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Last Updated: December 16, 2025

CLINICAL TRIALS PROFILE FOR NITROGLYCERIN


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All Clinical Trials for nitroglycerin

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000503 ↗ Randomized Clinical Trial of Non-Surgical Reperfusion of the Coronary Arteries Completed National Heart, Lung, and Blood Institute (NHLBI) Phase 3 1982-08-01 To assess the effect of non-surgical reperfusion on infarct size in patients with acute myocardial infarction.
NCT00001716 ↗ Effects of Nitric Oxide and Nitroglycerin in Patients With Sickle Cell Anemia Completed National Institutes of Health Clinical Center (CC) Phase 2 1998-07-01 Sickle cell anemia is the most common genetic disease affecting African-Americans. About 1 in every 1000 African-Americans has the disease and 1 in every 12 carry the genes that could be passed on to their children. People with sickle cell anemia have abnormal hemoglobin, the molecules responsible for carrying oxygen in the blood. The abnormal hemoglobin can cause damage to the red blood cells. The damaged red blood cell may then stick in the blood vessels and cause pain and injury to organs. Some of the complications caused by the sticking of blood cells are called acute pain crisis and acute chest syndrome (ACS). Nitric oxide (NO) is a gas that has been proposed as a possible therapy for the ACS complication of sickle cell anemia. Studies have shown that NO may favorably affect sickle cell hemoglobin molecules, thereby improving blood flow through small vessels. This study is designed to evaluate the effects of NO, when taken in combination with a drug called nitroglycerin on patients with sickle cell anemia and normal volunteers. The effects of these two drugs only last while the patient is receiving them. Researchers hope the information learned from this study will help to develop new therapies for sickle cell anemia.
NCT00034060 ↗ The Role of Cytokines on Growth Hormone Suppression in Premenopausal Women With Rheumatoid Arthritis and the Effect of Treatment With Etanercept Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 2 2002-04-01 This study has two phases. Phase 1 will examine the role of inflammatory mediators called cytokines on growth hormone levels in women with rheumatoid arthritis (RA). Phase 2 will evaluate the effect of etanercept on these growth hormone levels. Etanercept is approved for the treatment of RA. It lowers the levels of a key inflammatory mediator called tumor necrosis factor-alpha and is very effective in reducing arthritis symptoms. Growth hormone promotes bone and muscle growth. With aging, people lose muscle mass and bone strength, possibly because of decreased levels of growth hormone. People with RA have bone and muscle changes similar to those in older people, perhaps also due to decreased levels of growth hormone. The first part of this study will see if the inflammatory mediators responsible for joint inflammation (warmth, redness, pain, and swelling) in RA are related to the lowered growth hormone levels in this disease. The second part will evaluate the effect of etanercept treatment on muscle mass and bone density, in addition to growth hormone levels. Premenopausal women between 18 and 55 years of age with a recent diagnosis of rheumatoid arthritis (less than 3 years) are eligible for this study. Healthy volunteers will also be enrolled in the first phase of the study as control subjects. This study is conducted at two sites, the NIH and the Johns Hopkins Medical Center in Baltimore. Healthy volunteers enrolled in this study will be interviewed about their health status and will fill out questionnaires on diet and general physical function, including fatigue, energy and well being. In addition, they will be hospitalized once at the NIH Clinical Center for 24-hour blood sampling and will visit to Johns Hopkins Medical Center in Baltimore for a brachial artery reactivity study, as follows: - 24-hour blood sampling for growth hormone levels. Blood samples (1/2 teaspoon each) will be collected every 20 minutes from 8 AM one day until 8 AM the following day through a plastic tube in an arm vein. - Dual energy X-ray absorptiometry (DEXA) scan on a small area of the spine, hip and wrist to assess bone density and a total body DEXA scan to assess the amount and distribution of muscle and body fat. - Blood vessel (brachial artery reactivity) study to measure the ability of the brachial artery to dilate and increase its blood flow. For this procedure, the subject lies on a table with electrocardiogram leads attached to the chest. A blood pressure cuff is inflated for several minutes and a drop of nasal spray of nitroglycerin is given that may cause a headache. Blood pressure and headache are monitored and treated as needed. Patients with rheumatoid arthritis will be seen at the NIH clinic on six separate visits (weeks 0, 1, 6, 12, 18, and 26) over 26 weeks. Week 0 is a screening visit. At weeks 1 and 26, patients will be admitted to the hospital for 24-hour blood sampling, DEXA scans, and brachial artery reactivity tests, as described above, plus X-rays of the hand and feet. After the first visit, they will start taking etanercept, given by self-injection under the skin (like insulin shots) twice a week. Follow-up visits at weeks 6, 12, and 18 will involve evaluations of disease activity and drug side effects through joint examination, blood tests, and questionnaires.
NCT00043719 ↗ Nitroglycerin Ointment for Preventing Bone Loss in Postmenopausal Women Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 3 2002-07-01 Osteopenia and osteoporosis cause thinning of bone tissue and loss of bone density over time. The purpose of this study is to determine the safety and effectiveness of nitroglycerin ointment for the treatment of osteopenia in postmenopausal women. Study hypothesis: On average, participants in the base therapy cohort who receive placebo ointment control and calcium/vitamin D will lose more bone density than participants in the nitroglycerin cohort over the 36-month period.
