Glice Drug Interactions

Concomitant treatment with other vasodilators, calcium channel antagonists, ACE inhibitors, monoamine oxidase inhibitors, beta-blockers, diuretics, antihypertensives, tricyclic antidepressants, and neuroleptics, as well as the consumption of alcohol, may potentiate the hypotensive effect of the preparation.
The blood pressure lowering effect of glyceryl trinitrate will be increased if used together with phosphodiesterase inhibitors (e.g., sildenafil, vardenafil, tadalafil) which are used for erectile dysfunction. This might lead to life threatening cardiovascular complications. Patients who have recently taken phosphodiesterase inhibitors therefore must not be treated with glyceryl trinitrate in the intervening 24 hours (48 hours for tadalafil). Patients who are on nitrate therapy must not use phosphodiesterase inhibitors.
The use of glyceryl trinitrate with riociguat, a soluble guanylate cyclase stimulator, is contraindicated since concomitant use can cause hypotension.
Simultaneous intravenous infusion of tissue plasminogen activator (tPA) and glyceryl trinitrate may accelerate plasma clearance of tPA by increasing hepatic blood flow.
Reports suggest that, when administered concomitantly, glyceryl trinitrate may increase the blood level of dihydroergotamine and its effect. This warrants special attention in patients with coronary artery disease, because dihydroergotamine antagonizes the effect of glyceryl trinitrate and may lead to coronary vasoconstriction.
The use of heparin and glyceryl trinitrate solution can lead to a partial loss of action of heparin when both drugs are given simultaneously by intravenous route.
Concurrent administration of glyceryl trinitrate with acetyl salicylic acid may potentiate the blood pressure lowering effects of glyceryl trinitrate.
The nonsteroidal anti-inflammatory drugs except acetyl salicylic acid may diminish the therapeutic response of glyceryl trinitrate.
Sapropterine (tetrahydrobiopterine, BH4) is a cofactor for nitric oxide synthetase. Caution is recommended during concomitant use of sapropterine-containing medicine with all agents that cause vasodilation by affecting nitric oxide (NO) metabolism or action, including classical NO donors (e.g., glyceryl trinitrate (GTN), isosorbide dinitrate (ISDN), isosorbide 5-mononitrate (5-ISMN), and others).