Angist SR is indicated for acute relief of an attack or prophylaxis of angina pectoris due to coronary artery disease.
Important: If chest pain does not improve after the maximum recommended dose (3 tablets or 3 sprays within 15 minutes), seek emergency medical care immediately, as this may indicate a heart attack.
Angist SR is a nitrate medication used to prevent and relieve angina pectoris (chest pain caused by reduced blood flow to the heart). It works as a potent vasodilator, relaxing blood vessels and improving blood flow to the heart while reducing the heart’s workload. It is available as sublingual tablets, sustained-release tablets, and a metered-dose sublingual spray.
How It Works
Nitroglycerin releases nitric oxide (NO), which relaxes vascular smooth muscle. This causes:
- Dilation of veins, reducing blood return to the heart (preload)
- Dilation of arteries, reducing resistance against which the heart pumps (afterload)
- Improved oxygen supply to the heart muscle
- Reduced oxygen demand of the heart
These effects help relieve and prevent angina attacks.
Uses
- Acute relief of angina attacks
- Prevention of angina episodes
- Prevention of chest pain before physical activity known to trigger angina
Dosage
Sublingual Tablet (0.5 mg)
- Place 1 tablet under the tongue at the first sign of chest pain.
- If needed, repeat every 5 minutes.
- Maximum: 3 tablets within 15 minutes.
- Seek emergency medical attention if pain persists after 3 tablets.
Sustained-Release Tablets
- 2.6 mg: Usually 1 tablet twice daily before meals; may be increased if required.
- 6.4 mg: Usually 1 tablet twice daily.
Sublingual Spray
- 1–2 sprays under the tongue at the onset of chest pain.
- May repeat every 5 minutes if necessary.
- Maximum: 3 sprays within 15 minutes.
- May be used 5–10 minutes before activities likely to trigger angina.
Common Side Effects
- Headache
- Facial flushing
- Low blood pressure (hypotension)
- Dizziness
- Lightheadedness
These effects are often related to blood vessel dilation.
Important Precautions
- Sit or rest before using the spray or tablet to reduce the risk of dizziness or fainting.
- Avoid excessive use, as tolerance may develop over time.
- Use cautiously in patients with low blood pressure or dehydration.
- Do not inhale the spray; it should only be administered under the tongue.
Drug Interactions
Serious interactions can occur with:
- PDE-5 inhibitors such as sildenafil, tadalafil, and vardenafil (can cause life-threatening hypotension)
- Blood pressure medicines
- Beta-blockers
- Phenothiazines
- Alcohol
- Aspirin (may enhance nitroglycerin’s effects)
Contraindications
Angist SR should not be used in patients with:
- Use of sildenafil, tadalafil, or vardenafil
- Severe anemia
- Increased intracranial pressure
- Acute circulatory failure or shock
- Hypersensitivity to nitrates or nitrites
Pregnancy and Breastfeeding
Safety during pregnancy and breastfeeding has not been firmly established. It should only be used when the potential benefit outweighs the potential risk and under medical supervision.
Overdose Symptoms
Overdose may cause:
- Severe headache
- Vomiting
- Restlessness
- Marked hypotension
- Rapid heartbeat (tachycardia)
- Fainting (syncope)
- Cyanosis
- Methemoglobinemia
Immediate medical attention is required if overdose is suspected.
Storage
- Store below 25°C
- Protect from light and moisture
- Keep out of reach of children