A huge list of medicines has been developed for the treatment of diseases of the cardiovascular system, including Nitrospray. This is an inexpensive drug that is available in a convenient bottle that allows you to accurately dose the drug. The bottle is sold in cardboard packaging. It does not indicate much information that would be useful to the patient. All necessary information can be found in the instructions attached to Nitrospray.
Release form, composition and pharmacological properties
Nitrospray is a sublingual spray. It is available in bottles containing 10 ml of the drug (200 doses). It is a colorless and clear liquid. The main component of the drug is nitroglycerin, and the auxiliary component is ethanol.
"Nitrospray" refers to cardiovascular drugs. The medicine when it enters the body has an antianginal effect. The essence of this effect is a decrease in myocardial oxygen demand, an increase in the delivery of this vital element to the heart. Thanks to Nitrosprey, angina attacks are stopped and prevented.
Pharmacokinetic features
In the official instructions of Nitrospray, the manufacturer indicated that the drug is rapidly absorbed into the blood from the mucous membranes. A few minutes after application in plasma, a therapeutic concentration of the drug is achieved. It begins to have a therapeutic effect. Excretion of the drug from the body is carried out mainly by the urinary system.
Indications and contraindications
The “Nitrospray” shown in the photo contains a small list of indications in the instructions - this is angina pectoris, acute left ventricular failure, acute myocardial infarction. At the first indication, the drug helps to stop and prevent attacks. In other conditions, this drug is used in combination with other medicines, that is, Nitrospray in acute left ventricular failure and acute myocardial infarction is one of the elements of complex therapy.
Contraindications for use indicated in the Nitrospray instructions:
- increase in intracranial pressure due to trauma or hemorrhage in the brain;
- hypersensitivity to the components of the drug;
- collapse (a form of acute vascular insufficiency in which vascular tone drops sharply, the mass of circulating blood decreases, blood supply to vital organs deteriorates);
- glaucoma proceeding in a closed-angle form;
- severe arterial hypotension (pressure drop);
- concomitant use of drugs that are phosphodiesterase inhibitors;
- children's age (before reaching adulthood).
In some conditions, it is necessary to use the drug with caution. These include severe renal failure, acute myocardial infarction with low filling pressure of one of the heart (ventricle on the left side), liver failure, chronic heart failure with low filling pressure of the ventricle on the left side, endocrine pathology provoked by excessive functional thyroid activity, severe anemia, hypertrophic cardiomyopathy.
special instructions
There is no information about the safety of the drug for the fetus, so it is advisable not to prescribe Nitrospray during pregnancy. The instructions note that this drug can only be used:
- after comparing risk and benefit;
- if there is evidence;
- under strict medical supervision.
The question of the use of the medication during breastfeeding should be decided by the doctor. The penetration of nitroglycerin into breast milk has not been investigated, so a specialist should determine the possible risk to the baby and the expected benefit to the mother before prescribing the drug to a nursing woman.
In the instructions for use of Nitrospray, the manufacturer warns that it is impossible to simultaneously take alcohol-containing drinks and be treated with nitroglycerin. With the combination of alcohol and medication, an enhanced hypotensive effect is observed. Another special indication - at the beginning of treatment, it is recommended to abandon driving a car and work that requires quick reactions and increased attention.
Dosage and administration
The drug should be used only if the doctor has recommendations. To stop an attack of angina pectoris, 1 or 2 doses are required under the tongue (1 dose equivalent to 1 tablet of nitroglycerin is 1 click on the bottle cap). You can reapply the medicine after 5 minutes. In the absence of a positive effect after taking 3 doses for 15 minutes, the patient or his relatives urgently need to call a doctor. To prevent an attack of angina pectoris, 1 dose is enough for 5-10 minutes before the expected stress or load.
The instructions for use of Nitrospray indicate several rules:
- The medicine is best taken in a sitting position.
- The first time you use the bottle or after prolonged non-use, you need to press the cap 1 time - the available small amount of the medicine will go into the air and the aerosol chamber will be completely filled with the drug. The next stream of the drug should be directed into the mouth (under the tongue).
- The maximum single dose is 4 doses, and the maximum daily dosage is 16 doses.
- After using the drug, you need to close your mouth and try not to swallow the medicine.
Overdose
An overdose is possible if you ignore the recommendations from the instructions attached to the Nitrospray. Nitroglycerin can cause a decrease in pressure, headache, reflex tachycardia, facial flushing, dizziness, vomiting, diarrhea, sensation of heat, drowsiness. When using not too many doses of the patient, you need to put it on a sofa or bed so that his legs are in an elevated position.
