Suscard – Glyceryl trinitrate uses, dose and side effects

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2.5 mg, 5 mg buccal tablet er
glyceryl trinitrate

What Suscard is and what it is used for

Suscard contains the active substance glyceryl trinitrate and is used for angina in the heart. It works by widening the blood vessels and thereby facilitates the work of the heart. The effect occurs within 2-3 minutes. Suscard is used before an activity that is expected to cause chest pain (situational prophylactic treatment).

The tablet is placed under the upper lip. The time the tablet has an effect depends on how long the tablet is retained under the lip and can amount to 3-5 hours. The effect can be stopped earlier by taking the tablet out and the effect then disappears within 10-20 minutes.

Suscard can also be used to relieve sudden chest pain.

What you need to know before using Suscard

Do not take Suscard:

  • if you are allergic to glyceryl trinitrate or any of the other ingredients of this medicine (listed in section 6).
  • if you are allergic to other medicines containing nitrates.
  • together with medicines used for impotence such as sildenafil, vardenafil, or tadalafil (see also Other medicines and Suscard ).
  • if you have angina caused by a particular disease of the heart muscle (consult your doctor).
  • if you have increased pressure in the brain (such as with brain hemorrhage or head injury).

Warnings and precautions

Talk to your doctor or pharmacist before taking Suscard.

  • If the pain persists after 15-20 minutes despite treatment with Suscard, a doctor should be contacted immediately.
  • In certain forms of brain damage and heart disease, it may be inappropriate to use Suscard. Those who have brain damage, heart disease, low blood pressure, anemia, or poor thyroid function should therefore consult a doctor before starting treatment with Suscard.
  • Suscard may impair oxygenation in patients with lung disease.
  • Suscard contains lactose, if you cannot tolerate certain sugars, you should contact your doctor before taking this medicine.

Other medicines and Suscard

Tell your doctor or pharmacist if you are using, have recently used, or may be using other medicines at the same time as Suscard, even non-prescription ones. Certain medicines can affect or be affected by treatment with Suscard.

Suscard should not be used at the same time as certain medicines used for impotence (containing sildenafil, vardenafil, tadalafil) as this can result in a serious drop in blood pressure which can cause permanent damage to the heart and brain. Suscard can increase the blood pressure-lowering effect of antihypertensive drugs and lead to fainting attacks.

The risk of low blood pressure and fainting also exists when combined with alcohol. When Suscard is used with a long-acting nitrate preparation, the risk of developing tolerance should be monitored. The use of drugs containing nitrates can affect the anticoagulant effect of heparin, in case of simultaneous treatment with these substances the anti-coagulant effect should be checked.

Suscard with food, drink, and alcohol

Suscard can be used while eating or drinking. However, some patients prefer to take the tablet before a meal. It must then be replaced with a new tablet after the meal. The used tablet should always be thrown away.

There is a risk of low blood pressure and fainting when combined with alcohol.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before using this medicine.

Pregnancy

There is only limited experience with the use of Suscard in pregnant women. Use of Suscard during pregnancy should only be considered if the expected benefit to the mother outweighs any potential risk to the fetus.

Breast-feeding

It is unknown if Suscard passes into breast milk. A risk to the nursing child cannot be ruled out.

Fertility

It is unknown whether Suscard affects fertility.

Driving ability and use of machinery

As dizziness may occur when taking Suscard, this should be taken into account when increased attention is required, for example when driving a car or using machinery.

You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires increased attention. One of the factors that can affect your ability in these respects is the use of drugs due to their effects and/or side effects. Description of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. Discuss with your doctor or pharmacist if you are unsure.

Suscard contains lactose

Suscard contains lactose, if you cannot tolerate certain sugars, you should contact your doctor before taking this medicine.

How to take Suscard

Always take this medicine as directed by your doctor. Your doctor adjusts the dose individually for you. Ask your doctor or pharmacist if you are unsure.

Suscard can be used preventively before a situation that usually gives rise to chest pain or as a treatment for already triggered chest pain. The tablet should be taken out about 15 minutes after the strenuous activity has ended. If you have not used nitroglycerin before, the first dose should be taken while sitting or lying down, as there is a risk of dizziness.

The tablet should be placed far up on the gums under the upper lip. It can sit on the left or right side. The tablet is put in place either directly (see figure) or by placing the tablet on the tongue and then bringing it up under the lip.

ATTENTION! If you use dentures, the tablet should be placed in the same way, but where it feels comfortable under the upper lip. The tablet must have contact with the upper lip.

In the beginning, when you are above the tablet under the lip, it usually dissolves quite quickly. Over time, the tablet will last longer. The effect remains as long as the tablet remains under the upper lip, and is thus interrupted when it is taken out. Used tablets should always be thrown away.

The tablet’s position should be alternated between the right and left sides.

If you happen to swallow a tablet by mistake, it is not dangerous, and you can replace it with a new one if the need for Suscard remains.

If you stop using Suscard

If you have used Suscard for a long time and taken several tablets at the same time, you should not stop the treatment suddenly, but reduce the dose gradually to avoid the return of chest pain.

If you have further questions about this medicine, contact your doctor or pharmacist.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

If the side effects are bothersome, the tablet can be taken out of the mouth, whereby the side effects quickly disappear.

Very common (may affect more than 1 in 10 users): Headache

Common (may affect up to 1 in 10 users): Dizziness, drowsiness, feeling of lethargy.

These effects may occur the first few times you take the medicine, and are due to Suscard dilating the blood vessels. After treatment a few times, the symptoms disappear/reduce.

Stinging or stinging sensation under the upper lip. This effect is due to the dilation of the blood vessels where the tablet sits.

Nitroglycerin can sometimes lower blood pressure and make you feel dizzy. You can also get palpitations.

Uncommon (may affect up to 1 in 100 people): Nausea, fainting, heart attack, reduced oxygenation, facial flushing, nausea, vomiting, and insufficient blood circulation.

Rare (may affect up to 1 in 1,000 users): Increased caries frequency.

Very rare : (may affect up to 1 in 10,000 users): Effects on the blood count, restlessness, lack of oxygen in the brain, heartburn, bad breath, difficulty breathing, scaly reddening of the skin, rash.

If any side effects get worse or if you notice any side effects not mentioned in this information, contact your doctor or pharmacist.

How to store Suscard

Keep this medicine out of the sight and reach of children.

Use before the expiry date stated on the packaging after the Expiration date.

The expiration date is the last day of the specified month.

Medicines must not be thrown into the drain or among the household waste. Ask the pharmacist how to dispose of medicines that are no longer used. These measures will help to protect the environment.

Contents of the packaging and other information

Contents declaration

  • The active substance is glyceryl trinitrate 2.5 mg and 5 mg respectively.
  • Other ingredients are peppermint essence, mint essence, stearic acid, lactose monohydrate, anhydrous lactose, silicon dioxide, and hypromellose.

Appearance and package sizes of the medicine

The buccal tablets are white and round.

Blisters, 30, 90, and 100 tablets.

Not all pack sizes may be marketed.

Marketing Authorisation Holder:

Manufacturer:

SC Laropharm SRL, 145 A Alexandriei street, Bragadiru, Ilfov, 077025, Romania

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