Uses of Nitromint

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1. Uses of Nitromint

What is Nitromint? Nitromint 2.6 contains nitroglycerin 2.6mg. Nitroglycerin acts on the smooth muscle components of the vascular wall, dilating the peripheral veins. Thanks to this effect, venous capacity increases while venous return, left ventricular volume, end-diastolic pressure, and preload all decrease. At the same time, because the small arteries dilate, the peripheral resistance decreases, and the afterload decreases. As a result, the heart does not have to work too hard, the demand for oxygen is lower. Nitroglycerin also dilates the coronary arteries under the pericardium, reducing coronary vasospasm. Thanks to these effects and reduced preload, blood flow to the heart is more even, collateral circulation and perfusion to the ischemic and subpericardial areas are improved. Thus, cardiac performance and exercise tolerance are both increased.
Nitromint is indicated in the following cases:
Long-term treatment for coronary artery disease, prevention of angina; Supportive treatment of congestive heart failure (in combination with digitalis, ACE inhibitors, diuretics or vasodilators). Nitromint is contraindicated in the following cases:
People with hypersensitivity to nitroglycerin or other organic nitrate compounds; Patients with low blood pressure (systolic blood pressure less than 90mmHg); People with acute circulatory failure (shock, collapse); Patients with cardiogenic shock (except where left ventricular end-diastolic pressure is adequately secured by an intra-aortic balloon pump or by positive inotropic drugs); Patients with acute myocardial infarction with low pumping pressure; People with hypertrophic and obstructive cardiomyopathy; Patients with hypovolemia; Patients with aortic and mitral valve stenosis; Patients with low pericarditis, pericardial compression; The patient is prone to circulatory disturbances when standing; People with head trauma, intracranial hemorrhage or conditions with increased intracranial pressure; People with severe anemia clinically; Patients with narrow-angle glaucoma (nitrates can increase intraocular pressure); Concomitant use of nitrogen monoxide-producing compounds, phosphodiesterase inhibitors (sildenafil, vardenafil, tadalafil).

2. Usage and dosage of Nitromint

How to use: Patients need to take the drug orally. Nitromint tablets should be taken before meals, whole tablets with a little water, should not be chewed or crushed.
Dosage: Varies for each patient, depending on the patient's health and disease condition.
Usual starting dose: 1 Nitromint 2.6mg slow-release tablet twice daily, may increase dose up to 2-3 tablets twice daily. Should be taken twice a day in the morning and early afternoon. If the pain occurs mainly at night, the daily dose should be taken in the morning and at bedtime; Dosage for special patients: The drug has a risk of causing orthostatic hypotension in elderly patients, so it is necessary to start with a low dose, increasing the dose more slowly in this patient group; The safety and effectiveness of Nitromint have not been established in children; It is not necessary to increase the dose of Nitromint in patients with liver or kidney failure. Overdose: When taking an overdose of Nitromint, side effects will appear more severe. Depending on the degree of overdose, patients may experience hypotension (with postural blood pressure disorders), syncope, pulse collapse, reflex tachycardia, headache, body weakness, blurred vision, dizziness face, restlessness, lethargy, flushed skin, nausea, vomiting and diarrhea. Taking high doses of Nitromint can cause cyanosis, shortness of breath, rapid breathing, and convulsions. Very high doses of Nitromint can cause increased intracranial pressure. A long-term overdose of Nitromint can increase methaemoglobin levels.
When drug overdose, the patient is treated as follows: Absorb substances in the stomach, gastric lavage at an early stage; Place patient in supine position, elevate legs, monitor vital signs, adjust if necessary in intensive care conditions. If the patient is severely hypotensive and in shock, supportive fluids are needed. Exceptions require intravenous dopamine or noradrenaline to restore circulation. In case of patients with methaemoglobinemia, the following antidotes can be used depending on severity/severe: Vitamin C (1g orally or sodium salt intravenously), methylene blue (maximum 50ml 1% solution, IV). intravenous), toluidine blue (administered intravenously, initially at a dose of 2 – 4 ml/kg, if necessary repeated at 1 hour intervals with a dose of 2 ml/kg), oxygen therapy, hemodialysis blood exchange.
Missed dose: When forgetting a dose of Nitromint, the patient should take it as soon as possible. If it is almost time for your next dose, you can skip the missed dose and take your next dose at the scheduled time.

