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nitroglycerin (nitroglycerin, I2R / NitroMist)

✓ Approved

Seelos Therapeutics, Inc. · Small Molecule · Small Molecule

What is nitroglycerin?

nitroglycerin is a small molecule developed by Seelos Therapeutics, Inc.. It is approved for therapeutic indications via oral (po) or sublingual (sl)/oral transmucosal.

Drug Profile

Brand Namesnitroglycerin, I2R, NitroMist
CompanySeelos Therapeutics, Inc.
Drug ClassSmall Molecule
RouteOral (PO), Sublingual (SL)/Oral Transmucosal
StatusApproved
Sources: ClinicalTrials.gov, Seelos Therapeutics, Inc.

Therapeutic Indications

nitroglycerin is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Cardiac disordersAngina pectorisPreclinical

Related Research Articles

PubMedThe journal of headache and pain2026-05-23

Pharmacological and transcutaneous auricular vagal targeting of endoplasmic reticulum stress in the trigeminal ganglion alleviates migraine-like behaviors.

Lu Huan-Jun HJ, Huang Meng-Xuan MX, Wang Yi-Fan YF, Ren Ning-Yi NY et al.

Endoplasmic reticulum (ER) stress has emerged as a key player in the development of diverse chronic pain disorders; however, its specific contribution to migraine pathophysiology has yet to be fully elucidated. Although accumulating evidence indicates that transcutaneous auricular vagus nerve stimulation (taVNS) mitigates chronic pain, the precise molecular mechanisms governing this effect remain poorly understood. This study investigates the functional contribution of ER stress and its downstream signaling mechanisms in a nitroglycerin (NTG)-induced mouse model of chronic migraine, and whether taVNS exerts analgesic effects by modulating ER stress within trigeminal ganglion (TG) neurons. Chronic migraine was induced in mice via repeated intraperitoneal injection of NTG. Facial mechanical hypersensitivity was assessed using Von Frey filaments. Light-aversive and anxiety-like behaviors were evaluated through open field testing and light/dark box testing. mRNA and protein expression were analyzed using quantitative PCR (qPCR) and Western blot, respectively. The cellular localization of alpha7 nicotinic acetylcholine receptor (α7nAChR) receptors in the TG was determined by immunofluorescence staining. TG neuronal excitability was recorded using whole-cell patch-clamp electrophysiology. taVNS was delivered via the auricular branch of the vagus nerve using varying parameters. NTG injection induced migraine-like behaviors characterized by increased facial mechanical allodynia, anxiety-like behaviors and photophobia. Significant activation of ER stress-related marker proteins was observed in the TG of NTG-treated mice, and intra-TG injection of the ER stress inhibitor tauroursodeoxycholic acid (TUDCA) alleviated migraine-like behaviors and reduced neuronal excitability of TG neurons. Transcriptomic sequencing revealed that TUDCA treatment reduced the expression of genes related to the PI3K-AKT signaling pathway and cytokine-cytokine receptor interaction. Western blot confirmed that phosphorylated AKT (p-AKT) expression was also reduced by TUDCA. qPCR showed that NTG-induced upregulation of inflammatory mediators (including Ccl6, Ccl8, Ccl11 and Il-16) was also decreased by TUDCA. Additionally, daily treatment with 20 Hz taVNS mitigated ER stress, neuronal hyperexcitability, and inflammatory mediators' production, which were reversed by an inhibitor of α7nAChR. ER stress serves as an upstream driver of neuronal hypersensitivity and neuroinflammation in the TG, leading to pain sensitization, while taVNS targets this core organellar stress state through α7nAChR activation to exert therapeutic effects. These findings provide a novel mechanistic perspective and identify potential therapeutic targets for migraine treatment.

PMID 42174447
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PubMedPakistan journal of pharmaceutical sciences2026-05-22

Atorvastatin and nitroglycerin ointment in digit replantation: Associations with vascular crisis and circulating biomarkers.

Zhang Weihua W

Vascular crisis is a major threat to digit replantation success, leading to substantial failure rates and compromised functional recovery. To assess the association of combined atorvastatin and nitroglycerin ointment with vascular crisis, circulating biomarkers and clinical outcomes in patients undergoing unilateral digit replantation. 184 patients were prospectively allocated to combination (atorvastatin + nitroglycerin) or control (nitroglycerin alone) groups. Vascular crisis incidence, serum biomarkers (TNF-α, IL-6, CRP, NO, eNOS, ET-1), microcirculation indices and 30-day digit survival were systematically monitored. Combination therapy decreased vascular crisis incidence (6.52% vs. 16.30%, P=0.037) and improved 30-day digit survival (90.22% vs. 79.35%, P=0.040). Postoperatively, the combination group exhibited lower levels of TNF-α, IL-6, CRP and ET-1, along with higher NO/eNOS levels and improved microcirculation, with all differences statistically significant after Bonferroni correction (P<0.05). Atorvastatin combined with nitroglycerin ointment correlates with reduced vascular crisis and favorable 30-day outcomes, accompanied by beneficial shifts in biomarkers and microcirculation that may underpin the therapeutic effects.

