Possible Interaction: Nitroglycerin and Vitamin C

“The data of clinic observation and ECG-monitoring show that ascorbic acid significantly increases antianginal vasodilatory effects of nitroglycerine thus preventing from development of ischemic miocardial reaction in response to complamin injection.”

“ Vitamin C did not affect ex vivo platelet aggregability but enhanced the inhibition of platelet aggregation by SNP (62.7 ± 10.2 to 82.7 ± 4.8%, p = 0.03) and tended to increase responses to GTN (40.5 ± 9.0 to 53.4 ± 7.3, p = 0.06).”

“ Vitamin C failed to restore either the hemodynamic or venous effects of NTG.”

“ Vitamin C inhibited relaxation to GTN but potentiated relaxations to NP and SNAP, causing a parallel shift to a lower concentration range of the log dose‐response curve by approximately one log unit at the highest dose.”

“Pretreatment with 30 mg/kg vitamin C led to a significant decrease in CP formation: 0.27+/-0.14 microM (vitamin C plus GTN ) and 0.34+/-0.15 microM (vitamin C plus PETN).”

“Coadministration of carvedilol metabolite BM910228 or of Vit-C along with GTN suppressed noxious effects of GTN-induced oxidant stress such as increased platelet activity and impaired nitrate-induced vasorelaxation.”

“The basal cyclic guanosine monophosphate (cGMP) contents of platelets after GTN coadministered with BM910228 or with Vit-C increased on day 1 to 233 or to 250% versus control and remained at that level.”

“Cyclic GMP stimulation by GTN was up to 3.1‐fold higher when vitamin C (1–10 mM) was present during the pretreatment period.”

“During nonintermittent PETN and during GTN with additional vitamin C , a 9.8 +/- 0.4% coronary artery dilation was observed in contrast to that with GTN alone, which resulted in complete tolerance at day 4.”

“ Ascorbic acid prevented inactivation of XO, resulting in increased NO production from GTN.”