Nitrates Sublingual, Chewable, or Buccal (Systemic)

Category

• Antianginal
• Vasodilator, congestive heart failure

Description

Nitrates (NYE-trates) are used to treat the symptoms of angina (chest pain). Depending on the type of dosage form and how it is taken, nitrates are used to treat angina in three ways:

• to relieve an attack that is occurring by using the medicine when the attack begins;
• to prevent attacks from occurring by using the medicine just before an attack is expected to occur; or
• to reduce the number of attacks that occur by using the medicine regularly on a long-term basis.

Nitrates are available in different forms. Sublingual nitrates are generally placed under the tongue where they dissolve and are absorbed through the lining of the mouth. Some can also be used buccally, being placed under the lip or in the cheek. The chewable dosage forms, after being chewed and held in the mouth before swallowing, are absorbed in the same way. It is important to remember that each dosage form is different and that the specific directions for each type must be followed if the medicine is to work properly .

Nitrates that are used to relieve the pain of an angina attack include:

• sublingual nitroglycerin;
• buccal nitroglycerin;
• sublingual isosorbide dinitrate; and
• chewable isosorbide dinitrate.

Those that can be used to prevent expected attacks of angina include:

• sublingual nitroglycerin;
• buccal nitroglycerin;
• sublingual isosorbide dinitrate; and
• chewable isosorbide dinitrate.

Products that are used regularly on a long-term basis to reduce the number of attacks that occur include:

• buccal nitroglycerin;
• chewable isosorbide dinitrate; and
• sublingual isosorbide dinitrate.

Nitrates work by relaxing blood vessels and increasing the supply of blood and oxygen to the heart while reducing its work load.

Nitrates may also be used for other conditions as determined by your doctor.

The nitrates discussed here are available only with your doctor's prescription, in the following dosage forms:

Buccal
• Nitroglycerin
  • Extended-release tablets (U.S. and Canada)

Chewable
• Isosorbide dinitrate
  • Tablets (U.S.)

Sublingual
• Isosorbide dinitrate
  • Tablets (U.S. and Canada)
• Nitroglycerin
  • Tablets (U.S. and Canada)

Brand Names

Some commonly used brand names are:

In the U.S. -

• Isordil ¹
• Nitrogard ²
• Nitrostat ²
• Sorbitrate ¹

In Canada -

• Apo-ISDN ¹
• Coronex ¹
• Isordil ¹
• Nitrostat ²

Another commonly used name is:

• Glyceryl trinitrate