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Glyceryl Trinitrate: Difference between revisions
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==Formulations== | ==Formulations== | ||
There are two formulations in New Zealand. | There are two formulations in New Zealand. | ||
*Patches - 5mg/24 hour or 10mg/24 hour Nitroderm TTS patches are available. The literature describes using one-fourth to one-half of one of these doses but if you cut Nitroderm the medication leaks out. One can try use the full 5mg/24 hour dose or put medical tape under a portion of it. | *Patches - 5mg/24 hour or 10mg/24 hour Nitroderm TTS patches are available. The literature describes using one-fourth to one-half of one of these doses but if you cut Nitroderm the medication leaks out. One can try use the full 5mg/24 hour dose or put medical tape under a portion of it. The patches are fully funded. | ||
*Ointment - 0.2% Rectogesic. | *Ointment - 0.2% Rectogesic. This is not funded. | ||
== | ==Evidence== | ||
It can take up to 12 to 24 weeks to experience significant improvement. | There is no clear evidence of efficacy. A 2019 systematic review identified 10 eligible RCTs. There was improvement up to 6 months in pain, strength, and patient satisfaction with a mean effect size ranges from 0.12 to 0.26. It can be useful for all chronic tendinopathies as an adjunct to a loading programme. It can take up to 12 to 24 weeks to experience significant improvement.<ref>{{Cite journal|last=Challoumas|first=Dimitris|last2=Kirwan|first2=Paul D.|last3=Borysov|first3=Dmytro|last4=Clifford|first4=Christopher|last5=McLean|first5=Michael|last6=Millar|first6=Neal L.|date=2019-02|title=Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review|url=https://pubmed.ncbi.nlm.nih.gov/30301735|journal=British Journal of Sports Medicine|volume=53|issue=4|pages=251ā262|doi=10.1136/bjsports-2018-099552|issn=1473-0480|pmc=6362607|pmid=30301735}}</ref> | ||
==Adverse effects== | ==Adverse effects== | ||
Head is the most common in up to one in five patients. | |||
==Contraindications== | ==Contraindications== | ||
| Line 21: | Line 21: | ||
*Ingestion of phosphodiesterase inhibitors | *Ingestion of phosphodiesterase inhibitors | ||
*Ingestion of oral or sublingual nitroglycerin | *Ingestion of oral or sublingual nitroglycerin | ||
== Resources == | |||
{{PDF|Topical GTN for tendinopathies systematic review - Challoumas 2019.pdf|Topical GTN for tendinopathies systematic review - Challoumas 2019}} | |||
==See Also== | ==See Also== | ||
*[[Tendinopathy]] | *[[Tendinopathy]] | ||
== References == | |||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
Latest revision as of 08:13, 13 April 2022
This article is a stub.
Glyceryl Trinitrate is a treatment for Tendinopathy. It is applied to the degenerative area and may enhance collagen synthesis via the nitric oxide signaling molecule.
Formulations
There are two formulations in New Zealand.
- Patches - 5mg/24 hour or 10mg/24 hour Nitroderm TTS patches are available. The literature describes using one-fourth to one-half of one of these doses but if you cut Nitroderm the medication leaks out. One can try use the full 5mg/24 hour dose or put medical tape under a portion of it. The patches are fully funded.
- Ointment - 0.2% Rectogesic. This is not funded.
Evidence
There is no clear evidence of efficacy. A 2019 systematic review identified 10 eligible RCTs. There was improvement up to 6 months in pain, strength, and patient satisfaction with a mean effect size ranges from 0.12 to 0.26. It can be useful for all chronic tendinopathies as an adjunct to a loading programme. It can take up to 12 to 24 weeks to experience significant improvement.[1]
Adverse effects
Head is the most common in up to one in five patients.
Contraindications
- Hypotension
- Migraine headaches
- Rosacea
- Head injury
- Severe anaemia
- Ingestion of phosphodiesterase inhibitors
- Ingestion of oral or sublingual nitroglycerin
Resources
See Also
References
- ā Challoumas, Dimitris; Kirwan, Paul D.; Borysov, Dmytro; Clifford, Christopher; McLean, Michael; Millar, Neal L. (2019-02). "Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review". British Journal of Sports Medicine. 53 (4): 251ā262. doi:10.1136/bjsports-2018-099552. ISSN 1473-0480. PMC 6362607. PMID 30301735. Check date values in:
|date=(help)
