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DRUG REACTIONS
Nitroglycerin interacts with a1teplase Researchers from the US and Italy report that the
thrombolytic effects of alteplase [tissue-type plasminogen activator; Actilyse®] in acute MI are impaired in patients who receive concurrent nitroglycerin. The researchers believe that this is caused by a pharmacological interaction between the 2 agents.
Mean plasma tissue-type plasminogen activator antigen concentratIOns were> )U'1c lower 10 patients who received alteplase + nitroglycerin (n = 36) compared with those who only received alteplase (11); this difference persisted for 6 hours after the end of the alteplase infusion. The mean dose of IV nitroglycerin was 43 j.1g/min given for 9 hours and all patients received IV alteplase 100mg over 3 hours.
Reperfusion was sustained in only 44O/C of patients who received nitroglycerin + alteplase. compared with 91O/C of patients who received alteplase only. Furthermore. 28% of patients who also received nitroglycerin had intermittent reperfusion. Nicolini FA. Ferrini D. Ottani F. Galvani M. Ronchi A. et aI. Concurrent
nitroglycerin therapy impairs tissue·type plasminogen activator-induced
thrombolysis in patients with acute myocardial infarction. American Journal of
Cardiology 74: 662-666. I Oct 1994 100.-.
0156-2703194I095!HlOO211$01 .000 Adl. Inl8rMtlonal Umlted 111M. All rlghte ~
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INPHARMA- 15 Oct 111M