Buy Nitroglycerin sublingual tablets. 0.5 mg No. 40 in pharmacies

Effect on blood pressure

The active ingredient in Nitroglycerin is glycerol trinitrate. Its main purpose is to relieve an attack of angina and relieve pain accompanying colic and spasms. The drug is allowed to be used for diagnosed heart failure, in order to reduce the flow of venous blood to the myocardium.

An additional effect is the prevention of blood stagnation in the pulmonary circulation. When using the medicine, the myocardium relaxes, vascular spasms are relieved, which ultimately leads to a decrease in blood pressure. Therefore, if we talk about whether this drug increases or decreases blood pressure, then it reduces it.

Nitroglycerin can be taken - if really necessary - with low blood pressure, but it is important to carefully monitor the effect of the drug on the body and accompanying symptoms. If dizziness or nausea occurs, use should be stopped immediately.

Important! At what blood pressure should you not take Nitroglycerin? The product is prohibited for use at blood pressure of 100/60. Since the medicine reduces the indicators, it is possible that blood pressure will drop to a critical level.

Physicochemical characteristics

A transparent, viscous, non-volatile liquid (like oil), prone to hypothermia. Miscible with organic solvents, almost insoluble in water (0.13% at 20 °C, 0.2% at 50 °C, 0.35% at 80 °C). When heated with water to 80 °C, it hydrolyzes. Quickly decomposes with alkalis.

Very sensitive to impact, friction, high temperatures, sudden heating, etc. Impact sensitivity for a load of 2 kg - 4 cm (mercury fulminate - 2 cm, TNT - 100 cm). Very dangerous to handle. When ignited carefully in small quantities, it burns unsteadily with a blue flame. Crystallization temperature - 13.5 °C (stable modification, labile modification crystallizes at 2.8 °C). Crystallizes with a significant increase in sensitivity to friction. When heated to 50 °C, it begins to slowly decompose and becomes even more explosive. Flash point is about 200 °C. The heat of explosion is 6.535 MJ/kg. The explosion temperature is 4110 °C. Despite the high sensitivity, the susceptibility to detonation is quite low - a detonator capsule No. 8 is required for a complete explosion. Detonation speed is 7650 m/s. 8000-8200 m/s - in a steel pipe with a diameter of 35 mm, initiated using detonator No. 8. Under normal conditions, liquid NGC often detonates in a low-speed mode of 1100-2000 m/s. Density - 1.595 g/cm³, in solid form - 1.735 g/cm³. Solid nitroglycerin is less sensitive to impact, but more sensitive to friction, and therefore very dangerous. The volume of explosion products is 715 l/kg. High explosiveness and brisance strongly depend on the method of initiation; when using a weak detonator, the power is relatively low. High explosiveness in sand - 390 ml, in water - 590 ml (crystalline is slightly higher), operability (high explosiveness) in a lead bomb - 550 cm³. It is used as a component of some liquid explosives, dynamites and mainly smokeless powders (for the plasticization of cellulose nitrates). In addition, it is used in medicine in small concentrations.

Indications for use

Indications for the use of Nitroglycerin are not too numerous. The drug is used in the following cases:

• decrease in blood pressure;
• normalization of myocardial function;
• relief of an attack of angina of any strength;
• myocardial ischemia;
• swelling of lung tissue;
• hypertensive crisis;
• improving the patency of the gastrointestinal tract (gastrointestinal tract) and biliary tract;
• acute pancreatitis;
• reduction of pressure during neurosurgical operations.

Self-administration of the medication is unacceptable. The attending physician must decide whether Nitroglycerin can be taken or not.

Side effects

From the cardiovascular system: dizziness, “nitrate” headache, tachycardia, skin flushing, fever, decreased blood pressure; rarely (especially in case of overdose) - orthostatic collapse, cyanosis.

From the gastrointestinal tract: dry mouth, nausea, vomiting, abdominal pain.

From the side of the central nervous system: rarely (especially in case of overdose) - anxiety, psychotic reactions, lethargy, disorientation, blurred vision, headache (especially at the beginning of treatment, decreases with long-term therapy), dizziness and a feeling of weakness. Allergic reactions are possible.

Mode of application

There are specific instructions for using Nitroglycerin for high blood pressure. In order for the drug to provide the expected effect, the following rules must be observed:

• capsule - open it and place it under the tongue;
• tablet - place half under the tongue and wait for it to dissolve on its own;
• alcohol solution - pour 2 drops onto a piece of sugar or drop the same volume under the tongue;
• spray - spray the dose under the tongue.

Severe migraines are one of the possible reactions to starting to take the drug, caused by a sharp dilation of blood vessels

Before using the medicine, you need to sit down/lie down, as the medicine can cause severe dizziness. The permissible single dosage of tablets and capsules is 1 (for a single dose) and 5 (for a daily dose). Alcohol solution – 4 drops (one-time) and 16 drops (daily). After taking the medication, it is necessary to measure blood pressure every 15 minutes.

