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Nictoris 10 mgNictoris 10 mg is indicated for the prevention and long-term treatment of angina pectoris.Theropeutic ClassPotassium-channel activatorPharmacologyNictoris 10 mg dilates arterioles and large coronary arteries by opening the potassium channels, and stimulates guanylate cyclase causing venous vasodilatation. It therefore reduces preload and afterload, and improves coronary blood flow.Dosage & Administration of Nictoris 10 mgAdult: The usual therapeutic range is 10 to 20 mg twice daily. The usual?starting dose is 10 mg twice daily, in the morning and in the evening?preferably, and should be titrated upwards in accordance with patients needs, response and?tolerance up to 40 mg twice daily, if necessary. An even lower starting dose of 5 mg twice daily may be used in patients particularly prone to headache. Eldery: There are no?special dosage requirements for elderly patients, but as with all medicines the lowest effective?dose should be used. Nictoris 10 mg should be administered with care, using low starting?dosages, in the elderly. Children: Not recommended. Nictoris 10 mg should be used with?caution in patients with serious hepatic dysfunction.Hepatic Impairment: Dose reduction may be necessary.Dosage of Nictoris 10 mgAdult: The usual therapeutic range is 10 to 20 mg twice daily. The usual?starting dose is 10 mg twice daily, in the morning and in the evening?preferably, and should be titrated upwards in accordance with patients needs, response and?tolerance up to 40 mg twice daily, if necessary. An even lower starting dose of 5 mg twice daily may be used in patients particularly prone to headache. Eldery: There are no?special dosage requirements for elderly patients, but as with all medicines the lowest effective?dose should be used. Nictoris 10 mg should be administered with care, using low starting?dosages, in the elderly. Children: Not recommended. Nictoris 10 mg should be used with?caution in patients with serious hepatic dysfunction.Hepatic Impairment: Dose reduction may be necessary.Interaction of Nictoris 10 mgAlthough no pharmacological and/or pharmacokinetic interaction has been obsen/ed in animal and human studies with Nictoris 10 mg associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide, rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered concurrently, especially in combination with alcohol.ContraindicationsNictoris 10 mg tablet is contra-indicated in patients who have shown?hypersensitivity to Nictoris 10 mg. Use is contra-indicated with cardiogenic shock and acute?myocardial infarction with acute left ventricular failure and low filling pressures, in patients with?hypotension, and in patients taking phosphodiesterase-5 inhibitors because concurrent use of?Nictoris 10 mg can lead to a serious drop in blood pressure. Warnings and precautions: Nictoris 10 mg?should be used with caution in patients who may have blood volume depletion or in those who?present with low systolic blood pressure (below 100 mm Hg). The use of the drug in patients with?cardiogenic shock, or acute myocardial infarction with acute left ventricular failure and low filling?pressures should be avoided. Nictoris 10 mg should be discontinued and appropriate measures taken?if mouth ulceration, stomatitis or persistent or severe buccal ulcerations, appear. Caution is?advised for the use of Nictoris 10 mg in patients with glaucoma. The hypotensive effect of other?vasodilators, tricyclic antidepressants or alcohol can be increased by administration in?combination with Nictoris 10 mg. Therapeutic doses of Nictoris 10 mg may lower the blood pressure of?hypertensive patients and Nictoris 10 mg therefore, as with other antianginal agents, should be used?with care when prescribed with antihypertensive drugs. Animal mutagenicify and carcinogenicity?studies have not revealed any adverse effect of Nictoris 10 mg when used under experimental?conditions.Side Effects of Nictoris 10 mgHeadache (usually transitory), flushing, dizziness, nausea, vomiting and weakness. Hypotension and reflex tachycardia at high doses.Pregnancy & LactationAlthough animal studies have not shown any harmful?effect of Nictoris 10 mg to the foetus, has not been studied in human pregnancy. Use in pregnant?women requires that the anticipated benefit be weighed against possible hazard. It is not known?whether the drug is excreted in human milk. Caution should be exercised when Nictoris 10 mg is?administered to a nursing mother. Drug interactions: Although no pharmacological and/or?pharmacokinetic interaction has been obsen/ed in animal and human studies with Nictoris 10 mg?associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide,?rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect?of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered?concurrently, especially in combination with alcohol.Precautions & WarningsHypovolaemia, low systolic BP, acute pulmonary oedema, pregnancy. May impair ability to drive or operate machinery.Overdose Effects of Nictoris 10 mgln the case of overdosage, the likely symptomatology may be peripheral vasodilation with a fall in blood pressure and reflex tachycardia. In such an event, monitoring of cardiac function and general supportive measures should be used. If not successful, circulating plasma volume should be increased by substitution of fluid. ln life-threatening situations, administration of vasopressors should be considered.Storage ConditionsStore in a cool and dry place, protected from light.Drug ClassesPotassium-channel activatorMode Of ActionNictoris 10 mg dilates arterioles and large coronary arteries by opening the potassium channels, and stimulates guanylate cyclase causing venous vasodilatation. It therefore reduces preload and afterload, and improves coronary blood flow.PregnancyAlthough animal studies have not shown any harmful?effect of Nictoris 10 mg to the foetus, has not been studied in human pregnancy. Use in pregnant?women requires that the anticipated benefit be weighed against possible hazard. It is not known?whether the drug is excreted in human milk. Caution should be exercised when Nictoris 10 mg is?administered to a nursing mother. Drug interactions: Although no pharmacological and/or?pharmacokinetic interaction has been obsen/ed in animal and human studies with Nictoris 10 mg?associated with beta-blockers, calcium antagonists, digoxin, a combination of digoxin/furosemide,?rifampicin, and cimetidine, it is not excluded that the drug may nevertheless potentiate the effect?of other vasodilators, tricyclic antidepressants and antihypertensive drugs administered?concurrently, especially in combination with alcohol.