Treatment of angina pectoris as monotherapy or in combination w/ other anti-anginal drugs (eg, β-blockers &/or Ca antagonists). As supplementary treatment for CHF patients not responding adequately to conventional therapy w/ digitalis or other positive inotropic agents & diuretics. Nitroderm TTS 5 Prevention of phlebitis & extravasation secondary to venous cannulation for IV fluids.
Dosage/Direction for Use
Patch-off period of 8-12 hr, usually at night, every 24 hr to overcome tolerance. Angina pectoris Initially 1 Nitoderm TTS 5 daily; can be titrated to 1 Nitroderm TTS 10 (normal maintenance dose). Prevention of phlebitis & extravasation 1 Nitroderm TTS 5 patch.
Contraindications
Hypersensitivity to nitrogylcerin & related organic nitrates. Acute circulatory failure associated w/ marked hypotension. Conditions associated w/ elevated intracranial pressure. Myocardial insufficiency due to obstruction, as in aortic or mitral stenosis or constrictive pericarditis. Concomitant use w/ phosphodiesterase type 5 (PDE5) inhibitors eg, sildenafil.
Special Precautions
Remove before MRI, cardioversion or DC defibrillation, or diathermy treatment. Patients w/ recent MI & acute heart failure. Patients w/ arterial hypoxaemia due to severe anaemia, hypoxaemia & ventilation/perfusion imbalance due to lung disease or ischaemic heart failure. Patients w/ angina pectoris, MI or cerebral ischaemia. Hypertrophic cardiomyopathy. Increased frequency of angina during patch-off periods. Tolerance to SL nitroglycerin. Infusion site should be examined regularly for development of phlebitis. May impair ability to drive or operate machinery. Pregnancy & lactation.
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