NIROWIN 2.6 Tablet 25's

Introduction About NIROWIN 2.6 TABLET

NIROWIN 2.6 TABLET contains Nitroglycerine that belongs to the group of
medicines called Vasodilators. It is used for management of angina pectoris due
to coronary artery disease.

Angina is a type of chest pain which is caused by reduced blood flow to the
heart as a result of coronary artery disease. Symptoms are feeling pressure,
squeezing, heaviness, tightness or pain in the chest or a heavy weight is lying
on the chest.

Along with NIROWIN 2.6 TABLET your doctor may advise you to make certain
lifestyle changes such as quitting alcohol and smoking, eating a healthy diet,
manage weight and to improve your sleep pattern.

NIROWIN 2.6 TABLET is not recommended for use in patients having heart diseases
(hypertrophic obstructive cardiomyopathy), anaemia, raised pressure in head,
raised pressure in the eye (glaucoma), or are taking medicines to manage
erectile dysfunction (sildenafil, vardenafil, tadalafil.

NIROWIN 2.6 TABLET should be used with caution in patients having liver or
kidney diseases, underactive thyroid gland, low body temperature,
malnourishment, abnormally low levels of oxygen in blood, very low blood
pressure, low blood volume, disease of the blood vessels supplying the brain, or
conditions that lower blood volume in the heart.

NIROWIN 2.6 TABLET should be used with caution in pregnant and breast-feeding
women. Take your doctor’s advice before taking the medicine. NIROWIN 2.6 TABLET
is not recommended for use in children. NIROWIN 2.6 TABLET should be used with
caution in elderly patients.

The most common side effects of taking NIROWIN 2.6 TABLET are throbbing
headache, spinning sensation, dizziness, drowsiness, lack of energy. Consult
your doctor if the symptoms worsen or doesn’t improve.

Uses Of NIROWIN 2.6 TABLET

• It is used for management of angina pectoris due to coronary artery disease

How NIROWIN 2.6 TABLET Works

NIROWIN 2.6 TABLET causes relaxation of smooth muscles within blood vessels
which leads to relaxation and widening of blood vessels. This improves blood
supply to the heart muscles. As a result, it helps to relieve chest pain and
blood pressure.

How to use NIROWIN 2.6 TABLET

Always use NIROWIN 2.6 TABLET exactly as prescribed by your doctor.

For Tablet, Capsule: Swallow NIROWIN 2.6 TABLET with a glass of water. Do
not crush or chew the medicine.

For Sublingual Tablet: Place NIROWIN 2.6 TABLET inside your mouth, below the
tongue and allow it to dissolve completely. Do not swallow or chew the medicine.

Your doctor will decide the correct dose and duration of therapy for you
depending upon your age, body weight and severity of disease condition. Continue
to take NIROWIN 2.6 TABLET for the stipulated duration prescribed by your doctor
to achieve better results.

Side Effects Of NIROWIN 2.6 TABLET

Common

• throbbing headache
• spinning sensation
• fall in blood pressure when seated or standing up
• dizziness, drowsiness
• lack of energy

Uncommon

• fainting
• facial flushing
• nausea, vomiting
• localised burning sensation
• tongue blistering
• circulatory collapse

Rare

• restlessness
• heartburn
• bad breath, red, itchy, or flaky skin, skin rash

Stop taking NIROWIN 2.6 TABLET and contact your doctor immediately if you
experience any of the following side effects:

• worsening of angina symptoms, chest pain
• signs of hypoxaemia (low levels of oxygen in blood) (difficulty breathing, increased rate of breathing)
• signs of methemoglobinemia (breathing problems, tiredness, headache)
• difficulty breathing, bluish discolouration of the lips, fingers or toes (cyanosis)
• rapid or slowed heartbeat
• blindness in one eye
• cerebral ischaemia (impaired blood flow to brain) which may cause weakness in one leg or arm, or weakness in one entire side of the body
• difficulty speaking, slurred speech
• loss of coordination, loss of consciousness
• allergic skin reactions

How To Manage Side Effects

Nausea:

Take this medicine with or after meals. Stick to simple meals while taking this
medicine. Avoid eating rich or spicy food. Do not consume any medication by
yourself. Take your doctor’s advice if nausea doesn’t improve or worsen.

