Nidocard 400 mcg/METERED INHALATION Spray

Nidocard is a glyceryl trinitrate (nitroglycerin) metered spray, a nitrate vasodilator used in heart-related chest pain. It is mainly prescribed for angina by widening blood vessels and reducing the heart’s workload.

Nidocard 400 mcg/METERED INHALATION spray is a medicine from Drug International Ltd. that contains Glyceryl Trinitrate (GTN / Nitroglycerin), a fast-acting nitrate used to relieve and prevent angina — the tight, squeezing chest pain that occurs when the heart muscle does not get enough blood. Sublingual (under-the-tongue) forms act within minutes; longer-acting forms are used for prevention.

Glyceryl trinitrate is converted in the body to nitric oxide, a natural signal that relaxes the muscle in blood vessel walls. Veins widen first, so less blood returns to the heart and its workload drops; the coronary arteries that feed the heart muscle also widen. The heart then needs less oxygen while receiving more — which is why the chest pain eases within minutes of a sublingual dose.

• Acute angina attack — rapid relief of chest pain (sublingual tablet or spray)
• Prevention before exertion — taken minutes before activity known to trigger chest pain, such as climbing stairs
• Angina prophylaxis — longer-acting tablets or patches to reduce attack frequency
• Hospital uses — heart attack, acute heart failure and blood pressure control during surgery (infusion form)
• Anal fissure — special ointment form, as prescribed

ChamberBD shows dosing only from the approved product label, with its source named, and no label is on file for Nidocard 400 mcg/METERED INHALATION Spray. Use the dose your doctor prescribed and the instructions in the pack leaflet.

Most side effects come from blood vessels widening and are strongest in the first doses:

• Throbbing headache — very common; usually eases with continued use and responds to paracetamol
• Flushing, warmth of the face and neck
• Dizziness, light-headedness or faintness, especially on standing
• Fast heartbeat (palpitations)
• Low blood pressure; nausea
• Burning or tingling under the tongue (sublingual forms) — a sign the tablet is active
• Seek help if: fainting, severe persistent dizziness, blurred vision, or chest pain that does not settle

• Always sit down before taking a sublingual dose — the sudden pressure drop can cause fainting if you are standing.
• Carry Nidocard with you at all times; an angina attack cannot be scheduled.
• Do not drink alcohol around dosing — it multiplies the pressure drop.
• Rise slowly afterwards; avoid driving until dizziness passes.
• Tell your doctor if attacks become more frequent, occur at rest or wake you at night — this is unstable angina and needs urgent review.
• With regular long-acting nitrates, the body develops tolerance — your doctor will plan a daily nitrate-free interval; do not add extra doses yourself.
• Check the expiry and replace sublingual tablets as advised once the bottle is opened — old tablets lose potency.

• Erectile dysfunction medicines (sildenafil, tadalafil, vardenafil): absolutely must not be combined — together they can cause a catastrophic, life-threatening fall in blood pressure. A gap of at least 24 hours (sildenafil) or 48 hours (tadalafil) is required, decided by a doctor
• Riociguat: similarly contraindicated
• Other blood pressure medicines, beta-blockers, calcium channel blockers, diuretics: additive pressure drop
• Alcohol: increases dizziness and hypotension
• Ergotamine (migraine): nitrates can oppose it and ergotamine can worsen angina
• Heparin (infusion setting): effect may be reduced

Tell your doctor about all medicines you use — especially any medicine for erection problems.

• Allergy to glyceryl trinitrate or other nitrates
• Use of sildenafil, tadalafil, vardenafil or riociguat within the prohibited interval
• Severe low blood pressure or shock; severe anaemia
• Raised pressure inside the skull (head injury, brain haemorrhage)
• Hypertrophic obstructive cardiomyopathy, severe aortic stenosis, constrictive pericarditis (specialist assessment needed)
• Closed-angle glaucoma

Pregnancy: Glyceryl trinitrate is used in pregnancy only if the doctor judges the benefit outweighs the risk — human data are limited. It is sometimes used in hospital obstetric settings under specialist supervision. Tell your doctor if you are or may be pregnant before using it regularly.

Lactation: It is not known how much passes into breast milk. Occasional sublingual use is unlikely to be a problem, but discuss regular use with your doctor, who will weigh the options and monitor the baby if needed.

Store as printed on the pack and keep out of the reach of children.