The suggested starting doses for nitroglycerin transdermal administration typically range from 0.2 mg/hr to 0.4 mg/hr, with available patch sizes delivering doses from 0.1 mg/hr to 0.8 mg/hr. Patches are usually worn for 12-14 hours daily, followed by a 10-12 hour patch-free period to prevent tolerance. Nitroglycerin transdermal patches are indicated for angina prevention, not acute attacks, due to their gradual onset. Proper dosing and application schedules should always follow a physician's guidance.
Key Points Explained:
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Recommended Starting Dose Range
- The standard initial dosing for Nitroglycerin Transdermal Patch falls between 0.2 mg/hr and 0.4 mg/hr.
- This range balances efficacy (angina prevention) with minimizing side effects like headaches or hypotension.
- Lower doses (e.g., 0.1 mg/hr) may be used for patients with heightened sensitivity or comorbidities.
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Patch Sizes and Corresponding Doses
- Available systems deliver doses proportional to their surface area:
- 5 cm²: ~0.1 mg/hr
- 10 cm²: ~0.2 mg/hr
- 15 cm²: ~0.3 mg/hr
- 20 cm²: ~0.4 mg/hr
- 30 cm²: ~0.6 mg/hr
- 40 cm²: ~0.8 mg/hr
- Larger patches (e.g., 0.6–0.8 mg/hr) are reserved for patients requiring higher maintenance doses after titration.
- Available systems deliver doses proportional to their surface area:
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Application and Wear Time
- Patches are typically applied to hairless, clean skin (e.g., chest, arm) and worn for 12–14 hours daily.
- A patch-free interval of 10–12 hours is critical to prevent tolerance (diminished therapeutic effect).
- Rotate application sites to avoid skin irritation.
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Clinical Indications and Limitations
- Used for prophylaxis of angina pectoris, not acute relief, due to slow onset (~30 minutes).
- Avoid abrupt discontinuation to prevent rebound angina.
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Practical Considerations for Purchasers
- Confirm prescribed dose (e.g., 0.2 mg/hr vs. 0.4 mg/hr) to select correct patch size.
- Monitor inventory for patch sizes matching common starting doses (10 cm² and 20 cm²).
- Educate patients on proper application and patch-free intervals to optimize adherence.
For individualized dosing, always defer to clinician judgment based on patient response and tolerance.
Summary Table:
| Key Aspect | Details |
|---|---|
| Starting Dose Range | 0.2 mg/hr to 0.4 mg/hr (lower for sensitive patients) |
| Patch Sizes & Doses | 5 cm² (0.1 mg/hr) to 40 cm² (0.8 mg/hr) |
| Wear Time | 12–14 hours daily, with 10–12 hour patch-free interval |
| Application Sites | Hairless, clean skin (chest, arm); rotate to avoid irritation |
| Clinical Use | Prophylaxis of angina (not acute relief); avoid abrupt discontinuation |
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