Transdermal nitroglycerin: clinical and pharmacokinetic consequences of renewing the patch and the application site.
OBJECTIVE
We examined whether nitroglycerin (glyceryl trinitrate, GTN) patch treatment for 24 h could induce local cutaneous changes that impaired drug delivery and clinical efficacy.


METHODS
Twenty angina patients were exercise-tested after 2 and 24 h of treatment and then 2 h after patch renewal. The patch was either renewed on a new skin location or on the previous application site in a randomised, double-blind, cross-over protocol. GTN plasma concentrations and finger plethysmography were obtained before and after each exercise test.


CONCLUSIONS
The clinical efficacy, the effect seen on plethysmography and the GTN plasma concentrations tended to increase after patch renewal, regardless of the application site of the renewed patch. Hence, cutaneous changes of clinical importance could not be demonstrated.
Klemsdal
T O
TO
Department of Cardiology, Ullevål University Hospital, Oslo, Norway.
Mundal
H H
HH
Bredesen
J E
JE
Gjesdal
K
K
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D001682:Biological Availability; D018592:Cross-Over Studies; D005080:Exercise Test; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D017156:Photoplethysmography; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use
D014665:Vasodilator Agents; D005996:Nitroglycerin