Cutaneous administration of nitroglycerin: a review

Chronic administration of nitroglycerin may have important therapeutic effects in patients with angina, acute myocardial infarction, congestive heart failure and peripheral vascular disease. Because of unpredictable oral absorption and short duration of action, topical preparations provide an alternative mode of administration. New controlled release transdermal preparations appear to produce constant plasma nitroglycerin concentrations of 0.2-0.3 ng/ml that persist for up to 24 hours. Additional clinical trials of the therapeutic response to this drug form are necessary, particularly in regard to the relative hemodynamic efficacy and side-effect profile of sustained vs. fluctuating plasma nitroglycerin concentrations.