Trocer 2.6 SR

Indications

Trocer SR is recommended for the prevention of angina pectoris. It should be noted that this formulation does not act quickly enough to be effective in terminating an acute anginal attack.
Always consult a registered healthcare professional before using this medication.

Pharmacology

Nitroglycerin induces relaxation of the vascular smooth muscle, resulting in a vasodilatory effect on both peripheral arteries and veins. This venous dilation leads to increased blood pooling in the periphery, reducing the return of blood to the heart. Consequently, this decreases left ventricular end-diastolic pressure (preload). The relaxation of arteries decreases systemic vascular resistance and arterial pressure (afterload).

Dosage & Administration

Dosage must be tailored to each patient’s individual needs and the intensity of their anginal pain. For adults, it is generally recommended to take one 2.6 mg sustained-release Nitroglycerin tablet or capsule in the morning and evening, preferably on an empty stomach.
Always follow the guidance of a registered healthcare professional regarding medication use.

Interactions

Trocer SR causes peripheral blood vessel dilation, which may enhance the blood pressure-lowering effects of other vasodilators, calcium channel blockers, and beta-adrenergic antagonists. Using nitrates in conjunction with tricyclic antidepressants or alcohol can lead to elevated blood pressure. Additionally, combining nitrates with phosphodiesterase type 5 (PDE5) inhibitors—such as sildenafil, vardenafil, or tadalafil—may result in significant blood pressure drops. Aspirin can slow the clearance of Trocer SR and amplify its hemodynamic effects. Furthermore, Trocer SR may diminish the effectiveness of heparin when used together. Nitrates also increase the bioavailability of dihydroergotamine.

Contraindications

Nitroglycerin should not be used by individuals with a known hypersensitivity to nitroglycerin, other organic nitrates, or any components of the formulation. It is also contraindicated in cases of acute myocardial infarction, severe anemia, head trauma, cerebral hemorrhage, or closed-angle glaucoma.

Side Effects

While headaches are a common side effect at the onset of treatment, they typically resolve within a few days. If headaches persist, a dosage reduction may be necessary. Other potential side effects include tachycardia, postural hypotension, syncope, cyanosis, and methaemoglobinemia.

Pregnancy & Lactation

The safety of nitrates during pregnancy and breastfeeding has not been conclusively established. Therefore, Nitroglycerin should only be administered to pregnant women and nursing mothers if deemed essential by a healthcare provider.

Precautions & Warnings

Trocer SR should be used cautiously in patients prone to closed-angle glaucoma. Abruptly stopping therapy may worsen symptoms, so it is important to gradually taper the dosage over several days, with careful monitoring. During the initial phase of acute myocardial infarction, close monitoring of hemodynamics and clinical status is crucial to prevent complications such as hypotension and tachycardia.

Overdose Effects

In cases of overdose, symptoms may include peripheral vasodilation leading to decreased blood pressure and reflex tachycardia. Monitoring of cardiac function and supportive care is essential. If necessary, increasing circulating plasma volume through fluid replacement may be indicated. In severe situations, the use of vasopressors may be considered.

Therapeutic Class

Nitrates: Coronary vasodilators

Storage Conditions

Store in a cool, dry place, away from light and heat. Keep all medications out of reach of children.