Generic Name: glyceryl trinitrate
Product Name: Anginine
Indication: What Anginine is used for
Anginine is used for angina.
Angina is a pain or discomfort in the chest, often spreading to the arms or neck and sometimes to the shoulders and back. This is usually caused by too little blood and oxygen getting to the heart muscle. The pain of angina is usually brought on by exercise or stress. Other factors may also cause angina. Anginine is used to treat an angina attack or to prevent one developing.
Your doctor may have prescribed Anginine for another reason.
Ask your doctor if you have any questions about why this medicine has been prescribed for you.
There is no evidence that Anginine is addictive or habit forming.
Action: How Anginine works
Anginine belongs to a group of medicines called nitrates. It lets more blood and oxygen reach the heart muscle.
Anginine redistributes blood flow along collateral channels and from epicardial to endocardial regions and thus may increase blood flow to ischaemic areas. Anginine also reduces oxygen demand by increasing venous capacitance causing pooling of blood in the peripheral veins and thereby reducing ventricular volume. Furthermore, the fall in arterial pressure will also reduce myocardial oxygen demand, although this may be offset by a reflex tachycardia. The beneficial effects of nitrates in pulmonary oedema depend on venous dilation and reduction of pre-load. Anginine causes coronary vasodilation in coronary arteries that are in spasm, and may relieve pain in variant angina by this mechanism.
Anginine is thought to exert its vasodilator effect through the activation of guanylate cyclase in vascular smooth muscle cells by nitric oxide; this results in an increased synthesis of cyclic guanosine monophosphate, which leads to smooth muscle relaxation.
Anginine contains 600 microgram of the active ingredient glyceryl trinitrate.
Anginine tablets also contain lactose, dextrin, maize starch, mannitol, glycerol, magnesium stearate.
Anginine tablets contain lactose.
Dose advice: How to use Anginine
Before you use it
When you must not use it
Do not use Anginine if you have ever had an allergic reaction to:
- Glyceryl trinitrate, the active ingredient in Anginine;
- Other medicines containing glyceryl trinitrate.
- For example skin patches (such as Deponit, Minitran, Nitradisc, NitroDur, Transiderm-Nitro), and sprays (such as Nitrolingual Spray).
- Any medicine or food containing nitrates or nitrites;
- Any of the ingredients listed here.
Symptoms of an allergic reaction may be mild or severe. They usually include some or all of the following:
- Asthma, wheezing or shortness of breath;
- Swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing;
- Hayfever, lumpy rash (“hives”) or itching;
- Do not use Anginine if you are pregnant, trying to become pregnant or breastfeeding unless your doctor says you should;
- Not all heart problems are suitable for treatment with Anginine.
Do not use Anginine if you have a heart condition known as hypertrophic obstructive cardiomyopathy (HOCM).
- Do not use Anginine if you have or have had a head injury;
- Do not use Anginine if you have suffered a stroke due to a haemorrhage in the past;
- Do not use Anginine if you are taking Phosphodiesterase 5 inhibitors such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra);
- Do not use Anginine after the expiry date (EXP) printed on the pack, or more than three months after you first open your bottle.
If you use the tablets after the expiry date has passed, they may not work as well.
- Do not use Anginine if the packaging is torn or shows any signs of tampering;
- Do not take Anginine if the tablets show any visible signs of deterioration (e.g. broken or discoloured).
If you’re not sure whether you should be using Anginine, talk to your doctor.
Before you start to use it
You must tell your doctor if you have:
- An allergy to foods, dyes, preservatives or any other medicines;
- Poor blood supply to the brain;
- A blood condition, such as anaemia (reduced red blood count);
- Lung problems;
- May be worsened by nitrates;
- A recent heart attack.
- Nitrates may lower blood pressure and cause a fast heartbeat which may aggravate problems associated with heart attack;
- Heart problems as a complication of lung problems;
- Severe coronary artery problems as a complication of lung problems;
- poor liver function;
- An overactive thyroid gland (hyperthyroidism);
- Any other medical condition.
