سعر نيترونال1مجم/مل فيال 50 مل 2023

Nitronal 1 mg/ml glyceryl trinitrate solution for intravenous infusion, 50 ml vial, listed in Egypt at hospital price (Sunny Medical).

• Unresponsive congestive heart failure, including that secondary to acute myocardial infarction; acute left-sided heart failurePopulation: Adultselectronic medicines compendium (emc)
• Refractory unstable angina pectoris and coronary insufficiency, including Prinzmetal's anginaPopulation: Adultselectronic medicines compendium (emc)
• Control of hypertensive episodes and/or myocardial ischaemia during and after cardiac surgeryPopulation: Adultselectronic medicines compendium (emc)

• Very common: headache. Common: dizziness, somnolence, tachycardia, orthostatic hypotension. Uncommon: enhanced angina, circulatory collapse, nausea, vomiting, allergic skin reactions. Not known: palpitations, flushing, hypotension.International label, equivalent formulation · electronic medicines compendium (emc)

• Hypersensitivity to nitrates; acute circulatory failure (shock, collapse); cardiogenic shock unless adequate end-diastolic pressure is maintained; severe anaemia; severe cerebral haemorrhage; head trauma; uncorrected hypovolaemia; hypertrophic obstructive cardiomyopathy; constrictive pericarditis; pericardial tamponade; toxic pulmonary oedema; raised intracranial pressure; aortic or mitral stenosis; PDE5 inhibitors or riociguat.International label, equivalent formulation · electronic medicines compendium (emc)
• US IV nitroglycerin label: pericardial tamponade, restrictive cardiomyopathy or constrictive pericarditis; allergy to nitroglycerin.General active-ingredient information · DailyMed (U.S. National Library of Medicine)

• Caution in severe liver or renal disease, hypothermia, hypothyroidism, low filling pressures (avoid systolic BP below 90 mmHg), orthostatic dysfunction, hypoxaemia; tolerance and cross-tolerance may develop; no PDE5 inhibitors within 24 h (48 h for tadalafil); avoid alcohol; methaemoglobinaemia reported; solution contains glucose (diabetes).International label, equivalent formulation · electronic medicines compendium (emc)
• Nitroglycerin migrates into PVC plastics; absorption by PVC tubing can reduce delivered dose (20-60% delivered in published studies).General active-ingredient information · DailyMed (U.S. National Library of Medicine)

• PDE-5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil)Contraindicated: PDE-5 inhibitors amplify the vasodilatory effect of nitrates and can cause severe hypotension, syncope or myocardial ischaemia.electronic medicines compendium (emc)
• Riociguat (soluble guanylate cyclase stimulator)Contraindicated: concomitant use can cause hypotension.electronic medicines compendium (emc)
• Other vasodilators, calcium channel antagonists, ACE inhibitors, MAO inhibitors, beta-blockers, diuretics, antihypertensives, tricyclic antidepressants, neuroleptics, alcoholMay potentiate the hypotensive effect.electronic medicines compendium (emc)

• Developmental toxicity studies in rats and rabbits did not show effects on embryos, fetuses or young even at maternally toxic doses.International label, equivalent formulation · electronic medicines compendium (emc)
• Evidence inadequate; nitrates are excreted in breast milk and may cause methaemoglobinaemia in infants. Decide whether to stop breastfeeding or therapy.International label, equivalent formulation · electronic medicines compendium (emc)

• Nitroglycerin (glyceryl trinitrate): Nitroglycerin forms nitric oxide, which activates guanylate cyclase and raises cyclic GMP in vascular smooth muscle, causing vasodilatation (venous more than arterial) (US Nitrolingual label 12.1).