Nitrogen - instructions for use, analogs, reviews and release forms (tablets 2.6 mg Mite and 6.5 mg Forte) drug for the treatment of heart pain, angina in adults, children and pregnancy. Composition and alcohol

In this article, you can read the instructions for using the drug Nitrogen. There are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Nitrogon in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Nitrogen in the presence of existing structural analogs. Use for the treatment of heart pain, angina in adults, children, as well as during pregnancy and lactation. The composition of the drug and its interaction with alcohol.

Nitrogen - has an effective antianginal effect.Expands peripheral vessels, mainly venous, reduces pre- and postnagruzku on the heart, the need for myocardium in oxygen, due to the expansion of the coronary vessels improves blood flow to the myocardium.

Composition

Glycerol trinitrate (nitroglycerin) + auxiliary substances.

Pharmacokinetics

Nitron is subjected to an intense "first pass" effect through the liver with rapid metabolism and excretion. When administered orally, bioavailability is no more than 10% compared to Nitroglycerin administered sublingually. Glycerin trinitrate is metabolized predominantly in the liver by reductive hydrolysis under the action of glutathione-dependent reductase of organic nitrates. It converts fat-soluble organic nitrates into inorganic nitrite and water-soluble metabolites devoid of nitro groups. These metabolites are less active than the starting materials. Connection with blood plasma proteins - 60%. The total clearance was from 5.5 to 11 liters per minute, and the elimination half-life is from 2 to 33 minutes.

Indications

• prevention of angina attacks, including patients who underwent myocardial infarction.

Forms of release

Tablets of 2.6 mg Mite and 6.5 mg Forte.

Medicinal forms in the form of ointments or gel at the time of publication of the drug in the Directory did not exist.

Instructions for use and dosing regimen

Dosage depends on the condition of the individual patient and the severity of the course of the disease. To prevent the development of tolerance, the dosing regimen should include a 10 to 12-hour non-nitric interval.

Nitrogen forte is usually taken on 1-2 tablets twice a day, in the morning and after dinner. The absence of an evening dose provides a 12-hour non-nitric interval. If necessary, the drug may be prescribed 3 times a day, but with a 10 to 12-hour non-nitric interval.

If the patient's attacks occur mainly at night, Nitrogen should be taken after dinner and in the evening.

Tablets should be taken on an empty stomach, swallowed whole, do not bite and chew, squeezed a small amount of liquid.

The maximum single dose of Nitrog is 13 mg (2 tablets). The maximum daily dose should not exceed 30 mg.

Side effect

• nitrate headache;
• dizziness;
• sensation of heat;
• redness of the face;
• hypotension (in patients with acute myocardial infarction);
• swelling of the ankles and lower legs;
• cyanosis (blueing of the mucous membranes and skin); fainting;
• paradoxical bradycardia (decrease in heart rate) with acute arterial hypotension and / or syncope;
• dry mouth;
• nausea, vomiting;
• abdominal pain;
• drowsiness;
• increased fatigue;
• anxiety;
• retardation;
• disorientation;
• thrombocytopenia (decrease in the number of platelets);
• skin rash;
• itching;
• blurred vision;
• hypothermia (low body temperature);
• sweating;
• development of tolerance (including cross-over to other nitrates).

Side effects are dose-dependent and in most cases are associated with the vasodilating effect of nitroglycerin.

Contraindications

• hypersensitivity to nitrates or any other components of the drug;
• chronic heart failure with severe stenoses of the aortic, mitral valves or hypertrophic obstructive cardiomyopathy;
• acute myocardial infarction with low filling pressure of the left ventricle;
• cardiac tamponade;
• constructive pericarditis;
• severe arterial hypotension;
• acute circulatory disturbance (shock, collapse);
• toxic pulmonary edema;
• craniocerebral trauma;
• impaired cerebral circulation;
• hemorrhagic stroke;
• increased intracranial pressure;
• angle-closure glaucoma;
• simultaneous administration of inhibitors of phosphodiesterase type 5 (PDE 5) - sildenafil, tadalafil, vardenafil;
• age under 18 years (effectiveness and safety not established);
• lactation period.