Taking other medicines
Tell your doctor if you are taking or using any other medicines, including medicines you buy without a prescription from a pharmacy, supermarket or health food shop.
Some medicines may affect the way other medicines work. Your doctor or pharmacist will be able to tell you what to do when using Anginine with other medicines.
It is especially important that your doctor knows if you are taking any of the following:
- Medicines for high blood pressure;
- Medicines for heart conditions;
- Medicines for depression;
- You must not use phosphodiesterase 5 inhibitors such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) if you are taking Anginine.
Use in children
Do not give Anginine tablets to children.
We do not have enough information on use in children so it is not recommended for that age group.
Use in elderly
Elderly patients may be more sensitive to the side effects of Anginine tablets. It is advisable to take half a tablet as a starting dose.
How to use it
The pharmacist’s label on the pack will tell you how to use Anginine.
If there is something you do not understand, ask your doctor or pharmacist.
How much to use
At the first sign of an attack, sit down and place 1(one) Anginine tablet under your tongue or in your cheek, and allow it to dissolve.
If the Angina is not relieved within 5 minutes, take another dose of Anginine. You may use up to 2 tablets to relieve the angina pain or discomfort.
If a total of 2 fresh tablets and rest do not relieve your angina within 10 minutes, then you should immediately call an ambulance or the nearest hospital.
Anginine tablets are scored, so you can break or cut them in half. You should discuss your overall dose with your doctor.
How to use
Anginine is absorbed through the lining of your mouth.
Place your Anginine tablet under your tongue, or in your cheek and allow to dissolve.
It will dissolve more easily if your mouth is not dry.
Do not swallow, chew or crush your Anginine tablet, as swallowed Anginine tablets are NOT effective.
While the tablet is dissolving, avoid any eating, drinking or smoking until the tablet has completely dissolved.
Sometimes you may feel tingling in your mouth when using Anginine. However, the tablet still works even if you do not feel tingling.
When to use it
Use Anginine tablets at the first symptom of an angina attack.
Your doctor may also advise you to use Anginine just before exercise or stressful situations to stop you getting an angina attack.
How long to use it
After using Anginine, you should get relief of your angina pain or discomfort within a few minutes. When this occurs you may spit out any of the tablets which remain in your mouth to avoid side effect such as headache.
If your angina pain or discomfort is not relieved by a total of 2 fresh Anginine tablets within 10 minutes, then you should immediately call an ambulance or nearest hospital.
If you use too much (overdose)
Immediately telephone your doctor or the Poisons Information Centre (telephone 131126) for advice, if you think you or anyone else may have taken too much Anginine, even if there are no signs of discomfort or poisoning. You may need urgent medical attention.
Keep telephone numbers for these places handy.
Too much Anginine may cause bluish-coloured lips, fingernails or palms of hands; dizziness or fainting; feeling of extreme pressure in the head; shortness of breath.
If you are not sure what to do, contact your doctor or pharmacist.
While you are using it
Things you must do
Use Anginine exactly as your doctor has prescribed.
If you do not follow your doctor’s instructions, you may not get relief from your attacks of angina. Always carry your Anginine with you.
Tell all doctors, dentists, pharmacists and health professionals involved in your care that you are using Anginine.
Tell your doctor or pharmacist that you are using Anginine if you are about to be started on any new medicines.
Tell your doctor if you become pregnant or are trying to become pregnant.
Tell your doctor if, for any reason, you have not used your tablets exactly as prescribed.
Otherwise, your doctor may think that it was not effective and change your treatment unnecessarily. Keep a record of the number of angina attacks, when they happen and the possible cause (e.g. during exercise).
Tell your doctor if you continue to have angina attacks or if your angina attacks seem worse when using Anginine.
This helps your doctor give you the best possible treatment.
Things you must not do
Do not stop using Anginine, or change the dose without first checking with your doctor.
Do not give this medicine to anyone else, even if his or her symptoms seem similar to yours.
Do not use Anginine to treat any other complaints unless your doctor says so.
