Acceptance of transcutaneous nitroglycerin patches by patients with angina pectoris

The acceptance, preference, and side effects of the 3 commercially available nitroglycerin patches were examined in 30 patients with chronic, stable angina pectoris. Patients were serially interviewed after each treatment period regarding patch comfort, aesthetics, discomfort upon removal, adhesiveness, efficacy, and side effects. They were also interviewed and examined for adverse skin reactions. There were significant differences among the 3 patches with respect to comfort, aesthetics, discomfort, and adhesiveness. Skin reactions (mostly mild) occurred in 83% of patients: patch A, 70%; patch B, 43%; and patch C, 57%. Intolerable reactions, which would have caused patch discontinuation, were noted in 40% of patients: patch A, 30%; patch B, 7%; and patch C, 10%. Most patients had an intolerable reaction to only 1 patch. Significant differences were present only between patches A and B with respect to total and intolerable skin reactions. Thus the systems differed in terms of patient preference and skin reactions. Skin reactions are probably more prevalent than previously reported but usually occur with just one of the patches. Physicians and hospitals should probably individualize nitrate patch therapy within formulary and budgetary constraints.