MaxGun Sublingual Spray: Rapid Nitroglycerin Relief for Anginal Episodes

MaxGun Sublingual Spray

Price from 90.00 $

Product dosage: 10 ml
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MaxGun Sublingual Spray is a prescription medication formulated for the acute relief of angina pectoris attacks or for prophylactic use prior to anticipated physical or emotional exertion. It contains nitroglycerin, a potent vasodilator that acts primarily on the venous capacitance vessels, reducing preload and myocardial oxygen demand. This sublingual delivery system ensures rapid transmucosal absorption, bypassing first-pass metabolism for a swift therapeutic onset, typically within two minutes. It is an essential component of the management strategy for patients with confirmed coronary artery disease experiencing angina symptoms. The metered spray mechanism guarantees consistent and accurate dosing with each administration, making it a reliable emergency intervention.

Features

Active Ingredient: Nitroglycerin 0.4 mg per metered dose
Delivery System: Sublingual metered spray
Presentation: Glass bottle with patented, tamper-evident actuator and dust cap
Contents: 60 metered doses (200 actuations per container)
Onset of Action: Approximately 2-3 minutes
Duration of Effect: 30 to 60 minutes
Inactive Ingredients: Medium-chain triglycerides, peppermint oil, ethanol anhydrous

Benefits

Provides rapid relief from the pain and pressure of an ongoing angina attack.
Reduces cardiac preload and afterload, decreasing the heart’s workload and oxygen consumption.
The sublingual route offers superior bioavailability compared to oral tablets, ensuring consistent drug delivery.
The metered spray is more stable and less susceptible to degradation from environmental factors like light and moisture than traditional sublingual tablets.
The portable design allows for discreet and immediate use at the first sign of symptoms, whether at home or in public.
Can be used prophylactically to prevent angina episodes before engaging in known trigger activities.

Common use

MaxGun Sublingual Spray is indicated for the acute relief of an attack (treatment) or prophylaxis of angina pectoris due to coronary artery disease. It is used by patients with a confirmed diagnosis of stable angina. The spray is not intended for use in aborting acute myocardial infarctions. Patients should be instructed to use the spray at the very onset of anginal symptoms, such as chest pain, pressure, tightness, or pain radiating to the jaw, neck, shoulder, or arm.

Dosage and direction

At the earliest sign of an attack, sit down if possible.
Hold the spray container upright. Do not shake.
With the mouth closed, bring the container as close to the mouth as possible.
Press the button firmly to release one spray onto or under the tongue.
Do not inhale the spray. Close the mouth immediately after administration. Avoid swallowing for approximately 10 seconds.
If relief is not experienced within 5 minutes, a second dose may be administered.
If no relief is achieved after a total of 3 sprays within 15 minutes, this constitutes a medical emergency, and the patient or caregiver must seek immediate medical attention, as this may signal an acute myocardial infarction.
For prophylactic use, administer one spray 5 to 10 minutes prior to engaging in activity that is known to cause an angina attack.

Precautions

This medication can cause severe hypotension, especially in volume-depleted patients or those already taking other vasodilators or antihypertensive agents. This hypotension may be accompanied by paradoxical bradycardia and increased angina symptoms.
Syncope due to nitrate vasodilation has been reported.
Tolerance to the hemodynamic and antianginal effects of nitrates develops rapidly. To avoid tolerance, a daily nitrate-free interval of 10 to 12 hours is recommended. The dosing schedule should be planned to coincide with the patient’s individual vulnerability period.
Nitroglycerin can cause severe headaches, which may persist. Over-the-counter analgesics may be used to manage this side effect.
Use with caution in patients with hypertrophic cardiomyopathy, as nitrate-induced reduction in preload may exacerbate left ventricular outflow obstruction.
Nitrates may aggravate angina caused by aortic stenosis.

Contraindications

Hypersensitivity to nitroglycerin, other nitrates, or nitrites, or any component of the formulation.
Use of phosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, tadalafil, vardenafil) or soluble guanylate cyclase (sGC) stimulators (e.g., riociguat). Concomitant use can cause profound hypotension, syncope, or myocardial infarction.
Patients with severe anemia, increased intracranial pressure (e.g., following head trauma or cerebral hemorrhage), or uncorrected hypovolemia.
Constrictive pericarditis and cardiac tamponade.
Circulatory failure and shock states.

