Nitro-Dur (Nitroglycerin Transdermal)

Description

Nitro-Dur (Nitroglycerin Transdermal) is a transdermal patch used to prevent angina pectoris, a type of chest pain caused by coronary artery disease. This drug is classified as an organic nitrate and acts as a vasodilator, expanding both arteries and veins to boost blood flow. Nitro-Dur works by releasing nitroglycerin through the skin, gradually decreasing the occurrence and severity of angina attacks. This medication is not used to treat sudden chest pain episodes but rather serves as a preventative measure for individuals with coronary artery disease.

Directions

Nitro-Dur is administered through a transdermal patch applied directly to the skin. Use the medicine as directed by your doctor, without altering the dosage, frequency, or duration of use. When applying the patch, select a clean, dry, and hairless area of the skin, preferably on the chest or upper arm. The patch should be applied at the same time every day and replaced after 12 to 14 hours to allow for a nitrate-free interval, which helps prevent nitrate tolerance.

Ingredients

The active ingredient in Nitro-Dur is Nitroglycerin. Nitroglycerin is combined with acrylic-based polymer adhesives and a resinous cross-linking agent to create the transdermal system.

Contraindications

Avoid using this medication if any of the following apply:

• You have experienced an allergic reaction to Nitroglycerin or adhesive in the past.
• You are taking medications for erectile dysfunction, such as avanafil, sildenafil, tadalafil, or vardenafil
• You are using pulmonary hypertension medications, like riociguat

Cautions

• When using Nitro-Dur, there are certain precautions that must be taken to ensure safe and effective use. Tell your healthcare provider about the following:
• Other medications you take.
• Other medical conditions you have.
• Whether you are pregnant or breastfeeding.
• The combination of Nitro-Dur with phosphodiesterase inhibitors may cause low blood pressure. While the specifics of this interaction are not fully understood, treating it as an overdose may be recommended.
• The application of Nitro-Dur in cases of heart attacks or heart failure has not been thoroughly established. Your doctor may need to watch your health closely to avoid problems like dangerously low blood pressure or fast heartbeat.
• The placement of a cardioverter/defibrillator electrode directly over a Nitro-Dur patch should be avoided. It can cause harmless sparks, but it can lead to damage to the equipment and burns on the skin.

• Nitro-Dur should be used cautiously, especially in the elderly or those who may be volume-depleted, on multiple medications, or already hypotensive. Even small doses of nitroglycerin can cause severely low blood pressure, which may be accompanied by a paradoxical slow heartbeat and increased chest pain.
• Older adults should be cautious with Nitro-Dur as they may be more prone to the effects of low blood pressure and could have a higher chance of falling.
• In people with a certain type of chest pain caused by a thickened heart muscle, known as hypertrophic cardiomyopathy, Nitro-Dur might actually make things worse.
• People who have worked with nitrates over a long period can develop a tolerance. Suddenly stopping the medication might trigger severe chest pain or a heart attack, showing a physical dependency has formed.
• Some studies suggest taking a break from nitrates for 10-12 hours to avoid developing this tolerance. However, this could lead to more chest pain or decreased ability to exercise for some. Rebound effects, like worsening symptoms after stopping Nitro-Dur, are rare but not well-studied.

Side Effects

Nitro-Dur may cause side effects for some users. Common Nitroglycerin side effects can include headaches, dizziness, lightheadedness, and mild skin irritation at the site of the patch application. These side effects are usually mild and tend to resolve on their own over time. However, if they persist or worsen, it is recommended to consult a healthcare professional.

There are also more serious side effects associated with Nitro-Dur that may require immediate medical attention. These can include worsening chest pain, pounding heartbeats or fluttering in the chest, slow heart rate, and a lightheaded feeling like one might pass out. In addition, Nitro-Dur can cause heart attack symptoms, such as chest pain or pressure, pain spreading to the jaw or shoulder, nausea, and sweating. If you or someone you know is taking Nitro-Dur and experiences any of these serious side effects, seeking medical advice immediately is important.

References:

1. Nitro-Dur (Nitroglycerin Transdermal) Product Monograph. Whitehouse Station, NJ: Merck & Co., Inc; 2014.
2. Nitro-Dur (Nitroglycerin Transdermal) Drug Label Information. Orlando, FL: Ingenus Pharmaceuticals, LLC; 2022.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....