Things to be careful of
Be careful driving or operating machinery until you know how Anginine affects you.
Anginine may cause dizziness or faintness in some people. Make sure you know how you react to Anginine before you drive a car, operate machinery or do anything else that could be dangerous if you become dizzy or faint.
Get up slowly when getting out of bed or standing up, as you may feel light-headed, dizzy or faint.
You may feel light-headed, dizzy or faint after using Anginine. This is because your blood pressure drops. While the medicine is working, it is better for you to sit down and rest for a while. Especially if you are feeling dizzy or faint. Standing up slowly, especially when you get up from lying or sitting, will help your body get used to the change in position and blood pressure. Be careful when drinking alcohol while you are using Anginine.
If you drink alcohol whilst using Anginine, your blood pressure may drop, making you feel dizzy or faint.
After using it
Anginine tablets can easily lose their strength if not stored properly. Glyceryl trinitrate, the active ingredient in Anginine tablets, becomes less effective very easily.
- Keep your Anginine tablets in a cool, dry and dark place where it stays below 25°C.
- Do not carry the tablets close to your body where they become warm;
- Keep your supply of Anginine tablets in the original glass bottle.
- Always keep the lid tightly closed or your tablets will lose strength more quickly;
- Obtain a fresh supply of Anginine within three months after you first open the bottle, even if you have not used all the tablets.
- It is helpful to write the date of opening on the label of the bottle. Do not use Anginine tablets after the expiry date on the bottle;
- Do not store your Anginine tablets mixed with any other tablets.
- Always keep Anginine tablets out of reach of children.
- A locked cupboard at least one and a half metres above the ground is a good place to store medicines which you do not need to carry;
- Do not store it, or any other medicine, in a bathroom or near a sink.
- Heat and dampness can destroy some medicines;
- Do not leave Anginine in the car or on windowsills.
- Keep your Anginine tablets out of direct sunlight.
If your doctor tells you to stop using Anginine, or the Anginine has passed its expiry date, ask your pharmacist what to do with any Anginine left over.
Schedule of Anginine
Anginine is an S3 (Pharmacist Only Medicine).
Side effects of Anginine
Check with your doctor as soon as possible if you have any problems while using Anginine, even if you do not think the problems are connected with the medicine or are not listed here.
Like all medicines, Anginine can cause some side-effects. If they occur, they are most likely to be minor and temporary. However, some may be serious and need medical attention.
The most usual side-effects are:
- Low blood pressure, feeling faint or dizzy;
- Flushing (redness) of the face;
- Fast heartbeat.
If you are troubled by a throbbing headache when you use Anginine, you may remove the remaining part of the tablet from your mouth once the angina pain is relieved. Ask your doctor or pharmacist to answer any questions you may have.
Rarely reported side-effects are:
Ask your doctor or pharmacist to answer any questions you may have.
If you think you are having an allergic reaction to Anginine, tell your doctor immediately or go to the casualty department at your nearest hospital. Symptoms usually include some or all of the following:
- Asthma, wheezing or shortness of breath;
- Swelling of the face, lips or tongue;
- Difficulty in swallowing;
- Difficulty in breathing;
- Hay fever;
- Lumpy rash (“hives”);
Tell your doctor or pharmacist immediately if you notice any of the following:
- Severe nausea (feeling sick) and vomiting;
- Swelling of the face;
- Severe rash, hives, or itching of the skin;
- Shortness of breath or other breathing problems;
- Bluish colour of lips, nails or palms of the hands;
- Severe dizziness or fainting (caused by impaired blood circulation to the brain);
- Weak or unusually fast heartbeat;
- Severe headache;
- Unusual tiredness or weakness;
- Worsening of your angina pain.
This is not a complete list of all possible side-effects. Others may occur in some people and there may be some side-effects not yet known.
Tell your doctor if you notice anything else that is making you feel unwell, even if it is not on this list.
Ask your doctor or pharmacist if you don’t understand anything in this list.
Do not be alarmed by this list of possible side-effects. You may not experience any of them.
For further information talk to your doctor.