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Nitrong Tablets

Nitrong

For medical students2 min readUpdated 2026-10-10

Nitrong tablets represent a microencapsulated oral formulation designed for a prolonged pharmacological effect. Their primary pharmacokinetic feature is the use of significantly higher active substance dosages compared to traditional sublingual preparations, which is necessary to overcome the hepatic first-pass metabolism.

Drug ClassMicroencapsulated tablet formulations
Onset of ActionLatent period ranges from 10 to 20 minutes
DurationThe therapeutic effect lasts for about 6 hours
MetabolismExtensively degraded in the liver upon absorption from the gastrointestinal tract
DosageHigh dose: contains over 0.005 g of active substance

Classification and Pharmacokinetics

Nitrong belongs to the group of microencapsulated oral formulations. Other representatives of this category include Nitrogranulong and Sustac forte.

Because this formulation is intended for swallowing (absorption occurs via the gastrointestinal tract), it has specific temporal parameters:

Dosage Specifics and Metabolism

It is essential to understand why the nitroglycerin dosage in Nitrong tablets differs significantly from sublingual formulations.

The drug contains substantially higher doses (exceeding 0.005 g). This is not accidental, but a pharmacokinetic necessity. Upon absorption from the gastrointestinal tract, the active substance enters the portal circulation and is delivered directly to the liver. There, it undergoes extensive degradation (first-pass effect). To ensure that a sufficient number of molecules reach the systemic circulation to exert a therapeutic effect, the initial dose in the microencapsulated tablet must be high.

Alternatives: Transdermal Formulations

To bypass hepatic degradation and avoid gastrointestinal absorption, transdermal (topical) drug delivery systems are utilized in pharmacology. Absorption in this case occurs directly through the skin.

Two primary transdermal forms are distinguished:

  1. Nitroglycerin ointment (2%) — begins to act within 30–40 minutes, with a total duration of effect reaching up to 5 hours.
  2. Transdermal therapeutic systems (TTS or patches) — including Nitropercuten TTS and Deponit.

Patches are applied to intact skin for 10–12 hours. Their mechanism relies on the steady release of the active substance (at a dose of 0.0005 g per 1 cm² per day). The effect of TTS develops on average within 30 minutes, and the total duration of action depends directly on how long the patch remains on the skin.

Mnemonic

The word "Nitrong" can be broken down as "NITROglycerin + lONG". These are microcapsules designed for a prolonged action lasting about 6 hours.

Frequently asked questions

What are the pharmacokinetic features of Nitrong tablets?

The pharmacokinetic features of Nitrong tablets include a delayed onset and prolonged maintenance of the therapeutic effect.

  • Onset of action — latent period is 10–20 minutes.
  • Duration of effect — lasts for about 6 hours.
  • Metabolism — upon absorption from the GI tract, the drug undergoes extensive hepatic degradation, which is why the tablets contain high doses of nitroglycerin (over 0.005 g).
What are the primary indications for Nitrong tablets?

The primary use of prolonged oral nitrate formulations is the prevention of angina pectoris attacks.

  • Attack prevention — prolonged nitrate formulations, including tablets, are used prophylactically.
  • Nitrong tablets are microencapsulated oral nitroglycerin formulations with an onset of 10–20 minutes and a duration of action of approximately 6 hours.
What side effects can occur when taking Nitrong tablets?

Side effects may arise due to the systemic vasodilating action of nitroglycerin.

  • Central nervous system — severe headache and dizziness.
  • Cardiovascular system — hypotension (up to orthostatic collapse), reflex tachycardia, facial flushing, and a sensation of heat.
  • Blood system — methemoglobinemia is possible in cases of overdose.

Because the drug is a sustained-release formulation, there is a high risk of developing tolerance with continuous use, and withdrawal syndrome upon abrupt discontinuation.

What is the mechanism of the anti-anginal action of nitroglycerin?

The anti-anginal mechanism of nitroglycerin is based on systemic vasodilation, which reduces myocardial oxygen demand.

  • Molecular level — enzymatic release of nitric oxide (NO) mediated by thiol enzymes, leading to cGMP accumulation and vascular smooth muscle relaxation.
  • Reduction of preload — venous dilation decreases venous return to the heart.
  • Reduction of afterload — arterial dilation decreases peripheral vascular resistance.
  • Coronary blood flow — redistribution of blood flow in favor of ischemic subendocardial layers occurs.
Why is the active substance dose in Nitrong tablets greater than 0.005 g?

A high dose is required to compensate for the extensive hepatic degradation of the drug. Upon absorption from the gastrointestinal tract, the substance inevitably passes through the hepatic barrier, where it loses a portion of its activity.

How soon does a patient feel the effect after ingestion?

The latent (lag) period for microencapsulated tablets ranges from 10 to 20 minutes.

What medications belong to the same group as Nitrong?

Microencapsulated tablet formulations also include Nitrogranulong and Sustac forte.

What is the main difference between transdermal forms and Nitrong tablets?

Transdermal forms (ointments and patches) are absorbed through the skin, completely bypassing the gastrointestinal tract and the initial hepatic first-pass metabolism.

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