PMID 42170963
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PubMedCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026-05-22

Low-Dose Colchicine for Secondary Prevention in Patients With Chronic Coronary Syndrome: A Multicenter Real-World Study.

Gürses Ecem E, Doğduş Mustafa M, Uyan Umut U, Öz Ahmet A et al.

Chronic coronary syndrome (CCS) remains associated with recurrent ischemic symptoms and impaired quality of life despite contemporary guideline-directed medical therapy. Low-dose colchicine has demonstrated prognostic benefits in randomized trials; however, real-world data regarding its effects on functional capacity and angina-related outcomes are limited. This multicenter, real-world observational study included 614 patients with CCS receiving low-dose colchicine therapy for secondary prevention. Functional capacity and angina-related quality of life were assessed before and after colchicine treatment using the Seattle Angina Questionnaire. Changes in daily physical activities, angina frequency, nitroglycerin use, treatment satisfaction, and Canadian Cardiovascular Society (CCS) angina class were evaluated. Clinical outcomes and tolerability, including hospitalization, revascularization, and gastrointestinal adverse effects, were also analyzed. A clinically meaningful improvement was defined as a ≥ 10-point increase in the composite Seattle Angina Questionnaire score. The mean age of the study population was 68.8 ± 11.5 years, and 70.5% of patients were male. Following colchicine therapy, significant improvements were observed in functional capacity, including walking on level ground, household activities, and carrying heavy objects (all p < 0.001). Angina frequency scores improved, accompanied by reduced nitroglycerin use (p < 0.001). Treatment satisfaction increased and limitations in enjoyment of life decreased significantly (p < 0.001). CCS angina class decreased from 2.61 ± 0.7 to 1.4 ± 0.62 (p < 0.001). A clinically meaningful improvement in SAQ score was observed in 78.7% of patients. During follow-up, hospitalization occurred in 9.0% of patients, revascularization in 4.4%, and gastrointestinal adverse effects were reported in 9.4%. In a multicenter real-world cohort of patients with chronic coronary syndrome, low-dose colchicine therapy was associated with significant improvements in functional capacity, angina severity, and quality of life, with an acceptable safety profile. The high rate of clinically meaningful patient-reported improvement further supports colchicine as an effective adjunctive therapy for secondary prevention and symptom control in routine clinical practice.

PMID 42171107
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PubMedCureus2026-05-22

Malignant Extra-adrenal Paraganglioma of the Bladder: A Rare Clinical Entity.

Korrapati Venkata Ramana VR, Kandhan Lakshmi L, T Chandru C, Kumaresan Natarajan N et al.

Bladder paragangliomas are uncommon extra-adrenal neuroendocrine tumors that arise from chromaffin tissue within the bladder wall. Clinical presentation varies from hematuria to catecholamine-related paroxysms, and malignant transformation, although uncommon, carries significant morbidity. We report a 45-year-old woman who presented with painless hematuria. Contrast-enhanced computed tomography (CECT) revealed a 3.6×3 cm lobulated, enhancing posterior bladder wall mass. Transurethral resection of the bladder tumor (TURBT) was performed, and histopathology confirmed paraganglioma. The patient was asymptomatic for six months, when she re-presented with recurrent hematuria and palpitations. Urinary normetanephrines were markedly elevated (3239 μg/24 h; normal 119-451 μg/24 h). 68Ga-DOTANOC positron emission tomography (PET)/CT revealed recurrence with right external iliac nodal metastasis. Following α- and β-blockade, she underwent anterior pelvic exenteration with an ileal conduit. Intraoperative hypertensive crisis (blood pressure (BP) 224/120 mmHg) was managed with nitroglycerin infusion. Histopathology revealed malignant paraganglioma infiltrating perivesical fat (pT3b) with nodal metastasis (pN1). The tumor demonstrated comedo-type necrosis, >250 cells/HPF, atypical mitoses, and Ki-67 index of 40%. The Grading of Adrenal Pheochromocytoma and Paraganglioma (GAPP) score was 9, indicating poorly differentiated high-risk disease. Immunohistochemistry was positive for chromogranin, synaptophysin, S100, and INSM1. Margins were negative. Bladder paragangliomas are rare but clinically significant due to their malignant potential. Radical surgery with meticulous perioperative hemodynamic control is the cornerstone in recurrent/metastatic disease. Lifelong follow-up with imaging and biochemical surveillance is mandatory.

