Therapeutic Action
Vasodilator, antianginal
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Drug reference
Vasodilator, antianginal
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Prophylaxis and treatment of acute angina Treatment of left-sided or global chronic heart failure in patients with intolerance to angiotensin- converting enzyme (ACE) inhibitors Adjunctive therapy in acute heart failure (acute pulmonary oedema)
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Do not administer to patients with obstructive cardiomyopathy, hypotension, shock, severe anaemia, intracranial hypertension or neurologic injury. May cause: orthostatic hypotension (especially in older patients), headache, nausea, flushing of the face, haemolytic anaemia in patients with G6PD deficiency; severe hypotension with risk of circulatory collapse in the event of overdose. Avoid combination or use the lowest effective dose in patients taking another nitrate derivative, a vasodilator, a diuretic or an antihypertensive drug (enhances hypotensive effects), and in older patients. Do not combine with sildenafil or other drugs used for erectile dysfunction (risk of severe hypotension, syncope and acute coronary syndrome). Pregnancy: not recommended (safety is not established) Breast-feeding: not recommended (safety is not established)
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5 mg sublingual tablet
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Short-term prophylaxis of acute angina Adult: 5 to 10 mg sublingually taken 10 minutes before a precipitating event (physical exertion, stress, etc.) Long-term prophylaxis of acute angina and treatment of left-sided or global chronic heart failure Adult: 5 to 40 mg orally 2 to 3 times daily Gradually increase the dose until effective. Do not stop treatment abruptly. Treatment of acute angina Adult: 5 to 10 mg sublingually, to be repeated after 10 minutes if necessary Adjunctive therapy in acute heart failure (acute pulmonary oedema) Adult: 5 mg sublingually, to be repeated after 10 minutes if necessary. The objective is to lower the systolic pressure to 120-150 mmHg and the diastolic pressure to under 110 mmHg.
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According to clinical response
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By sublingual route, antianginal effect appears within less than 10 minutes and persists for 1 to 2 hours. Tolerance to nitrates develops with prolonged use and can be overcome by short periods of nitrate withdrawal, and not by dose escalation. Sustained-release formulations are used for the long-term management of acute angina and the treatment of heart failure. The time interval between each administration depends on the preparations.
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- - Below 25 °C
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5 to 10 mg sublingually taken 10 minutes before a precipitating event (physical exertion, stress, etc.)
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5 to 40 mg orally 2 to 3 times daily
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5 to 10 mg sublingually, to be repeated after 10 minutes if necessary
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5 mg sublingually, to be repeated after 10 minutes if necessary. The objective is to lower the systolic pressure to 120-150 mmHg and the diastolic pressure to under 110 mmHg.
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