Avoid alcohol and PDE5 inhibitors (e.g., sildenafil, tadalafil) due to the risk of severe hypotension or cardiac events.
✔️ Overdose Management
Symptoms include: Profound hypotension, headache, nausea, cyanosis, methemoglobinemia, arrhythmias, and collapse.
Treatment: Keep patient supine and warm. Supportive measures include oxygen, IV fluids, and methylene blue (for methemoglobinemia). Gastric lavage may help if ingestion was recent.
✔️ Drug Interactions
- May increase the effects of dihydroergotamine and prolong neuromuscular blockade from pancuronium.
- Reduced efficacy when used with drugs causing dry mouth (e.g., anticholinergics).
- NSAIDs (including aspirin) may blunt its anti-anginal effects.
- Risk of dangerous hypotension when used with alcohol, calcium channel blockers, tricyclic antidepressants, and other vasodilators.
✔️ Contraindications
Contraindicated in patients with hypersensitivity to nitrates, severe hypotension, hypovolemia, significant anemia, cerebral hemorrhage, recent head trauma, hypertrophic cardiomyopathy, or concurrent use of PDE5 inhibitors.
✔️ Precautions
Use cautiously in:
- Hepatic/renal impairment
- Hypothyroidism
- Malnutrition
- Hypothermia
- Cerebrovascular disease or glaucoma
- Patients with mitral valve prolapse, cardiac tamponade, or cor pulmonale
Pregnancy (Category C): Use only if clearly indicated
Lactation: Unknown if excreted in breast milk—use with caution
Prolonged high-dose use may lead to tolerance; ensure a nitrate-free interval in chronic use.
✔️ Storage
Store in a cool, dry place, protected from heat and light. Keep out of reach of children.
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here information is for informational purposes only.
The information contained herein should NOT be used as a substitute
for the advice of a qualified physician. This may not cover
everything about particular health conditions,
lab tests, medicines, all possible side effects, drug interactions,
warnings, alerts, etc. Please consult your healthcare professional
and discuss all your queries related to any disease or medicine. We
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