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Nitro-DUR (Nitroglycerin Transdermal) - Indications and Dosage

 
 



INDICATIONS AND USAGE

Transdermal nitroglycerin is indicated for the prevention of angina pectoris due to coronary artery disease. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute attack.

DOSAGE AND ADMINISTRATION

The suggested starting dose is between 0.2 mg/hr [Release rates were formerly described in terms of drug delivered per 24 hours. In these terms, the supplied NITRO-DUR systems would be rated at 2.5 mg/24 hours (0.1 mg/hour), 5 mg/24 hours (0.2 mg/hour), 7.5 mg/24 hours (0.3 mg/hour), 10 mg/24 hours (0.4 mg/hour), and 15 mg/24 hours (0.6 mg/hour).] and 0.4 mg/hr. Doses between 0.4 mg/hr and 0.8 mg/hr have shown continued effectiveness for 10 to 12 hours daily for at least 1 month (the longest period studied) of intermittent administration. Although the minimum nitrate-free interval has not been defined, data show that a nitrate-free interval of 10 to 12 hours is sufficient (see CLINICAL PHARMACOLOGY). Thus, an appropriate dosing schedule for nitroglycerin patches would include a daily patch-on period of 12 to 14 hours and a daily patch-off period of 10 to 12 hours.

Although some well-controlled clinical trials using exercise tolerance testing have shown maintenance of effectiveness when patches are worn continuously, the large majority of such controlled trials have shown the development of tolerance (ie, complete loss of effect) within the first 24 hours after therapy was initiated. Dose adjustment, even to levels much higher than generally used, did not restore efficacy.

HOW SUPPLIED

NITRO-DUR
System Rated
Release In Vivo Release rates were formerly described in terms of drug delivered per 24 hours. In these terms, the supplied NITRO-DUR systems would be rated at 2.5 mg/24 hours (0.1 mg/hour), 5 mg/24 hours (0.2 mg/hour), 7.5 mg/24 hours (0.3 mg/hour), 10 mg/24 hours (0.4 mg/hour), and 15 mg/24 hours (0.6 mg/hour).
Total
Nitroglycerin
Content
System SizePackage Size
0.1 mg/hr20 mg5 cm2Unit Dose 30
(NDC 0085-3305-30)
Institutional Package 30
(NDC 0085-3305-35)
0.2 mg/hr40 mg10 cm2Unit Dose 30
(NDC 0085-3310-30)
Institutional Package 30
(NDC 0085-3310-35)
0.3 mg/hr60 mg15 cm2Unit Dose 30
(NDC 0085-3315-30)
Institutional Package 30
(NDC 0085-3315-35)
0.4 mg/hr80 mg20 cm2Unit Dose 30
(NDC 0085-3320-30)
Institutional Package 30
(NDC 0085-3320-35)
0.6 mg/hr120 mg30 cm2Unit Dose 30
(NDC 0085-3330-30)
Institutional Package 30
(NDC 0085-3330-35)
0.8 mg/hr160 mg40 cm2Unit Dose 30
(NDC 0085-0819-30)
Institutional Package 30
(NDC 0085-0819-35)

Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F) [see USP Controlled Room Temperature]. Do not refrigerate.

Rx only

Rev. 12/04
18143690

Copyright © 1987, 2002, Key Pharmaceuticals, Inc.
All rights reserved.

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