Nitrosol 400 mcg/Spray is a fast-acting sublingual nitrate preparation used for the acute relief and short-term prevention of angina pectoris associated with coronary artery disease. It provides rapid vasodilation, helping to reduce cardiac workload and improve blood flow to the heart muscle. Due to its quick onset of action, Nitrosol is especially suitable for managing sudden anginal attacks and for use just before activities known to precipitate chest pain.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন 

Indications

Nitrosol 400 mcg/Spray is indicated for:

• Acute relief of angina pectoris

• Acute prophylaxis of angina pectoris due to coronary artery disease

Therapeutic Class

Nitrates: Coronary Vasodilators

Pharmacology / Mode of Action

Nitrosol 400 mcg/Spray releases free radical nitric oxide (NO) after administration. Nitric oxide activates the enzyme guanylate cyclase, leading to increased levels of cyclic guanosine 3’,5’ monophosphate (cGMP) in vascular smooth muscle. Elevated cGMP causes dephosphorylation of myosin light chains, resulting in smooth muscle relaxation and vasodilatation.
This vasodilatory effect reduces myocardial oxygen demand by decreasing preload and afterload, thereby relieving anginal pain.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন 

Dosage & Administration

• One spray (or sublingual dose) should be administered at the first sign of an acute anginal attack.

• The dose may be repeated every 5 minutes until relief is achieved.

• If chest pain persists after 3 doses within 15 minutes, immediate medical attention is required.

Nitrosol should be administered sublingually as directed by a physician.

Drug Interactions

Caution is advised when Nitrosol 400 mcg/Spray is used with:

• Antihypertensive drugs, beta-blockers, or phenothiazines due to additive hypotensive effects

• Calcium channel blockers, which may increase the risk of orthostatic hypotension

• Alcohol, which can enhance hypotensive effects

• Aspirin, which may potentiate vasodilatory and hemodynamic effects

Concomitant use with ergotamine or related drugs should be avoided or closely monitored due to the risk of ergotism.

Contraindications

Nitrosol 400 mcg/Spray is contraindicated in patients with:

• Early myocardial infarction

• Severe anemia

• Increased intracranial pressure

• Known hypersensitivity to nitrates

It is also contraindicated in patients using sildenafil citrate or other phosphodiesterase-5 inhibitors, as this combination may cause severe hypotension.

Side Effects

Commonly reported side effects include:

• Headache, which may be severe and persistent

• Dizziness or vertigo

• Weakness

• Palpitations

• Postural hypotension

These effects are generally dose-related.

Pregnancy & Lactation

Nitrosol 400 mcg/Spray should be used during pregnancy only if clearly needed. It is not known whether this medicine is excreted in human breast milk, so caution is advised during lactation.

Precautions & Warnings

• Use the lowest effective dose to control anginal attacks

• Excessive use may lead to drug tolerance

• Use with caution in patients who are volume-depleted or hypotensive

Storage Conditions

Store in a cool and dry place, protected from light and heat. Keep out of the reach of children.