- Approval Id
- 14bf195081959096
- Drug Name
- GLYCERYL TRINITRATE-HAMELN INJECTION 1MG/ML
- Product Name
- GLYCERYL TRINITRATE-HAMELN INJECTION 1MG/ML
- Approval Number
- SIN15105P
- Approval Date
- 2016-10-20
- Registrant
- ZYFAS PHARMA PTE LTD
- Licence Holder
- ZYFAS PHARMA PTE LTD
- Drug Type
- Therapeutic
- Forensic Classification
- PRESCRIPTION ONLY MEDICINES
- Dosage Form
- INFUSION, SOLUTION
- Dosage
- <p><strong>4.2 Posology and method of administration</strong></p>
<p><strong>Posology</strong></p>
<p><em>Adults</em><br>
The dose of Glyceryl Trinitrate-hameln should be adjusted to meet the individual needs of the patient.</p>
<p>The recommended dosage range is 10–200 micrograms/min but up to 400 micrograms/min may be necessary during some surgical procedures.</p>
<p><em>Paediatric population</em><br>
The safety and efficacy of Glyceryl Trinitrate-hameln has not yet been established in children.</p>
<p><em>Elderly population</em><br>
There is no evidence that a posology adjustment is required in the elderly.</p>
<p><em>Patients with renal and hepatic impairment</em><br>
Additional dose adjustments in patients with severe hepatic insufficiency or severe renal failure may be necessary and require additional monitoring.</p>
<p><u><strong>Use in Surgery</strong></u><br>
A starting dose of 25 micrograms/min is recommended for the control of hypertension, or to produce hypotension during surgery. This may be increased by increments of 25 micrograms/min at 5 minute intervals until the blood pressure is stabilized. Doses between 10–200 micrograms/min are usually sufficient during surgery, although doses of up to 400 micrograms/min have been required in some cases.</p>
<p><u><strong>Myocardial ischaemia</strong></u><br>
The treatment of perioperative myocardial ischaemia may be started with a dose of 15–20 micrograms/min, with subsequent increments of 10–15 micrograms/min until the required effect is obtained.</p>
<p><u><strong>Unresponsive congestive heart failure:</strong></u><br>
The recommended starting dose is 20–25 micrograms/min. This may be decreased to 10 micrograms/min, or increased in steps of 20–25 micrograms/min every 15–30 minutes until the desired effect is obtained.</p>
<p><u><strong>Unstable angina:</strong></u><br>
An initial dose of 10 micrograms/min is recommended with increments of 10 micrograms/min being made at approximately 30 minute intervals according to the needs of the patient.</p>
<p><u><strong>Method of Administration</strong></u><br>
For intravenous use. Glyceryl Trinitrate should be administered by means of a micro-drip set infusion pump or similar device which permits maintenance of constant infusion rate.</p>
<p>Glyceryl Trinitrate-hameln can be administered undiluted by slow intravenous infusion using a syringe pump incorporating a glass or rigid plastic syringe.</p>
<p>Alternatively, Glyceryl Trinitrate-hameln may be administered intravenously as an admixture using a suitable vehicle such as Sodium Chloride Injection B.P. or Dextrose Injection B.P. In case of dilution, Glyceryl Trinitrate-hameln must be mixed under aseptic conditions immediately after opening. For further instructions on dilution of the product before administration, see section 6.6 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>.</p>
<p>Prepared admixtures should be given by intravenous infusion or with the aid of a syringe pump to ensure a constant rate of infusion.</p>
<p>During Glyceryl Trinitrate-hameln administration there should be close haemodynamic monitoring of the patient.</p>
<p>The posology of GTN i.v. should be adjusted to achieve the desired clinical response.</p>
<p><em>Example of admixture preparation</em><br>
To obtain an admixture of GTN at a concentration of 100 micrograms/ml, add 50 ml Glyceryl Trinitrate-hameln solution (containing 50 mg glyceryl trinitrate) to 450 ml of infusion vehicle to give a final volume of 500 ml.</p>
<p>A dosage of 100 micrograms/min. can be obtained by giving 60 ml of the admixture per hour.</p>
<p>Vials of Glyceryl Trinitrate are for single use only and should not be regarded as multi-dose containers.</p>
- Route Of Administration
- INTRAVENOUS
- Indication Info
- <p><strong>4.1 Therapeutic indications</strong></p>
<p><em><strong>Surgery:</strong></em><br>
Glyceryl Trinitrate-hameln is indicated for:</p>
<ol>
<li>the rapid control of hypertension during cardiac surgery.</li>
<li>reducing blood pressure and maintaining controlled hypotension during surgical procedures.</li>
<li>controlling myocardial ischaemia during and after cardiovascular surgery</li>
</ol>
<p><em><strong>Unresponsive congestive heart failure:</strong></em><br>
Glyceryl Trinitrate-hameln may be used to treat unresponsive congestive heart failure secondary to acute myocardial infarction.</p>
<p><em><strong>Unstable angina:</strong></em><br>
Glyceryl Trinitrate-hameln may be used to treat unstable angina, which is refractory to treatment with beta blockers and sublingual nitrates.</p>
- Contraindications
- <p><strong>4.3 Contraindications</strong><br>
Glyceryl Trinitrate-hameln should not be used in the following cases:</p>
<ul>
<li>Known hypersensitivity to the active substance, other nitro compounds or any of the excipients listed in Section 6.1 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em></li>
<li>Acute circulatory failure (shock, collapse)</li>
<li>Cardiogenic shock (unless a sufficient end-diastolic pressure is maintained by appropriate measures)</li>
<li>Severe anaemia</li>
<li>Severe cerebral haemorrhage</li>
<li>Head trauma</li>
<li>Uncorrected hypovolaemia and hypotensive shock</li>
<li>Arterial hypoxaemia and angina caused by hypertrophic obstructive cardiomyopathy</li>
<li>Constrictive pericarditis</li>
<li>Pericardial tamponade</li>
<li>Toxic pulmonary oedema</li>
<li>During nitrate therapy, phosphodiesterase inhibitors type 5 (PDE5) (e. g. sildenafil, vardenafil, tadalafil) must not be used because PDE5 inhibitors may amplify the vasodilatory effects of GTN resulting in severe hypotension (see sections 4.4 and 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</li>
</ul>
- Atc Code
- C01DA02
- Atc Item Name
- glyceryl trinitrate
- Pharma Manufacturer Name
- ZYFAS PHARMA PTE. LTD.
- Company Detail Path
- /organization/zyfas-pharma-pte-ltd