Drug General Information (ID: DDISMN0L9X)
Drug Name			Nitroglycerin		Drug Info		Heparin		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Vasodilator Agents				Anticoagulants
Structure

Mechanism of Nitroglycerin-Heparin Interaction (Severity Level: Moderate)
Antagonize the effect of antithrombotic agents Click to Show/Hide Mechanism Graph
Drug Name		Nitroglycerin				Heparin
Mechanism		Intravenous nitroglycerin may decrease the anticoagulant activities of heparin				Heparin
Key Mechanism Factor 1
		Factor Name		Antithrombotic agents
		Factor Description		The beneficial effects of antithrombotic agents are reduced, leading to an increased risk of thromboembolism, stroke and/or myocardial infarction.
Mechanism Description		Antagonize the effect of Heparin when combined with Nitroglycerin

Recommended Action
Management		If these agents are coadministered or if the nitroglycerin is discontinued, consider close evaluation of the coagulation status of the patient and titrate the heparin dose as needed.

References
1	Bushe C, Wales E "A possible interaction between heparin and intravenous nitroglycerin." Am J Cardiol 68 (1991): 290
2	Raschke R, Guidry J, Laufer N, Peirce J "Nitroglycerin-induced heparin resistance." Am Heart J 121 (1991): 1849-50
3	Barnette RE, Brister NW "Heparin nitroglycerin interaction." Anesthesiology 71 (1989): 991