Headache:

Try to take rest and do not involve yourself in exertive activities. Rest in a
quiet and dark room. Apply a pain-relieving balm on your forehead. Take your
doctor’s advice if headache doesn’t improve.

Vomiting:

Drink clear or ice-cold drinks. Eat bland, light foods and avoid fried, oily, or
sweet foods. Avoid carbonated drinks. Take your doctor’s advice if vomiting
doesn’t improve.

Dizziness:

Lie, or sit down immediately when you feel dizzy. If you're feeling severe
episode of spinning(vertigo), lie in a dark and quite place with eyes closed.
Try to avoid vehicle driving. Take your doctor’s advice if dizziness doesn’t
improve.

Drowsiness:

Take adequate sleep. Do not involve in rigorous activities. Do not interfere
with your sleep cycle. Talk to your doctor if the drowsiness doesn’t improve.

Warning & Precautions

!### Pregnancy

NIROWIN 2.6 TABLET should be used with caution in pregnant women. Consult your
doctor before taking NIROWIN 2.6 TABLET.

!### Breastfeeding

NIROWIN 2.6 TABLET should be used with caution in breastfeeding women.  Consult
your doctor before taking NIROWIN 2.6 TABLET.

!### Driving and Using Machines

Do not drive or operate any machines if you feel dizzy after taking NIROWIN 2.6
TABLET.

!### Alcohol

Avoid consum
may increase some effects of the medicine.

!### Kidney

NIROWIN 2.6 TABLET should be taken with caution in patients with severe kidney
disease. Consult your doctor before taking it.

!### Liver

NIROWIN 2.6 TABLET should be used with caution in patients with severe liver
disease. Consult your doctor before taking it.

!### Allergy

Do not take NIROWIN 2.6 TABLET if you are allergic to Nitroglycerine or any
other components of this medicine.

!### Heart Disease

NIROWIN 2.6 TABLET is not recommended for use in patients having heart diseases
such as hypertrophic obstructive cardiomyopathy (thickening of heart muscles).
NIROWIN 2.6 TABLET should be used with caution in patients having other heart
diseases such as have had a recent heart attack, narrowing of heart valves,
inflammation of heart, heart failure or fluid build-up around the heart. Consult
your doctor before taking NIROWIN 2.6 TABLET.

Others

NIROWIN 2.6 TABLET is not recommended for use if you:

• have anaemia
• have raised pressure in head (including that caused by an accident)
• bleeding on brain (pain in eyes, changes in vision, bad headache behind the eyes)
• raised pressure in the eye

Before taking NIROWIN 2.6 TABLET inform your doctor if you have:

• underactive thyroid gland
• low body temperature
• malnutrition (poor nutrition due to digestion problem or imbalanced diet)
• abnormally decreased levels of oxygen in the blood
• severely low blood pressure
• low blood volume
• conditions that lower the blood volume in the heart
• cerebrovascular diseases (diseases affecting the blood vessels supplying the brain)

Use in paediatrics:

NIROWIN 2.6 TABLET is not recommended for use in children. Ask for the advice of
your child’s doctor before giving it to your child.

Use in geriatrics:

NIROWIN 2.6 TABLET should be used with caution in elderly patients. Ask for your
doctor’s advice before taking the medicine.

