Sublingual tablets: Discard tablets 8 weeks after opening bottle
Prescribe spray as Glyceryl trinitrate 400micrograms/ dose pump sublingual spray
Prescribing of patches in Primary Care should be on the advice of a specialist
Isosorbide Mononitrate (Tablet)
Short acting preparations should be administered twice a day with the last dose of the day in the early afternoon (asymmetric dosing) to allow an adequate nitrate-free period and prevent development of tolerance.
Isosorbide Dinitrate (Tablet, MR Tablet, 0.05% Solution for infusion, 0.1% Concentrate for dilution)
Injection: Hospital only (Glass or polyethylene infusion apparatus is preferable; loss of potency if PVC used)
RPH: 0.05% Solution for infusion and 0.1% Concentrate for dilution (For administration by IV infusion only except when administered by an intra-coronary injection during percutaneous coronary intervention)
NWAFT: 0.05% Solution for infusion
CUHFT: 0.05% Solution for infusion
Oral formulations: Formulary (Specialist advice)
Isosorbide mononitrate is preferred over isosorbide dinitrate as mononitrate preparations are more widely available and isosorbide dinitrate requires more frequent dosing.
Glyceryl Trinitrate (Nitrocine®) (Injection)
Injection: Glass or polyethylene apparatus is preferable; loss of potency will occur if PVC is used.
Non Formulary Items
Glyceryl Trinitrate (GTN® 300 mcg)
Isosorbide Dinitrate (Oral)
Prodrug of isosorbide mononitrate - use that instead.
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Available Over the Counter. Consider Self Care
Formulary - Can be prescribed in both secondary and primary care.
Formulary - Specialist Advice, secondary care advice provided for primary care initiation.
Formulary - Specialist initiation without shared care guidance.
Formulary - Specialist initiation with shared care guidance.
Restricted - Hospital only, not to be prescribed in primary care.
Not recommended for prescribing. Switch to alternative cost-effective option.
Not recommended for prescribing in primary or secondary care.
Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.