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Nitroglycerin Ointment

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Nitroglycerin Ointment, Nitroglycerin Paste, NItro-Bid Ointment

  • See Also
  1. Nitroglycerin Patch
  • Indications
  1. Congestive Heart Failure Exacerbation Management
    1. Nitroglycerin Infusion is used in critical CHF exacerbations for rapid Preload reduction
    2. Less severe CHF exacerbations may benefit from early Nitroglycerin Ointment during initial stabilization
      1. Unlike Nitroglycerin Infusion that requires ED/ICU care, Nitroglycerin Ointment may be used on regular medical wards
  2. Angina Pectoris
    1. Other Nitroglycerin preparations are preferred for acute Angina (e.g. Sublingual Nitroglycerin, Nitroglycerin Infusion)
    2. For chronic Angina, use Long Acting Nitroglycerin (e.g. Isosorbide or Nitroglycerin Patch) instead
  • Precautions
  1. Poor absorption (Other preparations are preferred)
  • Pharmacokinetics
  1. One inch of ointment equivalent to 10 mcg/min IV infusion
  • Dosing
  1. Nitroglycerin 2% ointment (15 mg per inch)
    1. Start: 0.5 inch every 8 hours
    2. Maintenance: 1-2 inches every 8 hours
    3. Maximum: 4-5 inches every 4 to 6 hours
  • Safety
  1. Pregnancy Category C
  2. Unknown safety in Lactation
  • Mechanism
  1. See Nitroglycerin
  • Adverse Effects
  1. See Nitroglycerin
  • Resources
  1. Nitro-Bid Nitroglycerin Ointment
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e464e9bb-48e8-4b9f-9fff-e220cfbac0c5
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 70-1
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia