Dosing and uses of Duotrate, Pentylan (pentaerythritol tetranitrate)
Adult dosage forms and strengths
Not available in Us
Angina Pectoris (Treatment & Prevention)
10-20 mg PO QID, may increase to 40 mg PO QId
Erythrityl Tetranitrate (Cardilate)
10 mg PO/SL PRN to no more than 100 mg/day
Other Information
Take 1/2 hour before or 1 hour after meals and at bedtime
SR: 80 mg PO BID on empty stomach
Pediatric dosage forms and strengths
Not FDA approved in children
Duotrate, Pentylan (pentaerythritol tetranitrate) adverse (side) effects
Frequency not defined
Flushing, hypotension, postural hypotension, tachycardia
Dizziness, headache
Hypersensitivity, rash
Nausea
Warnings
Contraindications
Recent (last 24 hr) Sildenafil (Viagra) or other PDE5 inhibitor use: potential for dangerous hypotension
Hypersensitivity
Sever anemia
Cautions
Alcohol use, glaucoma, head trauma, cerebral hemorrhage, hyperthyroidism, hypertrophic cardiomyopathy, incr ICP, incr IOP, postural hypotension, volume depletion, recent MI
Discontinue if blurred vision develops
Gradually decr dose to avoid withdrawal rxn
May need 10-12 hr/d nitrate-free interval to avoid tolerance development
Pregnancy and lactation
Pregnancy category: C
Lactation: not known whether the drug crosses into breast milk, use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Duotrate, Pentylan (pentaerythritol tetranitrate)
Onset: immediate release: 20-60 min
Duration
Immediate release: 5 hr
SR: 12 hr
Other Information
Metabolism: extensively metabolized in liver
Metabolites: pentaerythritol trinitrate, pentaerythritol dinitrate, pentaerythritol mononitrate, & pentaerythritol (inactive)
Excretion: mainly in urine
Mechanism of action
Organic nitrate which causes systemic venodilation, decreasing preload.
Cellular mechanism: nitrate enters vascular smooth muscle and converted to nitric oxide (NO) which acts as a cellular messenger leading to activation of cGMP and vasodilation
