How much nitroglycerin can be taken per day

The main indication for taking a peripheral vasodilator is angina pectoris – both for short-term prophylaxis and for blocking seizures of the disease.

Nitroglycerin (tablets) is necessary for myocardial infarction with exacerbation of the condition and during rehabilitation treatment. In addition, the medicine is used for acute left ventricular failure.

The treatment regimen of the drug, the required dose and dosage form should be determined by the doctor on the basis of individual indications, depending on the clinical picture.

The usual dose for angina pectoris is 1 tablet (0,5 mg) sublingually (under the tongue) or buccally (on the cheek). A smaller number is enough for some patients – half or even a third of the dragee can become their norm.

In most cases, the effect occurs in 1-2, a maximum of 5 minutes. If the pain disappeared before the Nitroglycerin tablet had time to resolve, then its residue can be removed from the mouth. In opposite cases – if after 5-6 minutes the pain is not stopped, one more dose should be taken. If you need a quick effect, the tablet can be chewed. When this does not help, you need to urgently call the doctors – there is a high probability of myocardial infarction.

With multiple doses of Nitroglycerin, the dosage can be increased to 2-3, and sometimes up to 5-6 tablets. This is due to the body getting used to the drug.

Capsules should be taken in a sitting position. If the pain is found while walking, it is recommended to find a suitable place and sit down.

It is allowed to use Nitroglycerin as a drug for prophylactic purposes. In this case, the tablet should be taken before the onset of stressful situations for the body, which may be associated with any emotional or physical overload.

Often in a pharmacy, instead of Nitroglycerin (tablets), they offer to buy a spray. Using the tool is very simple – in a seated position, 1-2 doses are administered under the tongue or on it by pressing a special valve. Then they remain with their mouth closed for several seconds without swallowing. If necessary, a repeat of the procedure is allowed – a maximum of 3 times in 15 minutes.

For prevention, 1 dose is administered 7-10 minutes before the planned stress or load.

Before use, the vial of Nitroglycerin with the drug should not be shaken.

A single tap on the dispenser provides a dose of 0,4 mg nitroglycerin. Inhaling spray is contraindicated.

In urgent cases: 1-2 tablets under the tongue every 15 minutes, in the absence of the expected effect, ampoules with the medicine are used. Their dosage can be different – 2, 5 and 10 ml. There are also 50, 10 and 500 ml injection vials.

Films for gluing on the gum come in 2 types:

  • pale yellow with a dosage of 1 mg;
  • green – 2 mg.

Initially, the doctor must determine the required dose. After that, the patient can take the drug on his own. At the first attacks of pain, the film should be glued to the upper gum in the area of ​​the canines, pressing it with your fingers for a few seconds.

Then the substance is left alone until completely dissolved. For the best effect, you can lick the film several times (enough 2-3) – this will accelerate the flow of nitroglycerin into the blood.

With the rapid disappearance of pain, you can remove the remainder of the substance. If the expected action is absent, then stick another film. When this does not help, you must urgently seek medical help.

The interaction of nitroglycerin with alcohol is strictly contraindicated.

In most cases, the effect occurs after a maximum of 5 minutes. If the pain disappeared before the Nitroglycerin tablet had time to resolve, then its residue can be removed from the mouth. In opposite cases – if after minutes the pain is not stopped, one more dose should be taken. If you need a quick effect, the tablet can be chewed. When this does not help, you need to urgently call the doctors – there is a high probability of myocardial infarction.

With repeated administration of the drug Nitroglycerin, the dosage can be increased for the time being and this is due to the addiction of the body to the drug.

Often in a pharmacy, instead of Nitroglycerin (tablets), they offer to buy a spray. Using the tool is very simple – in a sitting position, doses are administered under the tongue or on it by pressing a special valve. Then they remain with their mouth closed for several seconds without swallowing. If necessary, a repeat of the procedure is allowed – a maximum of 3 times in 15 minutes.

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For prophylaxis, 1 dose is administered minutes before the planned stress or load.

Then the substance is left alone until completely dissolved. For the best effect, you can several times (just lick the film – this will accelerate the flow of nitroglycerin into the blood.

The main indication for taking a peripheral vasodilator is angina pectoris – both for short-term prophylaxis and for blocking seizures of the disease.

Nitroglycerin (tablets) is necessary for myocardial infarction with exacerbation of the condition and during rehabilitation treatment. In addition, the medicine is used for acute left ventricular failure.

The treatment regimen of the drug, the required dose and dosage form should be determined by the doctor on the basis of individual indications, depending on the clinical picture.

The usual dose for angina pectoris is 1 tablet (0,5 mg) sublingually (under the tongue) or buccally (on the cheek). A smaller number is enough for some patients – half or even a third of the dragee can become their norm.

