Glyceryl Trinitrate

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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

  1. 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): 251–262. doi:10.1136/bjsports-2018-099552. ISSN 1473-0480. PMC 6362607. PMID 30301735. Check date values in: |date= (help)