If its level remains unchanged, you can take another tablet/capsule or take 2 more drops. But usually the effect of Nitroglycerin begins one to two minutes after administration and lasts about half an hour. The maximum duration of use is a month. Subsequently, addiction develops, and the effectiveness of treatment decreases significantly.

Reception features

Nitroglycerin should be taken in a sitting or lying position, especially for older people, since the development of dizziness and fainting is possible. If the therapeutic effect does not occur, then after two minutes you must take the next dose. The intervals between them are 5 minutes. The total number of receptions is 3 times. The dosage at the first dose should not exceed ½ tablet.

This will allow you to assess the tolerability of the drug. For older people, the dosage is also ½ tablet. The recommendation is due to the possibility of developing fainting conditions. If nitroglycerin drops are used, it is best to apply a single dose (2 drops) to a piece of sugar and dissolve. If this is not possible, then drip the same amount of product under the tongue.

How to reduce blood pressure using folk remedies?

And you also need to remember the following recommendations:

• After the first dose of the drug, a person may develop migraines. The reason is the rapid expansion of the lumens of blood vessels and a drop in blood pressure levels. After several days of use, the headaches weaken and disappear completely. This is a normal reaction of the body to the drug, it continues to work actively, the body has simply adapted and does not react so painfully. The recommended dosage cannot be increased. In this case, getting rid of migraines will be very problematic.
• 5 hours after taking the dose, it is possible that pain in the heart area may develop. The reason is the removal of the drug from the myocardium. The muscle begins to work in the same mode, which provokes painful sensations. To stabilize your health, you need to take the next dose.
• If after taking the capsule the pain does not stop within the next 15 minutes, you can put another capsule under the tongue.

The red capsules contain an oil solution of nitroglycerin. After two months of regular use of the drug, the body begins to get used to it, so it becomes ineffective. To avoid this, you need to take a break after taking it for a month.

To prevent addiction to Nitroglycerin, doctors recommend taking any form of the drug no earlier than after 5 hours. This will allow the active substances to completely leave the blood, and the body will receive a “new” dose each time.

If you have low blood pressure, use the medicine with extreme caution. If you exceed the dosage, you can get severe migraines, dizziness and fainting. If you have glaucoma, use Nitroglycerin only after consultation with your doctor.

In rare cases, vision deterioration occurs during treatment. An increase in intraocular pressure is possible. In both cases, therapy must be stopped immediately. It is important to remember that a physician should select the dosage, taking into account the current clinical picture. An overdose can cause severe nausea, paleness of the skin and mucous membranes, and loss of consciousness.

Receipt

In the laboratory it is obtained by esterification of glycerin with a mixture of concentrated nitric and sulfuric acids. Acids and glycerin must be free of impurities. To ensure process safety and good glycerol yield, the acid mixture must have a low water content. The process begins by mixing oleum (or laboratory 98% sulfuric acid) and melange. Mixing of acids is carried out while cooling to prevent thermal decomposition of concentrated nitric acid. Glycerin is added from a dropping funnel with vigorous stirring and constant cooling of the flask with ice (with the addition of table salt). Temperature control is carried out with a mercury or electronic thermometer. The process of mixing acids can be expressed in a simplified form by the following reaction:

The reaction is equilibrium with a strong shift of equilibrium to the left. Sulfuric acid is necessary for binding water into strong solvates and for protonating nitric acid molecules to form nitrosonium cations NO2+. The positive charge is delocalized over all electron orbitals of the cation, which ensures its stability.

Then the reaction mixture of acids and glycerin is kept for a short time under ice cooling. The liquid separates into two layers. Nitroglycerin is lighter than the nitrating mixture and floats as a cloudy layer. The esterification process is carried out at temperatures around 0˚C. At lower temperatures the speed of the process is low; at higher temperatures the process becomes dangerous and the product yield sharply decreases. Exceeding the temperature above 25 ° C threatens an explosion, so the synthesis must be carried out under strict temperature control. The equation for the esterification of glycerol with nitric acid in the presence of sulfuric acid can be simplified as follows:

The top layer from the reaction glass (flask) is immediately poured into a large volume of cold water with stirring. The water temperature should be 6–15 °C, the volume should be no less than 100–110 times the volume of the obtained NGC. Acids dissolve in water, and nitroglycerin settles to the bottom of the container in the form of cloudy beige drops. The water is drained and replaced with a new portion of cold water with the addition of a small amount of soda (1-3% by weight). The final washing is carried out with a small amount of soda solution until the aqueous phase reacts neutrally. To obtain the purest possible nitroglycerin (for example, for research purposes), a final purification is carried out by washing with water, which makes it possible to separate the remaining soda and sodium nitrate. The disadvantages of laboratory production of NGC are largely associated with the need to use a large volume of washing water, which sharply reduces the yield of the product due to irreversible losses of NGC due to solubility in water; in practice, these losses can reach 30-50% of the total product obtained. A large volume of rinsing water, on the contrary, allows you to rinse the NGC as quickly and safely as possible. Insufficient washing of NGC from acidic impurities and products of incomplete esterification leads to very low stability of products (gunpowder, TRT, BVV, etc.) and makes NGC extremely dangerous.