3. Nitromint side effects

When using Nitromint, patients may experience some side effects such as:
Headache (nitrate headache) is common in the early stages of taking the drug. The degree of headache depends on the dose, which can go away after a few days without stopping the drug (if necessary, pain medication can be used, if the dose must be reduced, the dose can be increased slowly, gradually increasing later); Rare side effects when starting treatment or after increasing the dose of Nitromint are hypotension, orthostatic hypotension with symptoms of increased heart rate, dizziness, lightheadedness, weakness; Nausea, vomiting : Rare; Facial flushing, restlessness, blurred vision, dry mouth, skin allergies, pulse collapse, sometimes bradycardia, fainting. In some cases, an excessive drop in blood pressure can worsen the symptoms of angina; palpitations, swelling of the legs and ankles, reflex hypertension, loss of taste (associated with nitrate use); Very rare: Occurrence of methaemoglobin – blood; There have been cases where the continuous use of Nitromint (3 times/day in the morning - noon - afternoon) can lead to nitrate tolerance and cross-tolerance with other nitrate derivatives. When experiencing serious side effects, patients should stop taking Nitromint and notify their doctor or go to the nearest medical facility for quick and timely treatment.

4. Be careful when using Nitromint

Some notes users need to pay attention to before and while using Nitromint:
The safety and effectiveness of the drug has not been proven when used in children; The drug is not suitable for the treatment of acute angina. In this case, the patient should take drugs with immediate effect; Patients who use nitroglycerin for a long time when needing to switch to another drug should reduce and stop the dose of nitroglycerin slowly; Due to its ability to increase blood flow in poorly ventilated alveolar areas, nitroglycerin transiently reduces arterial blood oxygen levels. In patients with coronary artery disease, this effect may reduce myocardial circulation and cause myocardial ischemia. Therefore, caution should be exercised when administering Nitromint to patients with cardiac pulmonary disease or arterial hypoxemia; The starting dose of Nitromint should be lower, increasing the dose more slowly in the elderly, because this subject is at high risk of orthostatic hypotension; Special caution when using nitroglycerin for people with liver disease, severe kidney disease, mitral valve prolapse, hypothyroidism, low body temperature, poor nutrition, recent myocardial infarction; During treatment, the incidence of angina attacks may be increased during periods of low nitrate levels. Adjunctive therapy with another antianginal agent with different active ingredients may be necessary to avoid the occurrence of attacks; Avoid using alcoholic beverages during treatment with Nitromint because it will cause severe headaches, low blood pressure, blood vessels,... In each Nitromint 2.6mg slow-release tablet, there is 23.5mg of lactose, so caution should be taken when taking the drug. in people with lactase deficiency, galactose - blood, glucose/galactose malabsorption syndrome; At first use, Nitromint may affect the ability to drive and use machines, so users need to be cautious; Do not take Nitromint during pregnancy, especially during the first 3 months of pregnancy, unless specifically directed by your doctor; Do not take Nitromint while breastfeeding, unless specifically directed by your doctor.

5. Nitromint drug interactions

Some drug interactions of Nitromint include:
Concurrent use of Nitromint with antihypertensive drugs, vasodilators, calcium channel blockers, beta blockers, diuretics, tricyclic antidepressants, sedatives mental or alcohol consumption may increase the antihypertensive effect of nitroglycerin; Patients who have previously taken an organic nitrate compound (eg, isosorbide or dinitrate) may require a higher dose of nitroglycerin to achieve the same effect. If used concurrently with dihydroergotamine, nitroglycerin increases the concentration of dihydroergotamine in the blood (ie, increases the vasoconstrictor effect of dihydroergotamine – increases blood pressure and causes ischemia); Concomitant use of nitroglycerin with heparin will reduce the effect of heparin; Phosphodiesterase inhibitors (sildenafil, vardenafil, tadalafil) can increase the blood pressure of nitrates, so if used in combination, it can lead to cardiovascular complications, leading to death, so the combination should be contraindicated. ; Laxatives may shorten the intestinal time of Nitromint delayed-release tablets, thereby reducing the amount of absorption and plasma concentrations of nitroglycerin. When taking Nitromint, the patient should follow all instructions given by the doctor on how to use and dose. In case of missed dose, overdose, side effects, ... the patient should immediately notify the doctor to receive appropriate advice.
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