Glyceryl Trinitrate

• Sublingual tablets 500micrograms (£7.53 = 100 sublingual tablets)
• Sublingual spray 400micrograms (£2.19 = 180 dose pump spray)

Indications

• Angina (acute relief)

Notes

1. GTN 500microgram sublingual tablets should be prescribed in quantities of 100 for the patient to keep in the unopened bottle until needed. Once open, the shelf life of the tablets is 8 weeks.
2. The spray may be more appropriate for those who only require GTN occasionally, as there are no shortened shelf life considerations.

Isosorbide mononitrate

• Modified-release tablets 60mg (click here for preferred brand)

Indications

• Angina (prophylaxis)

Notes

1. NICE guidance for stable angina recommends isosorbide mononitrate long acting is used only if betablockers and calcium channel blockers are contraindicated or not tolerated.
2. If initiating isosorbide mononitrate in nitrate naïve patients, commence with 30mg XL for the first 2-4 days (some tablets are scored and can be halved), or convert to XL product from standard release once tolerated. Prescribe the standard release tablets to be taken 8 hours apart rather than 12 hours to reduce the potential for nitrate tolerance.
3. Where a preferred brand is recommended for a particular presentation, prescribing by brand helps ensure cost-efficient use of local NHS resources (see preferred brand link above)

Isosorbide dinitrate

• Injection 25mg in 50ml (half strength), 50mg in 50ml