Possible side effect

The most common side effect, occurring in more than 10% of patients, is headache, which may be severe and persistent. Other frequently reported side effects (≥1% and <10%) include:

Hypotension, dizziness, and lightheadedness, especially upon standing (orthostatic hypotension)
Reflex tachycardia
Nausea and vomiting
Flushing, feeling warm
Syncope (fainting) Less common side effects (<1%) include:
Dermatitis and allergic skin reactions
Paroxysmal dyspnea
Palpitations
Weakness
blurred vision
Dry mouth

Drug interaction

Phosphodiesterase-5 Inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil): Absolutely Contraindicated. Concomitant use can lead to life-threatening hypotension.
Soluble Guanylate Cyclase (sGC) Stimulators (e.g., Riociguat): Absolutely Contraindicated. Profound hypotension risk.
Antihypertensive Agents (e.g., Beta-blockers, Calcium Channel Blockers, ACE inhibitors, ARBs, Diuretics): Additive hypotensive effect. Blood pressure must be monitored closely.
Alcohol: Potentiates the vasodilatory and hypotensive effects of nitroglycerin.
Dihydroergotamine: May decrease the vasoconstrictive effect of dihydroergotamine.
Aspirin: Coadministration may increase nitroglycerin bioavailability.
Adrenergic Agonists (e.g., Norepinephrine, Epinephrine): Nitroglycerin may reduce the vasoconstrictor effects of these agents.

Missed dose

This medication is used on an as-needed (PRN) basis for acute angina attacks. It does not have a scheduled dosing regimen, so the concept of a “missed dose” does not apply. The patient should use it immediately at the onset of symptoms.

Overdose

Symptoms: The primary manifestation of nitroglycerin overdose is vasodilation, resulting in severe hypotension with persistent throbbing headache, vertigo, palpitations, visual disturbances, flushing, perspiration, and syncope. Nausea, vomiting, and diarrhea may occur. Methemoglobinemia, with signs of cyanosis, hypoxia, and dyspnea, is a rare but serious complication, especially with high doses. Management:

Immediate Medical Attention is Required. Contact a poison control center or emergency room.
Supportive Care: Keep the patient recumbent in a shock position (legs elevated) to maximize venous return. Administer oxygen and respiratory support as needed.
Hypotension: Intravenous fluids are the primary treatment. If refractory, an alpha-adrenergic agonist (e.g., phenylephrine) may be considered. Epinephrine is ineffective and may exacerbate ischemia.
Methemoglobinemia: If diagnosed (typically at levels >30%), treatment with methylene blue (1-2 mg/kg IV over 5 minutes) is indicated.

Storage

Store at controlled room temperature 20°C to 25°C (68°F to 77°F). Excursions permitted between 15°C and 30°C (59°F and 86°F).
Keep the bottle in its original cardboard container to protect from light.
Do not freeze.
Do not expose to extreme heat or open flame. The contents are under pressure.
Do not puncture, break, or incinerate the container, even after it is empty.
Keep out of reach of children and pets.

Disclaimer

This information is for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The efficacy and safety profile of this product are based on clinical data; individual patient response may vary.

Reviews

Dr. Eleanor R., Cardiologist: “In my practice, I find the MaxGun spray offers a more reliable and stable delivery system compared to sublingual tablets, especially for elderly patients who may have difficulty handling small tablets. The onset of action is consistently rapid, which is critical during an anginal event.”
John D., Patient (5-star): “Having lived with angina for a decade, I’ve used various nitroglycerin forms. This spray is by far the easiest and fastest-acting. The peace of mind it provides is invaluable. The headache is significant but a small price to pay for the relief.”
Clinical Pharmacist Review: “The metered-dose mechanism ensures accurate dosing, which is a significant advantage. Patient counseling must emphasize the critical contraindication with ED medications. From a stability perspective, the spray formulation is superior for patients who may not use it frequently.”
Sarah L., Patient (4-star): “It works exactly as described, within minutes. The minty taste makes it more tolerable than the tablets. My only complaint is the price, but for effectiveness, it can’t be beaten.”
Dr. Marcus V., Emergency Medicine: “We often see patients in the ED who have correctly used their spray but got no relief, which is a crucial red flag for an MI. This product’s reliability makes it an effective tool not just for treatment, but also for helping to stratify cardiac risk.”