Nitrosol is a metered-dose sublingual spray that acts as a vasodilator belonging to the organic nitrate group. It works on both arteries and veins. Each spray delivers 400 micrograms of nitroglycerin, and each container provides 200 doses.
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Nitrosol sublingual spray is prescribed for the immediate relief and prevention of angina pectoris attacks caused by coronary artery disease.
Nitroglycerin primarily works by relaxing vascular smooth muscles, resulting in dilation of peripheral arteries and veins, especially the veins. This leads to decreased venous return to the heart (lower preload) and reduced resistance in the arteries (lower afterload), thereby easing the heart’s workload and improving blood flow.
At the beginning of an angina attack, apply 1 or 2 sprays under the tongue. Do not exceed 3 sprays within a 15-minute window. If chest pain continues, seek immediate medical help. For prevention, use the spray 5 to 10 minutes before physical or emotional stress that may provoke an attack. Safety and efficacy in children have not been established.
Symptoms of overdose include severe low blood pressure, persistent headaches, dizziness, palpitations, vision problems, nausea, vomiting (potentially with blood), fainting, bluish skin, breathing difficulties, slow heart rate, confusion, coma, seizures, and death due to circulatory collapse.
Methemoglobinemia: Although rare with standard doses, high doses or genetic predisposition may increase risk.
Treatment:
Potential side effects include headache, facial flushing, dizziness, nausea, vomiting, weakness, low blood pressure when standing (postural hypotension), and rapid heartbeat (reflex tachycardia).
Combining Nitrosol with alcohol can lead to significant low blood pressure and collapse. It may also increase the effects of dihydroergotamine. Using it alongside calcium channel blockers, phenothiazines, or tricyclic antidepressants may increase the risk of orthostatic hypotension.
Do not use in cases of known allergy to nitrates, low blood pressure, low blood volume, severe anemia, head trauma, cerebral bleeding, mitral valve narrowing, or angina due to hypertrophic obstructive cardiomyopathy. Avoid using with phosphodiesterase inhibitors for erectile dysfunction.
Category C. There are no adequate studies in pregnant women. Nitroglycerin should be used during pregnancy only if clearly necessary. It is unknown whether it passes into breast milk, so caution is advised during lactation.
In early stages of a heart attack, careful monitoring of blood pressure and heart function is necessary when using Nitrosol. Use with caution in patients with severe liver or kidney dysfunction, thyroid disorders, poor nutrition, or low body temperature.
Store in a cool, dry place away from light and heat. Keep out of reach of children.
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