Angispan TR (nitroglycerin, also called glyceryl trinitrate) is a vasodilator prescribed to patients who experience angina (chest pain), primarily resulting from coronary artery disease. Less commonly it is also sometimes used to help manage hypertension, heart failure, and similar conditions.

Coronary artery disease is a condition in which the inner walls of arteries become clogged with plaque, causing a narrow passage for blood and making the artery rigid. This condition can cause the heart to be deprived of oxygen during times of physical activity or emotional turmoil, or sometimes for no apparent reason.

Angispan TR alleviate the effects of constricted, rigid blood vessels; the medication relaxes blood vessels and improves blood flow.

The TR in this product's name indicates it is timed release. While more standard nitroglycerin medications work quickly to stop chest pain, Angispan TR is meant to prevent angina from developing. If taken when chest pain has already begun, Angispan TR is unlikely to provide rapid relief.

How to Take Angispan TR

For best results patients should be seen by a doctor prior to starting treatment. A doctor can best determine dosage, frequency of administration, and address other concerns, such as other medications being taken that may interact with Angispan TR.

That said, treatment with tablets is often very similar:

• In most cases patients are started on 2.5 mg to 6.5 mg tablets.
• Tablets are taken 2 to 4 times per day, with 2 to 3 times per day being most common.
• Do not exceed 26 mg per day (6.5 mg taken 4 times).

Patients with chronic heart failure are often treated with higher amounts; 10 mg 3 times per day is not unusual. All patients should follow doctor instructions even if they deviate considerably from the above.

It may take a few days before significant results are noticed, and in some patients it can take a week or two before maximum benefit is reached. Provided no serious side effects develop, patients are encouraged to give the medication at least 2 weeks before deciding it doesn't work.

Most patients who take Angispan TR are better able to go through life---with all its ups and downs as well as physical activity---without experiencing angina, or with episodes reduced.

Lifestyle Changes

Most conditions that cause angina can be mitigated, at least to some extent, when appropriate lifestyle changes are made and adhered to. This understandably sounds unpleasant, and may be unpleasant at first, but it really is worth the effort, and is likely the only way to minimize or eliminate angina without medications. Common suggestions include:

• Reaching a healthy weight
• Improving diet
• Controlling blood sugar
• Controlling blood cholesterol
• Getting regular exercise
• Quitting smoking

There are many other lifestyle changes that may be advised; there is an abundance of information about them on the internet. A doctor can also offer suggestions customized to an individual, regarding particular problems a patient has and according to the patient's ability to apply them.

Precautions Before Use

One of the biggest concerns with Angispan TR is interactions with other drugs. While there are many potential interactions with a wide range of drugs---patients should always double-check with a doctor or pharmacist before adding new medications---of greatest concern are:

• Alcohol
• Aspirin
• Tricyclic antidepressants
• Anticholinergics
• Ergotamine
• PDE-5 inhibitors

Use of alcohol while taking Angispan TR may cause a dangerously low drop in blood pressure, while use with aspirin may enhance the medication's vosodilatory (widening of blood vessels) and hemodynamic (blood flow) effects, which can also cause a dangerous drop in blood pressure. Low blood pressure is as dangerous as high blood pressure, and can result in death.

PDE-5 inhibitors are sometimes given to lower high blood pressure, but more commonly are found in erectile dysfunction medications like Cialis or Viagra. Taken together, these drugs can also reduce blood pressure as well as decrease the effects of Angispan TR.

Adverse Reactions

Taken as directed, side effects are typically mild and often stop occurring within the first couple weeks of treatment. Commonly experienced are:

• Dizziness
• Lightheadedness
• Flushing
• Nausea

The above are not cause for concern unless severe or persistant.

Very rarely more serious side effects occur; seek emergency medical attention if experiencing:

• Fainting
• Fast heartbeat
• Pounding heartbeat
• Irregular heartbeat

Angispan TR is not recommended for use if pregnant or breastfeeding unless benefits outweigh the risks. Pregnant or breastfeeding mothers should discuss the issue with a doctor.