Yixinmei Pentaerithrityl Tetranitrate Tablets

1. Indications and Usage
Chronic Angina: Indicated for the prophylactic treatment of angina pectoris.
Migraine: Also used for vasoconstrictive migraine.
2. Dosage and Administration
Standard Dose: The usual adult dosage is 10–30 mg taken orally 3 times daily.
Administration: Should be taken before meals.
Onset: The drug typically takes about 1 hour to become effective after oral administration, with effects lasting 4–6 hours.
3. Mechanism of Action
Nitric Oxide Donor: Similar to nitroglycerin, pentaerithrityl tetranitrate acts as a donor of nitric oxide (NO).
Vasodilation: NO activates guanylyl cyclase, increasing cyclic GMP in vascular smooth muscle, which leads to relaxation and vasodilation.
Hemodynamic Effects: It predominantly dilates veins, reducing preload and myocardial oxygen demand, while also dilating arteries to reduce afterload.
4. Safety and Warnings
Contraindications: Contraindicated in patients with severe hypotension, hypovolemia, right ventricular infarction, or increased intracranial pressure.
Special Populations: Use with caution in patients with severe liver or kidney dysfunction. Safety in pregnancy and breastfeeding is not well-established.
Tolerance: Continuous exposure can lead to tolerance (nitrate tolerance), reducing efficacy. A daily nitrate-free interval is often necessary.
5. Adverse Reactions and Clinical Research
Common Adverse Reactions: Headache (often transient), nausea, dizziness, blurred vision, and somnolence.
Hypotensive Effects: Can cause orthostatic hypotension, leading to dizziness or syncope, particularly when standing up.
Clinical Findings: Long-term use requires monitoring for tolerance and potential rebound angina if discontinued abruptly.
6. Drug Interactions
PDE5 Inhibitors: Concomitant use with phosphodiesterase-5 inhibitors (e.g., sildenafil) is contraindicated due to the risk of severe, life-threatening hypotension.
Alcohol: Moderate or excessive alcohol intake can potentiate the hypotensive effects of the drug.
Other Vasodilators: May enhance the hypotensive effects of other antihypertensive or vasodilating agents.
7. Pharmaceutical Information
Active Ingredient: Pentaerithrityl Tetranitrate.
Strengths: Typically available as 10 mg and 20 mg tablets.
Appearance: White or light yellow powder; tablets are usually white.
Storage: Store in a tight, light-resistant container at room temperature.