pentaerythritol tetranitrate (Discontinued)

Brand and Other Names:Duotrate, Pentylan, more...Peritrate
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Dosing & Uses

AdultPediatric

Not available in US

Angina Pectoris (Treatment & Prevention)

10-20 mg PO QID, may increase to 40 mg PO QID

Erythrityl Tetranitrate (Cardilate)

10 mg PO/SL PRN to no more than 100 mg/day

Other Information

Take 1/2 hour before or 1 hour after meals and at bedtime

SR: 80 mg PO BID on empty stomach

Not FDA approved in children

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Interactions

Interaction Checker

and pentaerythritol tetranitrate

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    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Flushing, hypotension, postural hypotension, tachycardia

            Dizziness, headache

            Hypersensitivity, rash

            Nausea

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            Warnings

            Contraindications

            Recent (last 24 hr) Sildenafil (Viagra) or other PDE5 inhibitor use: potential for dangerous hypotension

            Hypersensitivity

            Sever anemia

            Cautions

            Alcohol use, glaucoma, head trauma, cerebral hemorrhage, hyperthyroidism, hypertrophic cardiomyopathy, incr ICP, incr IOP, postural hypotension, volume depletion, recent MI

            Discontinue if blurred vision develops

            Gradually decr dose to avoid withdrawal rxn

            May need 10-12 hr/d nitrate-free interval to avoid tolerance development

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known whether the drug crosses into breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Onset: immediate release: 20-60 min

            Duration

            Immediate release: 5 hr

            SR: 12 hr

            Other Information

            Metabolism: extensively metabolized in liver

            Metabolites: pentaerythritol trinitrate, pentaerythritol dinitrate, pentaerythritol mononitrate, & pentaerythritol (inactive)

            Excretion: mainly in urine

            Mechanism of Action

            Organic nitrate which causes systemic venodilation, decreasing preload.

            Cellular mechanism: nitrate enters vascular smooth muscle and converted to nitric oxide (NO) which acts as a cellular messenger leading to activation of cGMP and vasodilation

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