No

Vasodilator

Prophylaxis and long-term treatment of frequent or recurrent anginal pain and reduced exercise tolerance associated with angina pectoris

C

Hypersensitivity to erythrityl tetranitrate or any component; severe anemia; angle-closure glaucoma; postural hypotension; cerebral hemorrhage; head trauma

Use with caution in patients with hypertrophic cardiomyopathy, in patients with glaucoma, or volume depletion; tolerance may develop

>10%: Central nervous system: Headache

1% to 10%: Cardiovascular: Tachycardia, hypotension, flushing

<1% (Limited to important or life-threatening symptoms): Restlessness, dizziness, nausea, vomiting, diarrhea, methemoglobinemia, weakness

Sildenafil: Significant reduction of systolic and diastolic blood pressure with concurrent use. Do not give sildenafil within 24 hours of a nitrate preparation.

Erythrityl tetranitrate, like other organic nitrates, induces vasodilation by dephosphorylation of the myosin light chain in smooth muscles. This is accomplished by activation of guanylate cyclase, which eventually stimulates a cyclic GMP-dependent protein kinase that alters the phosphorylation of the myosin. Venodilation causes peripheral blood pooling, which decreases venous return to the heart, central venous pressure, and pulmonary capillary wedge pressure. A reduction in pulmonary vascular resistance occurs secondary to pulmonary arteriolar dilation and afterload may be decreased by a lowering of systemic arterial pressure.

Adults: Oral: 5 mg under the tongue or in the buccal pouch 3 times/day or 10 mg before meals or food, chewed 3 times/day, increasing in 2-3 days if needed. Dosages of up to 100 mg/day are tolerated. Some patients may need bedtime doses if they experience nocturnal symptoms.

Should be administered before meals

Concomitant use of sildenafil (Viagra®) may precipitate acute hypotension, myocardial infarction, or death. Nitrates used in right ventricular infarction may induce acute hypotension. Nitrate use in severe pericardial effusion may reduce cardiac filling pressure and precipitate cardiac tamponade.

May cause restlessness or dizziness

Hypotensive effects may be exacerbated by low potency antipsychotic (chlorpromazine) and TCAs

No information available to require special precautions

No effects or complications reported

Do not change brands without consulting physician or pharmacist; notify physician if persistent headache, dizziness, or flushing occurs; seek medical help if chest pain is unresolved after 15 minutes; do not chew or swallow sublingual tablet

Do not crush sublingual drug product

Monitor blood pressure reduction for maximal effect and orthostatic hypotension

Tablet, oral or sublingual: 10 mg