Vasodilators for heart diseases. Organic nitrates.
Pentaerythrityl tetranitrate 10 mg in one tablet.
Nitrolong is a nitropreparation with prolonged antistenocardial action. It induces
relaxation of the smooth muscles mainly of the venous vessels, reducing the
venous reflux to the heart, the central venous pressure and the diastolic
ventricular filling. The preloading of the heart and to a weaker degree the after
loading decreases. The work of the myocardium is relieved, its oxygen needs
diminish and the oxygen supply of the heart is improved. The preparation
induces redistribution of coronary blood circulation towards the ischemic
subendocardial zones of the myocardium. Venous pressure in the pulmonary
In oral administration nitrolong is absorbed comparatively well. Therapeutic
action begins within 30 min after ingestion and lasts 4-5 hours. The drug is
excreted mainly through the kidneys, almost entirely in the form of metabolites.
Ischemic heart disease - for prophylaxis of attacks of angina pectoris; post-
myocardial infarction conditions; chronic congestive cardiac insufficiency - in the
Hypersensitivity to nitropreparations; pronounced anemia; fresh head injuries;
cerebral hemorrhages; hypotension; shock conditions; constrictive pericarditis;
glaucoma; severe hepatic insufficiency (risk of methaemoglobinaemia);
hypertrophic cardiomyopathy; fresh myocardial infarction (in case of risk of
developing of hypotension, cardiogenic shock and/or left ventricular cardiac
ADVERSE REACTIONS/SIDE EFFECTS
Usually the side effects are short-lived and do not necessitate discontinuation of
treatment but only temporary reduction of the dose. Undesirable reactions (dose-
dependent) such as reddening of the face and/or the neck, headache, tachycardia,
noise in the ears, hypotension, dizziness and palpitations are fairly common. Less
often diarrhea, rashes and itching may occur.
DRUG AND NON-DRUG INTERACTIONS
Nitrolong potentates the action of all antihypertensive agents such as beta-
adrenoblockers, calcium antagonists and ACE-inhibitors. Combination with other
vasodilators, alcohol, diuretics and opioid narcotics may provoke orthostatic
hypotension. Concomitant usage with acetylholine and histamine reduces their
therapeutic effect. Sympathomimetics may weaken the antianginose effect of
nitrolong. Parallel administration with Sildenafil (Viagra) is contra-indicated.
PRECAUTIONS AND WARNINGS
Due to the risk of orthostatic hypotension and strong headache the dose should
be increased gradually until optimum amount is attained. In case of high dose
administration the abrupt withdrawal of the drug is contra-indicated.
Nitrolong administration in children is not recommended since controlled studies
proving the drug’s efficacy and safe employment have not been carried out.
Elderly patients are more sensitive to the hypotensive action of the preparation
and more easily develop orthostatic hypotension.
If headache or reddening of the face occur temporary reduction of the dose and
following gradual increase is recommended.
In case of cyanosis without data for accompanying pneumopatia the level of
Nitrolong is not suitable for treatment of attacks of angina pectoris.
Patients sensitive to other nitropreparations may prove so to nitrolong as well.
In gastrointestinal hypermotility or malabsorptional syndrome the desired plasma
levels may not be attained (in which case an increase of the dose would be
In hypertrophic cardiomyopathy nitropreparations, including nitrolong, can
The drug should be used with caution in patients with severe dehydration (in
intensive diuretic therapy etc) due to the risk of hypotension.
In long-term treatment a tolerance to the effect of the drug is developed which
can be prevented by regular 10-12 hour interruption intervals in nitrolong intake 1-
PREGNANCY AND BREAST-FEEDING
It is recommended that nitrolong is administered with caution in pregnancy and
during the period of lactation. The drug has not been reported to pass into the
EFFECTS ON ACTIVE ATTENTION, DRIVING ABILITY AND
OPERATION OF MACHINERY
Adverse effects on the active attention, reflexes and motor activity have not been
MODE OF ADMINISTRATION AND DOSAGE
Nitrolong is taken orally. Treatment starts with 1 tablet 2-3 times daily. The dose
can be increased according to the individual needs of the patient up to 2 tablets
3-4 times daily. The usual maintenance dose is 1 tablet 3 times daily in a long-
term treatment determined by a specialist.
Symptoms: severe hypotension, headache, tachycardia or bradycardia; nausea,
vomiting and diarrhea; reddening and warming of the skin of the face and neck;
cyanosis of the lips, the fingernails or the palms of the hands; dizziness; sense of
intense tension in the head; superficial tachypnoea; weak and quick pulse;
unusual weakness and fatigue; fever and convulsions.
Treatment: gastric lavage, raising of the patient’s legs in order to improve the
venous reflux, hospitalization, symptomatic therapy and monitoring of
In methaemoglobinaemia over 0.8 g/100 ml methylene blau is administered
intravenously 1-2 mg/kg or 50 mg/kg orally in lighter cases.
DOSAGE FORM AND PACKAGES
In a dry place protected from light at 15-25oC.
MANUAL DE CONVIVENCIA COLEGIO PARROQUIAL RINCON DE SUBA BASE LEGAL El (Consejo Directivo) Rector del Colegio Parroquial Rincón de Suba en uso de sus facultades y las que le confiere la Constitución Política , la Ley 115 y el Decreto 1860/94, el Código del Menor, ley a. Que es un deber junto con los demás estamentos del gobierno escolar, padres de familia, tomar las medidas conduce
02 Documentos 2079 9-17 12/1/05 12:42 Página 9Documento descargado de http://www.doyma.es el 31/01/2006. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. Guía clínica del manejo del prolactinoma y otros estados de hiperprolactinemia B. MORENO, G. OBIOLS, C. PÁRAMO Y A. ZUGASTI* *En nombre del Grupo de Trabajo de Neuroendocrinologí