Interactions

A. Drug-Drug interactions:

Before taking NIROWIN 2.6 TABLET, inform your doctor if you are taking any of
the following medicine:

• medicines for erectile dysfunction (male impotence) (Ex. sildenafil, vardenafil, tadalafil)
• medicines used to manage paracetamol overdose (Ex. n-acetylcysteine)
• medicines for migraine (Ex. ergotamine)
• other nitrates used to manage heart diseases (Ex. isosorbide dinitrate, isosorbide mononitrate, disopyramide), high blood pressure (Ex. ramipril, atorvastatin)
• medicines used for thinning your blood and manage blood clots (Ex. warfarin)
• medicines used to manage Parkinson’s disease (Ex. apomorphine)
• medicines used to manage stomach ulcers (Ex. propantheline)
• medicines used to manage anxiety and depression (Ex. amitriptyline, isocarboxazid)

Overdosage:

If you or anyone else uses too much of NIROWIN 2.6 TABLET, consult your doctor
immediately or visit the nearby hospital. Symptoms of overdosage of NIROWIN 2.6
TABLET may include nausea, low blood pressure, restlessness, fainting, blue
coloration of the skin, methaemoglobin in the blood, breathing difficulties,
lack of oxygen in tissues, slow heartbeat or mental illness.

Synopsis

Drug	:	Nitroglycerin (Glyceryl trinitrate)
Pharmacological Category	:	Vasodilators
Therapeutic Indication	:	Angina pectoris
Dosage Forms	:	Tablet, Capsule, Sublingual Tablet, Injection, Patch, Spray

More Information

• Keep NIROWIN 2.6 TABLET out of reach in children
• Store NIROWIN 2.6 TABLET at room temperature below 25°C

FAQs About NIROWIN 2.6 TABLET

Q: Why is NIROWIN 2.6 TABLET prescribed?

A: NIROWIN 2.6 TABLET is used for management of angina pectoris due to coronary
artery disease. Angina is a type of chest pain which is caused by reduced blood
flow to the heart as a result of coronary artery disease. Symptoms are feeling
pressure, squeezing, heaviness, tightness or pain in the chest or a heavy weight
is lying on the chest.

Q: Can NIROWIN 2.6 TABLET be used in elderly patients?

A: NIROWIN 2.6 TABLET should be used with caution in elderly patients. Take the
medicines sat down to reduce possible low blood pressure or fainting. Your
doctor may change the dose to suit your condition. If you notice that NIROWIN
2.6 TABLET is not working as well at relieving pain as they have done, contact
your doctor.

Q: How to useNIROWIN 2.6 TABLET?

A: Always use NIROWIN 2.6 TABLET exactly as prescribed by your doctor.

For Tablet, Capsule: Swallow NIROWIN 2.6 TABLET with a glass of water. Do
not crush or chew the medicine.

For Sublingual Tablet: Place NIROWIN 2.6 TABLET inside your mouth, below the
tongue and allow it to dissolve completely. Do not swallow or chew the medicine.

Your doctor will decide the correct dose and duration of therapy for you
depending upon your age, body weight and severity of disease condition. Continue
to take NIROWIN 2.6 TABLET for the stipulated duration prescribed by your doctor
to achieve better results.

Q: Can NIROWIN 2.6 TABLET cause headache?

A: Yes. NIROWIN 2.6 TABLET can cause throbbing headache. If it happens, try to
take rest and do not involve yourself in exertive activities. Rest in a quiet
and dark room. Apply a pain-relieving balm on your forehead. Do not consume any
medication without consulting a doctor. Take your doctor’s advice if headache
doesn’t improve.

Q:Is it safe to consume alcohol while being managed with NIROWIN 2.6
TABLET?

A: You are advised not to drink alcohol with NIROWIN 2.6 TABLET, as some of the
effects of this medicine are increased such as dizziness. If you have a habit of
drinking alcohol, take your doctor’s advice before taking NIROWIN 2.6 TABLET.

Q: Can NIROWIN 2.6 TABLET affect my ability to drive?

A: As NIROWIN 2.6 TABLET can cause dizziness, you should make sure you are not
affected before driving or operating machinery, especially if taken with
alcohol. Do not drive or operate any machines if you feel dizzy after taking
NIROWIN 2.6 TABLET. You can resume doing your activities after you feel normal
again.

Useful Diagnostic Tests

• ECG (electrocardiogram)
• Kidney Function Tests
• Liver Function Tests
• Chest Xray