Posology : מינונים

4            Dosage and administration
General rules
Nitroderm TTS is not intended for the immediate relief of acute attacks of angina pectoris; if these occur, rapid-acting nitrate preparations should be used.
The response to nitrate preparations varies from patient to patient; the lowest effective dose should be prescribed. The application site should be changed regularly to prevent local irritation.
Development of tolerance or attenuation of therapeutic effect commonly occurs with prolonged or frequent administration of long-acting nitrates, including Nitroderm TTS or other transdermal systems. A patch-off period of 8-12 hours, usually at night, every 24 hours is recommended to overcome tolerance. Clinical trials have shown that in most patients intermittent therapy is more effective than continuous administration. Continuous application of Nitroderm TTS may be appropriate for patients in whom long-term clinical responsiveness can be reliably assessed.

Prophylaxis of angina pectoris
Treatment should be initiated with one Nitroderm TTS 5 daily. According to the clinical response the daily dose can then be titrated upwards to:
• one Nitroderm TTS 10 (normal maintenance dose)
• one Nitroderm TTS 10 plus one Nitroderm TTS 5
• two Nitroderm TTS 10 
Special populations

Geriatric patients (above 65 years age)
No specific information on use in the elderly is available; however, there is no evidence to suggest that the dosage needs to be adjusted in elderly patients.

Pediatric patients
Not enough is known about the effects of Nitroderm TTS in children, which means that it cannot be recommended for use in this age group.
NIT API JUN21 V4.1                        Page 2 of 11