In most cases, the effect occurs in 1-2, a maximum of 5 minutes. If the pain disappeared before the Nitroglycerin tablet had time to resolve, then its residue can be removed from the mouth. In opposite cases – if after 5-6 minutes the pain is not stopped, one more dose should be taken. If you need a quick effect, the tablet can be chewed. When this does not help, you need to urgently call the doctors – there is a high probability of myocardial infarction.

With multiple doses of Nitroglycerin, the dosage can be increased to 2-3, and sometimes up to 5-6 tablets. This is due to the body getting used to the drug.

Capsules should be taken in a sitting position. If the pain is found while walking, it is recommended to find a suitable place and sit down.

It is allowed to use Nitroglycerin as a drug for prophylactic purposes. In this case, the tablet should be taken before the onset of stressful situations for the body, which may be associated with any emotional or physical overload.

Often in a pharmacy, instead of Nitroglycerin (tablets), they offer to buy a spray. Using the tool is very simple – in a seated position, 1-2 doses are administered under the tongue or on it by pressing a special valve. Then they remain with their mouth closed for several seconds without swallowing. If necessary, a repeat of the procedure is allowed – a maximum of 3 times in 15 minutes.

For prevention, 1 dose is administered 7-10 minutes before the planned stress or load.

Before use, the vial of Nitroglycerin with the drug should not be shaken.

A single tap on the dispenser provides a dose of 0,4 mg nitroglycerin. Inhaling spray is contraindicated.

In urgent cases: 1-2 tablets under the tongue every 15 minutes, in the absence of the expected effect, ampoules with the medicine are used. Their dosage can be different – 2, 5 and 10 ml. There are also 50, 10 and 500 ml injection vials.

Films for gluing on the gum come in 2 types:

  • pale yellow with a dosage of 1 mg;
  • green – 2 mg.

Initially, the doctor must determine the required dose. After that, the patient can take the drug on his own. At the first attacks of pain, the film should be glued to the upper gum in the area of ​​the canines, pressing it with your fingers for a few seconds.

Then the substance is left alone until completely dissolved. For the best effect, you can lick the film several times (enough 2-3) – this will accelerate the flow of nitroglycerin into the blood.

With the rapid disappearance of pain, you can remove the remainder of the substance. If the expected action is absent, then stick another film. When this does not help, you must urgently seek medical help.

The interaction of nitroglycerin with alcohol is strictly contraindicated.

Nitroglycerin (tablets): dosage and instructions for use of the drug

Indications for the use of Nitroglycerin are:

  • Angina pectoris (relief and short-term prophylaxis of angina attacks before emotional stress or physical exertion);
  • Acute myocardial infarction, including complicated by acute left ventricular failure (infusion solution);
  • Pulmonary edema (infusion solution);
  • Unstable angina pectoris (infusion solution).

To prevent complications Nitroglycerin is recommended to be taken as directed by a doctor.

Nitroglycerin tablets are taken (sublingually) under the tongue, held in the mouth until completely absorbed, without swallowing.

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Nitroglycerin should be taken immediately when the first signs of an attack of angina appear, or before the alleged physical exertion or emotional stress. Single dose – 1 tablet. With stable angina pectoris, the effect can occur from a lower dose, in this case, the remainder of the pill, which did not have time to resolve, is recommended to spit out. In most cases (in 75% of patients), improvement is noted during the first 3 minutes of Nitroglycerin administration.

If an attack of angina pectoris is not stopped within 5 minutes, you should take another 1 tablet.

In cases of lack of therapeutic effect after taking 2 tablets of Nitroglycerin, you should immediately consult a doctor.

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Hyoid spray

It is injected into or under the tongue, preferably in a sitting position, with a breath hold. After spraying, the spray is not swallowed immediately, but is kept, closing the mouth for several seconds.

To avoid complications, Nitroglycerin should be used as directed by a doctor.

When the first signs of an angina attack appear, 1-2 doses of the spray are administered (depending on severity). If necessary, it is possible to introduce another 1 dose, but not more than 3 doses (1,2 mg) within 15 minutes.

If after applying 3 doses for 15 minutes the condition has not improved, you need to consult a doctor.

The maximum single dose is 3 doses of the spray.

If the indication for the use of Nitroglycerin is the prevention of angina attacks, the drug is used in 1 dose 5-10 minutes before the expected load or stress.

Before use, the packaging with the spray should not be shaken. When spraying, keep the bottle upright.

Infusion solution

The rate of intravenous administration of Nitroglycerin is selected individually, taking into account blood pressure, heart rate, central venous pressure, ECG and other indicators. The solution should be administered through an infusomat or automatic dispenser, allowing it to be accurately dosed and to control the rhythm of administration.

