Nitroglycerin ointment for the prevention of postmenopausal osteoporosis.
OBJECTIVE
To determine whether clinical trial data support the use of nitroglycerin for prevention of postmenopausal osteoporosis.


METHODS
A literature search using MEDLINE (1966-September 2011) and EMBASE (1973-September 2011) was conducted using the search terms nitroglycerin, bone mineral density, fracture, and osteoporosis. References of identified articles were reviewed for additional citations.


METHODS
All English-language articles related to the use of nitroglycerin ointment in postmenopausal women were reviewed.


RESULTS
Four observational studies reported significant improvements in bone mineral density of postmenopausal women with the use of nitrates. One pilot study and 2 prospective, randomized, placebo-controlled clinical trials reported conflicting results regarding the efficacy of nitroglycerin ointment.


CONCLUSIONS
Clinical data do not support use of nitroglycerin for this indication; its potential is limited at this time by inconclusive efficacy and a high incidence of headache. Further well-designed clinical trials demonstrating efficacy and safety of nitroglycerin ointment for prevention of postmenopausal osteoporosis are needed before this medication can be recommended for routine use.
Manchester College School of Pharmacy, Fort Wayne, IN, USA.
Robert D
RD
Beckett
Amy Heck
AH
Sheehan
D015519:Bone Density / Q000187:drug effects*; D005260:Female; D006801:Humans; D005996:Nitroglycerin / Q000627:therapeutic use*; D009824:Ointments / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy / Q000517:prevention & control*; D010865:Pilot Projects; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic
D009824:Ointments; D005996:Nitroglycerin