NCT00076414 ↗ The Effect of Lopinavir/Ritonavir on Endothelial Function Completed National Institutes of Health Clinical Center (CC) Phase 1 2004-01-01 This study will examine how the anti-HIV protease inhibitor lopinavir/ritonavir (Kaletra® (Registered Trademark)) affects the function of the endothelium (lining of the arteries). Medications such as protease inhibitors can dramatically change the course of HIV infection in many patients; however, among their side effects is development of abnormal lipid levels resulting in high cholesterol and insulin resistance. These side effects may damage the lining of the arteries that supply blood to the heart, leading to premature coronary artery disease. The study will determine whether lopinavir/ritonavir directly affects endothelial function and whether it alters cholesterol levels, glucose tolerance, and markers of inflammation in people who take the drug for 4 weeks. Healthy normal volunteers between 18 and 40 years of age may be eligible for this study. Candidates must be HIV-negative and have no history of heart disease, hypertension, or diabetes mellitus. They must not have smoked for at least 6 weeks before entering the study. Volunteers will be screened with a medical history, physical examination, blood tests (including a pregnancy test for women of childbearing potential), and electrocardiogram. In addition, candidates will have an oral glucose tolerance test (see description below). Participants will undergo the following procedures: - Lopinavir/ritonavir: 4 weeks (3 capsules twice a day) beginning study day 1 - Flow-mediated vasodilatation test (study days 0 and 29) - An ultrasound device for measuring the size of the brachial artery (artery in the upper arm) is placed just above the elbow. The size of the artery is measured before and 5 minutes after blood flow to the arm is stopped for 5 minutes, using a blood pressure cuff. The artery is also measured before and after taking nitroglycerin, a medicine that dilates blood vessels. These measurements tell how well the drug treatment works on the cells lining the brachial artery, which is an indicator of coronary artery function. This test takes about 1.5 hours. - Forearm blood-flow test (study days 1 and 30): Small tubes are inserted into an artery and vein in the forearm at the inside of the elbow. Blood pressure cuffs are placed around the upper arm and wrist, and a strain gauge (a rubber band-like device) is placed around the forearm. When the blood pressure cuffs are inflated, blood flows into the forearm, stretching the strain gauge at a rate proportional to the blood flow. When the devices are in place, a salt water solution is injected in the small tube in the artery. After 20 minutes, small doses of the following drugs are given through the catheter at various intervals: 1) L-NMMA (blocks production of nitric oxide, a substance produced by the blood vessels that causes them to dilate); 2) sodium nitroprusside (dilates blood vessels, increasing blood flow); 3) acetylcholine (lowers blood pressure); and 4) acetylcholine plus L-NMMA. The effect of the different drugs on blood flow in the forearm is measured. The study takes about 2 hours to complete. - Blood tests (screening and study days 1,15, 30, and 44) - Electrocardiogram (at screening and on study day 30) - Oral glucose tolerance test (at screening and on study day 30) - A blood sample is collected. Then, the subject drinks 300 milliliters of a glucose solution (a liquid that contains sugar dissolved in water). Two hours after drinking the solution, blood is drawn again to examine how the body responds to the increase blood sugar levels.
NCT00090558 ↗ Effect of Nitric Oxide Donor on Endothelial Progenitor Cells in Patients With Coronary Artery Disease Completed National Heart, Lung, and Blood Institute (NHLBI) Phase 2 2004-08-01 Regular exercise reduces the risk of heart problems, in part because it improves the work of the endothelium (the cells that line blood vessels). Exercise appears to release precursor cells from the bone marrow that will later become endothelial cells. A molecule called nitric oxide (NO) appears to be involved in this release. However, some heart patients do not improve their endothelial function despite regular exercise. The researchers believe that the heart disease in these patients may interfere with the normal relationship between exercise and endothelial function. This study is designed to test whether giving a patient nitroglycerin (which is converted to NO in the bloodstream) will increase the release of endothelial precursor cells from the bone marrow. If the study succeeds, it may lead to improved healing of arteries in heart disease patients. Adults may be eligible for this study if they have coronary artery disease and do not take nitroglycerin or nitroglycerin-like medication on a daily basis. Volunteers will be admitted to the Clinical Center on 2 separate nights at least 1 week apart. On the morning after each admission, volunteers will have blood drawn from an arm vein for laboratory tests, and then walk on a treadmill until fatigue or discomfort prevents further exercise, or until asked to stop. On one of their admissions, volunteers will receive 1 tablet of nitroglycerin under the tongue shortly before the treadmill test. Volunteers will be monitored by EKGs and blood pressure tests during the treadmill tests, and will have more blood drawn at about 15 minutes and 24 hours after each treadmill test. Researchers will examine the levels of endothelial precursor cells and nitric oxide in the blood samples taken before and after exercise.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for nitroglycerin

Condition Name

Condition Name for nitroglycerin
Intervention Trials
Coronary Artery Disease 10
Hypertension 9
Raynaud's Disease 5
Healthy 5
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Condition MeSH

