Heating and cooling of the nitroglycerin patch application area modify the plasma level of nitroglycerin
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19 healthy volunteers wore a nitroglycerin patch releasing 10 mg per 24 h for 2 h. Subsequently, the skin area surrounding the patch was exposed to 15 min of local heating with an infrared bulb (Group A, n =10), or local cooling with an ice-pack (Group B, n = 9). The patch was protected by an insulating shield (Styrofoam).
After 10 min of heating, the median (Walsh) plasma nitroglycerin level increased from 3.1 to 7.6 nmol·1−1. Body temperature remained constant. After 15 min of cooling the median plasma level had dropped from 2.1 to 1.4 nmol·1−1.
The results demonstrate that changes in skin temperature may cause extensive short-term changes in the bioavailability of nitroglycerin. Presumably, a subcutaneous or cutaneous reservoir builds up during transdermal treatment, and changes in regional cutaneous blood flow affect the rate of drainage from the reservoir into the systemic circulation.
Key wordsGlyceryl trinitrate transdermal patch, pharmacokinetics, cutaneous circulation, skin temperature
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