In industry, it is obtained by continuous nitration of glycerin with a nitrating mixture in special injectors. The resulting mixture is immediately separated in separators (mainly Biazzi systems). After washing, nitroglycerin is used in the form of an aqueous emulsion, which simplifies and makes its transportation between workshops easier and safer. Due to the possible risk of explosion, NGC is not stored, but is immediately processed into smokeless powder or explosives.

Most of the production premises of the enterprise producing NGC are occupied by workshops for the cleaning and processing of liquid waste and other production waste. The most promising technologies in this area are based on closed cycles of using circulating media (wash water, spent acid mixture, etc.).

Reviews

Patients suffering from negative manifestations of hemorrhoids often leave extremely positive reviews about Nitroglycerin ointment for anal fissures . They note that when using this drug, already in the first days there is a significant relief from the pain and bleeding of cracks , and with a course of use of the drug, complete healing of problem skin areas occurs within 2-3 weeks. Also, applying this ointment facilitates the process of defecation and promotes healthy sleep. Naturally, Nitroglycerin ointment alone will not be enough to fully treat the problem of hemorrhoids , and the only correct solution in this situation will be a consultation with a proctologist, undergoing the necessary studies and then prescribing adequate therapy.

The use of Nitroglycerin ointment to increase potency is also quite often discussed on the Internet in various specialized forums. In this case, reviews about the effectiveness of this remedy are ambiguous, and along with a purely positive assessment of the drug’s effect, there are also absolutely critical reviews about the advisability of its use. Most likely, the matter is in the individual reasons for the decrease in erectile function and the severity of this pathological condition, which requires a different approach to treatment and the use of different medications.

Nitroglycerin drug overdose, symptoms and treatment

Manifested by a decrease in blood pressure (below 90 mm Hg), orthostatic reactions, reflex tachycardia, headache, dizziness, drowsiness, feeling of heat, nausea, vomiting, with a significant overdose (more than 20 mg/kg) - collapse, cyanosis, methemoglobinemia, dyspnea and tachypnea. If symptoms of overdose develop, stop further administration and remove the patch. The head end of the bed should be lowered and the patient's legs should be raised. As a rule, blood pressure normalizes within 15–20 minutes after stopping the administration of nitroglycerin, then administration can be continued after the infusion rate has been re-established. To correct blood pressure, it is possible to use phenylephrine, epinephrine and other vasoconstrictors. For methemoglobinemia, depending on the severity, ascorbic acid 1 g is prescribed orally or in the form of a sodium salt intravenously; IV methylene blue 0.1–0.15 ml/kg 1% solution (up to 50 ml), oxygen therapy, hemodialysis, exchange blood transfusion.

List of pharmacies where you can buy Nitroglycerin:

• Moscow
• Saint Petersburg

Nitroglycerin ointment price, where to buy

It should be remembered that today in the post-Soviet countries it is not possible to buy factory-produced Nitroglycerin ointment, since this medicine is not officially registered. In this regard, purchasing this drug is difficult and requires an individual prescription from the attending physician and ordering the drug from an industrial pharmacy that manufactures drugs.

In this case, the price of Nitroglycerin ointment 0.2%, prepared according to an individual recipe, should be in the range of 250-350 rubles per 30 gram bottle.

Interaction

Simultaneous use with vasodilators, antihypertensive drugs, ACE inhibitors, beta-blockers, CCBs, procainamide, tricyclic antidepressants, MAO inhibitors, phosphodiesterase inhibitors, as well as ethanol, enhances the hypotensive effect.

Prescription with dihydroergotamine may lead to an increase in its content in the blood and an increase in blood pressure (due to increased bioavailability of dihydroergotamine).

The simultaneous administration of nitroglycerin and heparin reduces the effectiveness of the latter (after discontinuation of the drug, a significant decrease in blood clotting is possible, which may require a reduction in the dose of heparin).

Contraindications

The ointment is not recommended for use when:

• pronounced negative symptoms inherent in arterial hypotension ;
• diagnosed severe pathologies of cardiovascular origin;
• personal hypersensitivity to nitroglycerin or to the ointment base;
• parallel use of medicinal products, including organic nitrates .

Use the drug with caution:

• elderly patients;
• lactating and pregnant women.