Comparative Pharmacology
Head-to-head clinical analysis: NITROGLYCERIN versus NITROL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITROGLYCERIN versus NITROL.
NITROGLYCERIN vs NITROL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nitroglycerin is a vasodilator that is converted to nitric oxide (NO) in vascular smooth muscle cells. NO activates guanylyl cyclase, increasing cGMP levels, leading to dephosphorylation of myosin light chains and vasodilation. Predominantly dilates venous capacitance vessels, reducing preload; also dilates coronary arteries at higher doses.
NITROL (nitroglycerin) is a vasodilator that relaxes vascular smooth muscle via the release of nitric oxide (NO), which activates guanylate cyclase and increases cyclic guanosine monophosphate (cGMP) levels, leading to vasodilation.
Sublingual: 0.3-0.6 mg every 5 minutes up to 3 doses for angina; Transdermal: 0.2-0.8 mg/hour patch applied daily for 12-14 hours; Intravenous: 5-200 mcg/min continuous infusion for acute coronary syndromes or heart failure; Topical 2% ointment: 15-30 mg (0.5-1 inch) every 6-8 hours.
Sublingual: 0.3-0.6 mg every 5 minutes as needed for angina, up to 3 doses in 15 minutes. Translingual spray: 1-2 sprays (0.4 mg/spray) under tongue every 5 minutes as needed, max 3 doses in 15 minutes. Transdermal: 0.2-0.8 mg/hour patch applied daily for 12-14 hours. Intravenous: Initial 5 mcg/min, titrate by 5 mcg/min every 3-5 minutes until response, usual range 10-200 mcg/min.
Clinical Note
moderateNitroglycerin + Etacrynic acid
"The risk or severity of adverse effects can be increased when Nitroglycerin is combined with Etacrynic acid."
Clinical Note
moderateNitroglycerin + Bumetanide
"The risk or severity of adverse effects can be increased when Nitroglycerin is combined with Bumetanide."
Clinical Note
moderateNitroglycerin + Hydrochlorothiazide
"The risk or severity of adverse effects can be increased when Nitroglycerin is combined with Hydrochlorothiazide."
Clinical Note
moderateNone Documented
None Documented
Terminal half-life: 1–4 minutes for the parent compound; clinical effects dissipate within the same time frame, correlating with rapid metabolism.
1-4 minutes for nitroglycerin; clinical effect disappears within 30-60 minutes due to rapid metabolism and redistribution.
Metabolized extensively by hepatic glutathione-organic nitrate reductase and other non-specific esterases; renal excretion of metabolites accounts for approximately 50%, with fecal elimination of about 20-30%. Less than 1% of unchanged drug is excreted renally.
Renal: minimal, <1% unchanged; extensive metabolism by liver, metabolites excreted renally. Biliary/fecal: negligible.
Category C
Category C
Nitrate Vasodilator
Nitrate Vasodilator
Nitroglycerin + Indapamide
"The risk or severity of adverse effects can be increased when Nitroglycerin is combined with Indapamide."