nitroglycerin patches

Has anyone with chronic angina used these successfully?
I'm tempted to ask for them.
Are there contraindications?
all best for the New Year

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I use the nitro paste 12 hours a day. It does seem to help some

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YES, I use the Nitro-Dur transdermal patch, 0.8mg/hour. They do help. However, with longtime (5 years) chronic unstable angina, I still have angina "adventures" both "big" (pain level 6-7-8>) and "small" (3-4-5). I recently opted for Spinal Cord Stimulation (by Medtronic), implanted Oct 31 2012, and it is reducing the "small" angina adventures. Try the patches and see how they work for you, of course, getting the OK from your cardiologist!

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Hi there,

I use the patches every day (10mg). You can only use them for 12 out of every 24 hours because the body need time off or it can get resistant to the nitro effect. I use them at night (8pm - 8am) because my coronary artery spasm is worse at night. I don't think I have any side effects and noticed an improvement in my chest pain as soon as I started using them. I no longer have to use my nitro spray all the time!!

I can thoroughly recommend them. I have even got the ok from my cardiologist to use an extra patch when I do competetive running as it stops me having to use my spray every few kms. I noticed with that also a massive improvement in my capabilities exercise wise.

Good luck!!


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Yes, nitro patches are only used part of the day; I wear mine from about 9am to 9pm.

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Hi patch users ...
Have all of you used long acting nitrates like Imdur (mononitrate) before you tried the patch? If yes WHY did you swap to the patch instead?
I have asked my cardiologist if I could try the patch, but she said NO!
Smiles Tamara

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Yes I was on imdur first last time I was in the hospital they took me off and put me on the paste 12 hours during the day. They really never gave me a reAson, but the imdur wasn't helping that' much

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The patch is easier and less messy than the pAste but with the paste u can use more if needed. That's why my dr went with the paste

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Yes and they work better that the pills for me.

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I am on longer acting nitro tablets as well but use the patches at night becasue I have coronary artery spasm which is worse at night and stops me sleeping. I don't know why I was put on the patches but they appeared when I was in hospital and I am loathed to stop them as they work so well. I have found a lower dose long acting nitro tablet and the patch the best combination for me. I know every cardiologist seems to have their favourite treatments and often dont explain their rationale!! we are only the person who it is affecting but sometimes they forget that we might like to know what they are doing to us!

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Yes, I too was on Imdur for a while, then I was switched to another med (I take so many meds I can't keep track:) and also put on the Nitro-Dur patch. My cardiologist said, simply, that the Imdur was not working (as I was continuing to have frequent angina "adventures"). However, it took until I had the SCS (Medtronic) implant two months ago - on top of all my meds and the Nitro patch - that I am +finally+ getting some relief from so frequent angina adventures. The SCS has improved the quality of my life, a blessing as I approach the five year mark with my Heart Adventures.

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Thanks ever so much everyone. I'll go for it! I want to walk and dance!

(-I suppose I'll have to adjust ranexa, bisoprolol, isopomorbide, ramipril doses? I was fainting recently with LBBB).


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Ranexa! That's what I got after I went off Imdur!

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I have been on nitro patch because nothing else works and this has been the case since 2008. I am never to be without it as the severity of my MVD warrants it 24/7. I am faithful on checking by BP as that is a common issue with nitro. Nitro patch or paste are old drug forms and have been used by CAD patients for many, many years. Tolerance and the studies done on nitro need to be reviewed and correct information taken from those studies.
I have found out that the break recommended by the nitro maker is based on these studies. The break needed from nitro is not possible for me but I understand that any reduction of dose can easily re-set the enyzmes that act upon the nitro. Rememeber that nitroc oxide, the end result of the metabolic breakdown of nitrogylcerine is a naturally found ( endogeneous) in our bodies. The exogenous ( outside the body) donation of Nitric oxide from nitrogylcerine is why we are prescribed this drug as the body needs it to react on the endotheilum of our vessells, especailly a very good reaction on our heart's vessels.....thank goodness. It is a daily life saver for me and my dosage has had little change since my cardiac arrest at Emory.
I also use the spray form immediately when I feel that a cardiac demand has not worked well and that extra nudge really helps my vasospastic vessels open up more and settle down.

