Nitrates include Erythrityl tetranitrate, Isosorbide dinitrate, Isosorbide mononitrate, nitroglycerin , pentraerythritrol tetranitrate, glyceryl trinitrate Refer - Isorbide 5- mononitrate 

Orthostaic hypotension may be produced by combined use of calcium channel blockers, hypertensives, phenothiazines and tricyclic antidepressants.Alcohol may cause severe hypotension and collapse.Enhances bioavailbilty of dihydroergotamine.

Angina pectoris

Flushing of the face, dizziness, tachycardia, throbing headache and tolerance.Large dose can cause vomiting, restlessness, hypotension, syncope, cyanosis(rare), tolerance, ethaemogobinaemia, impaired respiration,bradycardia.False positive decrease in serum cholestrol. I.V.admininstrtion: I.V.preparation contains substantial quantities of alcohol and alcohol intoxification can occur during high dose I.V.infusion. Sublingual tabs/spray: Delayed dissolution due to dry mouth,localised burning sensation. Topical preparation: Contact dermititis.

Transdermal patches:Contact dermititis,should be removed before cardioversion,defibrilation, diathermy. Buccal tablets: Delayed dissolution,may be swallowed by mistake.

Hypertropic obstructive cardiomyopathy,patients with cerebral damage or head trauma.

Special precautions:

Cerebrovascular diseases,lung diseases or cor pulmonale.

Pregnancy,lactation. May cause syncope.

Indication-

Angina pectoris

Dosage-

Acute attack - 0.5mg every 3 minutes till cessation of pain or limiting side effects

Prophylaxis- 0.5mg prior to activity Absorbed through buccal mucose and hence chew and not swallow

Nitrates include Erythrityl tetranitrate, Isosorbide dinitrate, Isosorbide mononitrate, nitroglycerin , pentraerythritrol tetranitrate Refer - Isorbide 5- mononitrate Nitrates

1. Avoid alcohol

2. Brand interchange- Do not change the brand of this drug to another without consulting your pharmacist or physician. products manufactured by different companies are not equally effective

3. May cause headache, dizziness, or flushing. Notify physician if blurred vision, dry mouth, or persistent headches occurs. In patients who get headaches, the headaches may be a marker of the drugs activity. patients should not try to avoid headaches by altering treatment schedule, since loss of headache may be associated with simulateneous loss of efficacy. Aspirin or acetaoaminophen may be used for relief.

4. Take oral nitrates on an empty stomach with a glass of water.

5. Carefully follow the prescribed schedule of dosing

6. Keep tablets and capsules in original container. Keep container closely tightly

7. Inhalants- Use when lying down only. Highly falmmable, do not use wher it might be ignited. Use in a well ventilated room.