Pregnancy is always a special situation where every action or side effect of the drug varies when compared to a situation of a non-pregnant patient. It is not only because the pregnant woman's metabolism differs due to the hormonal and other changes happened to her, but also because every medicine or its metabolite passes to the baby and shows its action there. The only thing is, be cautious, attentive and well supervised when you take any single drug in pregnancy. The interactions can vary in pregnancy, and the dosage may differ as well. Strict supervision of the Physician is mandatory.
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Nitromak Retard crosses the placenta (David 2000).
Following a single maternal IV bolus dose of Nitromak Retard at the time of incision prior to cesarean delivery, concentrations in the umbilical cord at birth were significantly lower than the maternal plasma (~1 minute after dosing); a wide variation in maternal plasma concentrations was observed (David 2000). Following application of a transdermal patch 0.4 mg/hour to pregnant women 20 to 36 weeks gestation, concentrations of Nitromak Retard were low but detectable in the fetal serum ~1 to 4 hours after the patch was applied (fetal/maternal ratio: 0.23) (Bustard 2003).
Intravenous Nitromak Retard is recommended in pregnant females when preeclampsia is associated with pulmonary edema (ESC [Regitz-Zagrosek 2018]). Nitromak Retard may be beneficial in cases of uterine inversion following delivery when immediate relaxation of the uterus is needed (ACOG 183 2017). Additional data may be necessary to further define the role of Nitromak Retard use in other conditions requiring uterine relaxation, such as external cephalic version, retained placenta, or preterm labor (Abdel-Aleem 2015; Axemo 1998; Caponas 2001; Cluver 2015; Duckitt 2014).
Nitromak Retard breastfeeding
When a drug is taken when the patient is breast feeding, a part of the drug is secreted in her breast milk and is passed to the baby. The dosage of the medicine to mother and baby are different, and many drugs actions are side effects when you take them without a disease, and what if you the baby takes them without a disease? What if the drug is contraindicated in newborns, infants or children? So, breastfeeding is a very alarming situation when the mother is on medications. Ask your Physician or Pediatrician about the effect of the drug on the baby and how much is excreted in breast milk and if it harms the baby!
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AU: Contraindicated UK: A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother. US: Caution is recommended. Excreted into human milk: Unknown Excreted into animal milk: Data not available
Topical use for anal fissures by nursing mothers appears to have no adverse effects on their breastfed infants. This drug has been used topically on the nipples for Raynaud phenomenon of the nipples, but only after discontinuation of breastfeeding.
See references
References for pregnancy information
"Product Information. Tridil (Nitromak Retard)." DuPont Pharmaceuticals, Wilmington, DE.
Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
Cerner Multum, Inc. "Australian Product Information." O 0
"Product Information. Tridil (Nitromak Retard)." DuPont Pharmaceuticals, Wilmington, DE.
United States National Library of Medicine "Toxnet. Toxicology Data Network. Available from: URL: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT." ([cited 2013 -]):
DailyMed. "NITROGLYCERIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
PubMed Health. "Nitroglycerin (Oral route, Sublingual route): This section provide the link out information of drugs collectetd in PubMed Health. ". http://www.ncbi.nlm.nih.gov/pubmedhe... (accessed September 17, 2018).
Human Metabolome Database (HMDB). "Nitroglycerin: The Human Metabolome Database (HMDB) is a freely available electronic database containing detailed information about small molecule metabolites found in the human body.". http://www.hmdb.ca/metabolites/HMDB0... (accessed September 17, 2018).
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