We would not be having any of these on going problems with under prescribing or not prescribing this amazing old drug if physicians would read beyond the drug insert and trust that the patient can monitor there own BP and be given a chance at a trial just like we do with many other drugs that have a vessel dilating effect. I recently met an older doctor who has a 20 year use patient who about every 2 years experiences a diminshed effect of the 24/7 nitro patch use. The patient, in pain is admitted, sedated, given pain med and then kept sedated for 24-36 hours and monitored. After that time, the nitro is re-applied and the patient goes on to be fully feeling the relief and is discharged. The physician calls it a 'nitro holiday'. So the studies do say that reapplication and a challenge with exercise does show that the nitro continues to work. Good Luck to all. And please have a view of me spraying nitro on Episode Angina. Joan

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Thank you for the info, once again,don't ever leave this forum, or we will come after you!!

I use Ranexa, and Nitro-dur patch .04 and take off at bedtime as my escapades are usually in the evening.
Have gone 6 days now with out an attack, but also diagnosed yesterday with nasty C-Diff!!
Resulting from Antibiotics in hospital, due to Ischemic colitis, due to Prinzmetals, such a nice chain of events in 7 weeks:

Joan, is it because the Nitro lowers our BP, that we need to monitor it?

From my heart,

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The Nitro patch was recommended for me because I can take the patch off when my blood pressure gets too low. You miss that option with the long acting pills. As for adjustments with a patch vs paste, if one patch isn't enough I can add another one. I really prefer it and the Imdur has a side effect of causing swelling which was a problem for me.

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I was diagnosed June 2007, with this horrible, unforgiving disease and I think I must be the only one who cannot get her doctors to put her on nitro patches. The first nitro I ever saw was the little tablets they gave me June 13, 2012, after my first HA. Every time I have said something, I get ignored! I have been on and taken off a lot of the meds you are all using. I have fired seven doctors last year for doing nothing. I give up! I would love to try nitro patches and get rid of this pain I have ALL the time all day!

Hugs and Hope

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Mine is improving a bit now but I was like you, Christie. Angina is not supposed to be like that is it? Do you spend your life being admitted to A and E or do you try and ignore it?
I feel for you.

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Hi Christie, My pain is mostly controlled with 5mg Amlodipine and 60-90mg Isosorbide Mononitrate (Imdur/Duride) I also use nitro-lingual as needed, some days not at all and other dyas 1-10x ... Thr Imdur only works for 12-16 hours and then if needed these last 8 hours of the day I use nitolingual.
My cardiologist refuses to let me try the pathc, as she said it is still in the experimental use stage in the USA and she is not going to budge!
so for now I am just getting on with what I have nad for the most part I can carry on with nitro-lingual bottles everywhere! (Car, by the bed, in my office, in my purse and by my exercycle)

Christie are you taking a long acting nitrate to give you some cover during the day? And a Calcium Channel Blcoker? I was first started on Amlodipine, but my "big" pains only started to subside a bit when the Imdur was added to the cocktail.
Please don't give up ... life is worth the fight and the more we fight the more women will will save from this in the furture. So we are fighting for more than ourselves!

Smiles Tamara

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Christie, I'm so sorry you have found so many MDs who won't even TRY it. Keep going, or you have to be tied in (and your local MD) to a big research facility.

xoxoxo Mary

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<"My cardiologist refuses to let me try the pathc, as she said it is still in the experimental use stage in the USA" >

Hi Tamara,

I have never heard before that the Nitro Patch was experimental for angina/chest pain. The patch that I use was approved by the FDA in 1996. Could it be that the insurance company doesn't cover it because it's more expensive than the paste and they consider it experimental? (The use of it for Osteoporosis is sill experimental according to the People's Pharmacy and medical studies are being conducted on it, but that's all I could find.)

A new store pharmacist saw how often I was filling my pill form of nitro and said I really needed to talk to my cardiologist right away. I went though a couple of different meds before winding up on the nitro patch. The cardiologist who put me on it was at a large teaching hospital so I don't know if that made a difference in anyway. But she insisted on the patch over paste because of the higher accuracy of receiving the correct dosage. It doesn't smear or slide off, the right dose is in full contact with your skin and doesn't come in contact with anything else. In the hospital the paste would come out from under the paper and make a mess all the time.

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