Carefully:

• severe anemia;
• hyperthyroidism;
• hypertrophic cardiomyopathy (there may be more episodes of angina pectoris);
• atherosclerosis;
• severe renal insufficiency;
• severe hepatic insufficiency (risk of development of methemoglobinemia);
• pregnancy;
• increased peristalsis of the gastrointestinal tract;
• malnutrition;
• malabsorption syndrome.

Application in pregnancy and lactation

Nitron can be used in pregnancy only in those cases when the benefit of treatment for the mother exceeds the possible risk to the fetus.

It is not known whether nitroglycerin is excreted in breast milk, therefore, during treatment with the drug, breast-feeding should be discontinued.

Use in children

Data on the safety and efficacy of glycerol trinitrate in children are limited,therefore it is not recommended to apply the drug to children and adolescents under 18 years of age.

special instructions

Nitron is not indicated for the treatment of acute attacks of angina pectoris. In these cases, the quick-acting form of nitroglycerin is used (tablets under the tongue, spray).

Care should be taken when prescribing the drug to patients with severe anemia, hypertrophic cardiomyopathy, severe atherosclerosis and dehydration, as well as severe hepatic insufficiency, thyroid dysfunction, hypothermia, malabsorption syndrome and low-calorie and irregular meals.

The patient should be informed that the headache, which can sometimes occur at the beginning of treatment, is associated with the use of the drug.

When determining the dose, it is necessary to provide a 10 to 12-hour non-nitric period in order to prevent the development of tolerance to nitrates.

Long-term use Nitrogen should be discontinued gradually, as a sudden discontinuation of the drug may cause heart failure or acute myocardial infarction.

Simultaneous reception of alcohol can cause severe headache, arterial hypotension, and also collapse.

The preparation contains lactose.Patients with rare hereditary disorders - galactosemia, lactase deficiency or glucose-galactose malabsorption syndrome should not use this drug.

Influence on the ability to drive vehicles and control mechanisms

At the beginning of treatment and especially when combined with alcohol, Nitrog can affect the ability to drive vehicles or other mechanisms due to the possibility of arterial hypotension and dizziness.

Drug Interactions

The hypotensive effect of Nitrog can be enhanced by simultaneous appointment with other vasodilators, antihypertensive agents, calcium antagonists, tricyclics, bicyclics, tetracyclic antidepressants and neuroleptics.

Laxatives can accelerate the passage of nitroglycerin through the gastrointestinal tract, thus reducing the amount of nitrate reabsorbed, as well as its concentration in the plasma.

The combination of glycerin trinitrate and Sildenafil (Viagra) or other similar drugs intended for the treatment of erectile dysfunction is contraindicated.

Glycerol trinitrate increases the bioavailability of dihydroergotamine.

Analogues of the drug Nitroung

Structural analogs for the active substance:

• Gluconite;
• Depot;
• Nirmine;
• Nit-ret;
• Nitradisk;
• Nitro;
• Nitroglycerine;
• Nitrodzhekt;
• Nitrocore;
• Nitrolingly;
• Nitrolong;
• Nitromint;
• Nitrog Forte;
• Nitroperpecten;
• Nitrospray;
• Nitrosprint;
• Perlingant;
• Sustak;
• Sustonite;
• Trinitrolong.

Analogues for the pharmacological group (nitrates and nitrate-like agents):

• Amyl nitrite;
• Aerosonite;
• Dilaside;
• Dinisorb;
• Isacardin;
• Isoket;
• Isolong;
• Cardiac;
• Cardix;
• Corvaton;
• Monizide;
• Monolong;
• Mononite;
• Monosan;
• Olicard;
• Pectrol;
• Pentacard;
• Sidnofarm;
• Sorbimon;
• Erinit;
• Efoks.

Response of a cardiologist

Nitron is an effective medicine for relieving pain in the heart. I prescribe it as a prophylaxis for the onset of angina attacks in patients with coronary heart disease or who underwent myocardial infarction. The main active substance of the drug is nitroglycerin. It effectively improves the blood supply to the heart muscle. It should be understood that Nitron is not intended for relief of acute attacks of angina pectoris - for this, high-speed drugs with nitroglycerin (sprays, tablets under the tongue) are used.It is strictly forbidden to drink alcohol during treatment.

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