PMID 42170150
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PubMedAesthetic surgery journal2026-05-21

Establishing a Predictive Perfusion Threshold Using SPY-PHI QP in Staged Breast Reconstruction: A Prospective Evaluation With Nitroglycerin Adjustment.

Rezania Nikki N, Harmon Kelly A KA, La-Anyane Okensama O, Fritsch Annie A et al.

The SPY Fluorescence Imaging system enables intraoperative visualization of microvascular perfusion. Recently, SPY has been integrated with Quantitative Perfusion (QP) software to provide numerical assessment of relative tissue perfusion; however, clinically actionable perfusion thresholds predictive of mastectomy skin necrosis complications have not been clearly established. To evaluate the predictive performance of proposed SPY-PHI QP perfusion thresholds in patients undergoing staged breast reconstruction and to explore a QP-specific cutoff while accounting for nitroglycerin ointment use as a potential confounder. Patients undergoing staged breast reconstruction with tissue expander placement were included. SPY-PHI QP was used intraoperatively to assess relative perfusion. Diagnostic performance metrics-including sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and odds ratios-were calculated. A sub-analysis excluding patients who received nitroglycerin ointment was performed to identify a QP-specific cutoff in unmanipulated tissue. Fifty-eight patients (83 breasts) were included. Using a 33% perfusion threshold, SPY-PHI QP® demonstrated high sensitivity (87.5%) and negative predictive value (98.3%) for mastectomy skin flap necrosis. After adjusting for nitroglycerin use, the association between low perfusion and mastectomy skin flap necrosis was attenuated. In patients who did not receive nitroglycerin, a perfusion threshold of 30% demonstrated optimal diagnostic performance (sensitivity 100%, specificity 76.7%, AUC 0.8875). SPY-PHI QP provides quantitative, real-time assessment of tissue perfusion during breast reconstruction. In patients not treated with nitroglycerin, a 30% perfusion threshold may be predictive of wound complications. These findings support further investigation of QP-specific thresholds in larger, prospective studies that account for adjunctive interventions.

PMID 42161886
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PubMedThe journal of headache and pain2026-05-20

Medial prefrontal cortex-targeted low-intensity focused ultrasound alleviates migraine-related allodynia and affective symptoms via modulating glutamate/GABA balance in mice.

Liu Jiayi J, Zhang Mingjie M, Cai Qiuquan Q, Yang Chunxiao C et al.

Migraine affects nearly one billion people worldwide and remains a major global health burden with inadequate treatment options. In this study, transcranial low-intensity focused ultrasound (LIFU) targeting the medial prefrontal cortex (mPFC) was assessed as a novel, non-invasive neuromodulatory strategy for migraine abortive treatment. The therapeutic potential and safety of LIFU were evaluated in animal models to support its future clinical translation. Male C57BL/6 mice were administered intraperitoneally with nitroglycerin (NTG) to induce an acute migraine model, whereas control animals received vehicle (VEH). Following model induction, mice were subjected to either mPFC-targeted LIFU or sham stimulation, which underwent an identical protocol without ultrasonic output. A series of behavioral, histological, and molecular assays was performed to evaluate the therapeutic effects and neuromodulatory mechanisms of LIFU. Mechanical allodynia was assessed using the von Frey test; anxiety-like behavior was evaluated in the elevated plus maze. Neuronal activation was examined via c-Fos immunofluorescence and GABA/glutamate co-staining. Tissue safety was assessed by HE staining and TUNEL assay. All quantitative analyses were conducted under blinded conditions. NTG injection induced significant allodynia and anxiety-like behaviors. LIFU stimulation significantly attenuated cephalic and plantar allodynia and ameliorated anxiety-like behaviors compared to the sham group. The NTG-induced migraine model exhibited significant mPFC c-Fos hyperactivation, which LIFU stimulation effectively suppressed. NTG injection significantly increased the proportion of activated glutamatergic neurons (GLU-N) and decreased activated GABAergic neurons (GABA-Ns) among total c-Fos-positive cells in the mPFC. This imbalance was reversed by LIFU, i.e., it was characterized by a decrease in activated GLU-Ns and an increase in activated GABA-Ns. No significant histopathological damage or apoptosis was detected following LIFU exposure. Aberrant activation and excitatory and inhibitory (E/I) imbalance of neurons in mPFC were involved in acute NTG-induced episodes. The LIFU targeting mPFC could alleviate NTG-induced mechanical allodynia and anxiety-like behavior by restoring E/I balance. LIFU is a novel, safe, non-invasive neuromodulatory strategy offering a potential migraine treatment.

PMID 42157087
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