In severe cases, when taking a large number of doses, symptoms such as cyanosis, a feeling of lack of air, rapid surface breathing, orthostatic collapse, methemoglobinemia (the appearance of an increased amount of methemoglobin in the blood) are recorded. With such manifestations of an overdose, doctors use methods of treatment of intoxication and shock (the volume of circulating blood must be replenished, the use of norepinephrine and / or dopamine, etc. is necessary).
Side effects and drug interactions
Nitrospray, like any other drug, has side effects. In the reviews of cardiologists and in the instructions for the use of Nitrospray, it is indicated that the drug can cause the following symptoms:
- lowering blood pressure;
- dizziness and headache;
- tachycardia;
- feeling of heat;
- dry mouth
- weakness;
- burning under the tongue.
In rare cases, patients complain of nausea, vomiting, abdominal pain, lethargy, anxiety, skin rash and itching, blurred vision.
It is important for patients to remember that this drug, when combined with some other agents, can cause unwanted effects. For example, the hypotensive effect of nitroglycerin may be enhanced. The instructions for use of "Nitrospray" indicate that this is possible with a combination of medication:
- with vasodilators (drugs from the group of vasodilators);
- antihypertensive drugs (lowering blood pressure);
- angiotensin - converting enzyme inhibitors (medicines that are part of modern standards for the treatment of arterial hypertension and chronic heart failure);
- antipsychotics, tricyclic antidepressants (psychotropic drugs used in the treatment of psychoses, severe mental disorders, depressive states);
- type 5 phosphodiesterase inhibitors (widely used by specialists in the treatment of erectile dysfunction).
Reviews about Nitrospray
Nitrospray receives positive reviews from those people who have been diagnosed with angina pectoris. The advantages of the drug include ease of use. To obtain a dose of the drug, you need to open your mouth and, having directed the bottle in the right direction, press once on the cap. Other advantages of the medication are effectiveness, speed, availability of instructions for use. In reviews of Nitrospray, people write that within a few minutes the medicine stops an attack of angina pectoris.
The low price of the drug pleases patients. For example, in Moscow, a bottle with 10 ml of the drug can be bought for about 95 rubles. The disadvantages of Nitrospray are its side effects, which sometimes scare patients. However, you should not be afraid of side effects, because they do not occur too often.
Pills Analogs
The main analogue of Nitrospray in the form of tablets is a drug called the active substance. It's about Nitroglycerin. This medicine acts in the same way as Nitrospray. However, the effect is not so fast compared to the spray. Tablets need to be dissolved, holding them under the tongue. The spray in liquid form enters the oral cavity and begins to be absorbed through the mucous membrane. The price of Nitroglycerin is about 58 rubles per pack with 40 sublingual tablets.
Nitrocor is still being produced in tablet form with the instructions attached to it. The analogue of Nitrospray receives positive reviews. The active substance is nitroglycerin, and the auxiliary is lactose. This drug is available in cardboard boxes containing 40 tablets. The price of packaging is about 50 rubles.
Analogs in the form of a spray
In the form of a spray, there are 2 analogues. One of them is Nitromint. Available in cylinders of 10 g (180 doses) with a metering pump with a spray head. Contains nitroglycerin, ethanol, propylene glycol. For stopping an attack of angina pectoris, 1 or 2 doses are sufficient. Within 15 minutes, you can enter the drug no more than 3 times. In order to prevent an attack, only 1 dose is needed. In acute left ventricular failure, the development of pulmonary edema, 4 or more doses are applied sublingually while controlling hemodynamics (systolic blood pressure should exceed 100 mmHg). The price of the medicine is about 155 rubles.
Another analogue is Nitroprint. Available in bottles of 15 ml (300 doses). The composition of the drug includes nitroglycerin, propylene glycol, ethanol, purified water. Indications, contraindications, features of use are the same as those of Nitrospray and other analogues mentioned above. The price is about 134 rubles.
Analogs in the form of films
You can stop and prevent angina attacks not only with the help of tablets and spray. There is another dosage form containing nitroglycerin - this is a film for sticking to the gum. In such a dosage form, Trinitrolong is produced. Auxiliary components in its composition - brilliant green, cocoa butter, bio-soluble polymer.
The drug is available in cardboard packs. Each of them contains 1 glass test tube with 10, 20 or 40 films. The composition of the drug includes components such as cocoa butter, biosoluble polymer, diamond green. The price of Trinitrolong is about 84 rubles.
The drug is easy to use. The patient needs a plate with the selected dose to attach (stick) on the upper gum above the fangs and small molars. The drug begins to act immediately. The effect lasts for 3-4 hours.
Nitrospray with instructions for use and analogues are sold in pharmacies without a prescription. However, it is not recommended to purchase these drugs on their own, because they can harm your health. In case of a sudden attack of angina pector, you can go to the pharmacy and buy Nitrospray or its analogue, but then you must go to the doctor, undergo examinations and get the necessary appointments.