Nitro-Bid Nitroglycerin Ointment 2%

Nitro‐Bid® is a prescription-strength 2% nitroglycerin ointment (20 mg/g) for topical use. It contains nitroglycerin (an organic nitrate vasodilator) in a lanolin/white petrolatum base (with a small amount of lactose). Each 1-inch strip of ointment (≈2.5 cm) delivers about 15 mg of nitroglycerin. Nitro-Bid is used to prevent angina pectoris (chest pain) in coronary artery disease by dilating blood vessels and reducing cardiac workload. Because the ointment is absorbed slowly through the skin, it is not for acute chest pain relief (its onset is too slow to treat an ongoing anginal attack). Nitro-Bid is Rx-only and for external use on skin.

Key Points:

• Active Ingredient: Nitroglycerin 2% (organic nitrate). Mechanism: relaxation of vascular smooth muscle (veins and arteries), reducing heart preload/afterload.
• Dosage Form: Ointment (semi-solid), supplied in tubes (e.g. 30 g) and as unit-dose foil packets (“foilpacs”). Comes with ruled paper applicator pads for dosing. (Each foilpac contains ~1 inch of ointment = ~15 mg nitroglycerin.)
• Indication: Prevention of angina pectoris due to coronary artery disease. Designed for maintenance therapy, not for stopping an active angina attack.
• Application: Use only on clean, hairless skin (typically on the chest or upper arm). Measure the prescribed amount using the supplied applicator: place the paper applicator printed-side down flat, squeeze ointment onto it. Then apply the applicator (ointment side down) to the skin and spread gently (do not rub in) over an area roughly the size of the applicator. Tape the applicator securely in place. Cover the site (and applicator) with plastic wrap to prevent nitroglycerin from staining clothing. Remove any remaining ointment from previous dose before applying fresh dose.
• Dosage/Regimen: A common starting schedule is ½ inch (≈7.5 mg) of ointment twice daily (e.g. morning and 6 hours later). Each foilpac (unit dose) is ~1 inch (≈15 mg). The dose can be increased (under physician guidance) up to 1–2 inch (15–30 mg) per dose if needed. Nitrate-Free Interval: It is essential to include a daily “nitrate-free” period (about 10–12 hours) to prevent tolerance. For example, a typical plan might use Nitrobid in the morning and late afternoon, then remove it overnight. Follow your doctor’s instructions for dose and timing. Discard used foilpacs immediately after use..
• Side Effects/Cautions: The most frequent side effect is headache (due to vasodilation). Patients may also experience lightheadedness, flushing, or dizziness, especially on standing up (orthostatic hypotension). Advise patients to rise slowly from sitting or lying. If dizziness or faintness occur, lying down may be needed. Nitroglycerin under the skin can also cause local redness or burning. Use only as directed; overdose signs (rapid pulse, severe headache, hypotension) require medical attention. Drug interactions: Concomitant use with PDE-5 inhibitors (e.g. sildenafil/Viagra) or other phosphodiesterase-5 inhibitors can cause dangerous hypotension and is contraindicated. Avoid alcohol or other blood-pressure-lowering drugs with Nitro-Bid. Do not use if allergic to nitroglycerin or if severe anemia or elevated intracranial pressure exists.
• Packaging and Handling: Nitro-Bid comes with a pad of app licators in each carton. Store at room temperature (20–25 °C). Keep the tube tightly closed and away from direct heat or flame (petrolatum base is flammable). Wash hands after handling. Ensure the applicator is disposed of properly — the foilpacs and paper applicators are single-use (discard after use). Cover furniture or bedding (plastic wrap) to avoid ointment staining, as Nitro-Bid can mark fabric.
• Regulatory: Prescription-only medication.

Nitro-Bid is a topical nitroglycerin ointment (2%) used for long-term prevention of angina pectoris in coronary artery disease. Doses are measured by length (inches) of ointment applied to the skin, using the supplied applicator. Proper use includes taping the applicator in place and allowing a daily nitrate-free interval to avoid tolerance. Headache and hypotension are common effects. Always follow the doctor’s directions for dose and timing. This medication, like all nitrates, should be handled carefully and used under medical supervision.

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