The introduction of Nitroglycerin using a conventional system for transfusion of liquids ensures dosage accuracy by counting the number of drops of transfused liquid. Prior to administration, the Nitroglycerin solution is diluted in a 0,9% sodium chloride solution or 5% glucose (dextrose) solution to a concentration of 0,01%. Other solvents should not be used.

It is advisable to use glass and polyethylene tubes, since the active substance is absorbed on the walls of the polyvinyl chloride tubes (losses can be 40-80%). The solution of Nitroglycerin is rapidly destroyed in the light, so the transfusion system and vials must be shielded with opaque material. Storage of the solution in an opened ampoule is not allowed.

The initial rate of introduction of the solution is 0,5-1 mg per hour, the maximum speed is 8-10 mg per hour.

Recommended concentrations and rate of administration of Nitroglycerin are: 1 mg / h (0,0166 mg / min) – 24 mg per day through an automatic dispenser (solution volume 1 mg / ml) or 240 mg per day through an intravenous system (solution volume 0,1 3 mg / ml); the rate of administration is 4-1 drops per minute (20 ml corresponds to drops).

The duration of therapy is determined by clinical indications and can vary from several hours to 2-3 days.

Contraindications and side effects during treatment

Contraindications to taking this drug may be associated with various somatic pathologies, the mechanism of development of angina pectoris and acute myocardial infarction. If the patient has a clinic of ischemia of the heart wall with low pressure, then the use of nitroglycerin can lead to tachycardia, poor filling of the left ventricle with blood and heart rhythm disturbance. Such symptoms will only intensify the formation of necrosis in the heart wall, and the patient’s condition will become more severe.

Other reasons for not using nitrates for angina pectoris and myocardial infarction include various chronic diseases:

  • disruption of the brain vessels, including hemorrhagic stroke and intracranial hypertension;
  • the presence of acute and chronic multiple organ failure in a patient, including hepatic and renal;
  • various hormonal disorders, thyrotoxicosis, acute and chronic anemia;
  • taking nitroglycerin is strictly prohibited for women during pregnancy and lactation, due to the harmful effects of nitrates on the fetus and baby.
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In addition to contraindications for use, this group of drugs can cause various side effects in the treatment of heart disease. On the part of the cardiovascular system, the most frequent heart rate, headache, fever, dizziness. With a significant overdose of nitroglycerin, a drop in blood pressure is possible up to a loss of consciousness and cardiac arrest.

The gastrointestinal tract reacts to nitrates with dry mouth, nausea, vomiting, abdominal pain and other disorders of the entire digestive system. Especially similar symptoms are characteristic if the patient uses drugs of prolonged action nitroglycerin.

Various pathological symptoms are also possible from other organs and systems. Most often, an allergic reaction to the reception is manifested by skin itching and rashes on the abdomen and limbs of the patient.

Can nitroglycerin cure angina pectoris?

In any case, you need to take nitroglycerin only after consulting with your doctor. If a drug is prescribed, it should always be with a person suffering from angina pectoris.

You can’t rely only on drugs. A major role is played by the normalization of lifestyle, the regularization of the regime of work and rest, the elimination of physical and psycho-emotional stress, smoking cessation, diet, and the normalization of sleep.

Stop physical activity, then the patient should sit down or lie down.

Then it is necessary to take nitroglycerin in tablet or spray form: “Nitro-Mik ™” (spray based on nitroglycerin), is sprayed in the oral cavity under the tongue, the effect occurs after 30-60 seconds. Iso-Mick ™ spray is also effective. In this case, the stopping effect after 2-3 minutes. , and the duration of action lasts up to 1 hour (used for the prevention and relief of angina attacks).

Provided that you do not have individual intolerance to nitroglycerin, you must know that nitroglycerin when taken sublingually sharply reduces blood pressure. Its working pressure should not be lower than 100/60 mm. Hg. Art. The first dose of nitroglycerin is best done in the presence of a doctor who will help determine the boundaries of blood pressure and timely identify the patient’s individual sensitivity to the drug.

If the pain persists within 4-5 minutes, it is necessary to repeat the administration of nitroglycerin (in tablet or spray form (“Nitro-Mik ™”). For example, tablet nitroglycerin can be taken every five minutes until the attack stops, but no more than three tablets in 15 minutes;

mustard must be placed on the heart area;

give valocordin or corvalol 25-30 drops;

If the pain behind the sternum does not stop with nitroglycerin within 15 minutes, then give the patient 1 tablet of pain medication (baralgin or spazgan) – and call an ambulance!

You should be aware that when taking nitro drugs (nitroglycerin, isosorbide dinitrate), side effects can develop, most often it is a headache that occurs as a result of exposure to nitroglycerin on meningeal vessels, which quickly passes. With regular administration of nitro drugs, headaches usually do not bother.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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