Nitrates (Formulary: Cardiovascular)

Important: Formulation and dosage details

Formulation:

Aerosol spray 400 micrograms/metered-dose (first choice)

Dosage:

• Prophylaxis of angina: 1 to 2 sprays, to be administered under the tongue and then close mouth prior to activity likely to cause angina.
• Treatment of angina: 1 to 2 sprays, to be administered under the tongue and then close mouth. Dose may be repeated at 5 minute intervals if symptoms have not resolved, up to a maximum of 3 sprays in total. Seek urgent medical attention if symptoms have not resolved 5 minutes after the second dose, or earlier if the pain is intensifying or the person is unwell.

Important: Formulation and dosage details

Formulation:

Transdermal patches 5mg, 10mg

Dosage:

Improve venous patency in hospital off-label.
To aid compliance in primary care. 

Nitrate patches may need to be removed for several consecutive hours to produce a nitrate-free period.

Important: Formulation and dosage details

Formulation:

Injection 5mg/5mL, 50mg/50mL

Important: Formulation and dosage details

Formulation:

Tablets 10mg, 20mg, 40mg (first line)

Dosage:

Initially 20mg 2 to 3 times daily or 40mg twice daily (10mg twice daily in those who have not previously received nitrates).
Give asymmetrically, ie morning and afternoon (8am and 2pm) to prevent nitrate tolerance.

Important: Formulation and dosage details

Formulation:

Modified release capsules 25mg, 50mg

Dosage:

25mg in the morning, increasing up to 100mg to 120mg in the morning if necessary.

Important: Formulation and dosage details

Formulation:

Modified release tablets 60mg

Dosage:

1 tablet in the morning, increasing up to 2 tablets in the morning if necessary.