The Medical Letter on Drugs and Therapeutics
NitroMist Nitroglycerin Spray for Angina
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The FDA has approved a lingual aerosol formulation of nitroglycerin (NitroMist – Akrimax) for acute relief of an attack or acute prophylaxis of angina pectoris. It is the second nitroglycerin lingual spray to become available in the US; Nitrolingual Pumpspray was approved in 1985. Most patients with angina use sublingual nitroglycerin tablets.

PHARMACOKINETICS — After being sprayed on or under the tongue, nitroglycerin can be detected in plasma within 2 minutes, and levels persist for up to 90 minutes. It is metabolized mainly in the liver, partly to active metabolites that have a half-life of 40 minutes.

CLINICAL STUDIES — In an unpublished trial in 30 patients with stable angina, summarized in the package insert, single doses of 0.2, 0.4 and 0.8 mg of NitroMist significantly prolonged exercise duration to development of moderate angina by 1.2, 1.6 and 1.7 ... more      

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Title: NitroMist Nitroglycerin Spray for Angina
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