Condition MeSH for nitroglycerin
Intervention Trials
Coronary Artery Disease 18
Myocardial Ischemia 15
Hypertension 13
Coronary Disease 12
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Clinical Trial Locations for nitroglycerin

Trials by Country

Trials by Country for nitroglycerin
Location Trials
United States 178
Egypt 22
Canada 16
China 14
Russian Federation 9
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Trials by US State

Trials by US State for nitroglycerin
Location Trials
California 20
New York 11
Tennessee 9
Massachusetts 9
Texas 9
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Clinical Trial Progress for nitroglycerin

Clinical Trial Phase

Clinical Trial Phase for nitroglycerin
Clinical Trial Phase Trials
PHASE4 8
PHASE3 1
PHASE2 3
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Clinical Trial Status

Clinical Trial Status for nitroglycerin
Clinical Trial Phase Trials
Completed 115
Recruiting 28
Unknown status 26
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Clinical Trial Sponsors for nitroglycerin

Sponsor Name

Sponsor Name for nitroglycerin
Sponsor Trials
MediQuest Therapeutics 9
Vanderbilt University 6
National Heart, Lung, and Blood Institute (NHLBI) 5
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Sponsor Type

Sponsor Type for nitroglycerin
Sponsor Trials
Other 230
Industry 45
NIH 12
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Clinical Trials Update, Market Analysis, and Projection for Nitroglycerin

Last updated: October 28, 2025


Introduction

Nitroglycerin, a longstanding cornerstone in cardiovascular therapeutics, primarily treats angina pectoris and heart failure. Originally developed in the late 19th century, it continues to serve as a vital medication owing to its vasodilatory properties. Despite its age, recent clinical trials and evolving medical contexts have spurred renewed interest in optimizing its use and developing novel formulations. This analysis evaluates current clinical trial activity, market dynamics, and future projections for Nitroglycerin, considering recent developments, regulatory trends, and emerging healthcare needs.


Clinical Trials Landscape for Nitroglycerin

Current and Recent Clinical Trials

The clinical investigation of Nitroglycerin has shifted focus from traditional uses to novel delivery methods and addressing potential adverse effects. As of 2023, several notable ongoing and recently completed trials highlight this trajectory:

  • Transdermal and Sublingual Formulations: Trials (e.g., NCT04693856) assess optimized transdermal patches and sublingual sprays for rapid onset and controlled release in acute settings. These efforts aim to improve patient compliance, minimize first-pass metabolism, and enhance bioavailability.

  • Combination Therapies: Emerging studies explore Nitroglycerin adjuncts with other cardiovascular drugs, such as beta-blockers and calcium channel blockers, to optimize angina management strategies with improved safety profiles ([2]).

  • Novel Delivery Vehicles: Researchers examine nanoparticle-based systems to enhance tissue targeting, reduce systemic side effects, and extend duration of action (e.g., NCT05054321).

  • Safety and Tolerability: Several trials focus on elucidating mechanisms behind nitrate tolerance and developing strategies to mitigate it, including intermittent dosing schedules and co-administration approaches.

Clinical Trial Outcomes and Insights

While no groundbreaking new indications have emerged, these trials collectively aim to refine Nitroglycerin's therapeutic window. Results indicate:

  • Efficacy: Traditional efficacy metrics, such as reduction in angina episodes and improved exercise tolerance, remain robust across formulations.

  • Safety: Adverse effects like headaches and hypotension persist but are manageable with dosing adjustments. Nitrate tolerance remains a challenge, influencing clinical practice.

Regulatory and R&D Activities

No recent approvals of novel Nitroglycerin formulations have been observed, but ongoing R&D activities suggest incremental enhancements rather than paradigm shifts. The focus remains on optimizing existing formulations and delivery routes with a view to increase patient adherence and minimize side effects.


Market Analysis of Nitroglycerin

Historical Market Context

Nitroglycerin has historically enjoyed a global market driven by its high prescription volume and well-established efficacy profile in angina management. According to a 2021 report, the global cardiovascular drugs market was worth approximately USD 200 billion, with nitrates—defined by Nitroglycerin as a leading subgroup—holding a significant market share.

Market Drivers

  • Aging Population: Increased prevalence of coronary artery disease (CAD) and angina correlates with rising Nitroglycerin demand.
  • Established Efficacy and Market Penetration: Long-standing clinician familiarity sustains high prescription rates.
  • Generics and Biosimilars: The availability of low-cost generic formulations maintains widespread accessibility.

Market Challenges

  • Nitrate Tolerance and Side Effects: Limitations drive innovation but also constrain market growth.
  • Emergence of Newer Agents: Drugs such as ranolazine and ivabradine offer alternative options, impacting Nitroglycerin market penetration.
  • Regulatory and Reimbursement Factors: Pricing pressures and reimbursement policies influence sales dynamics.

Regional Market Dynamics

  • North America: Largest market share driven by high diagnosis rates and prevalent cardiovascular comorbidities.
  • Europe: Stable but growing market facilitated by aging demographics and healthcare infrastructure.
  • Asia-Pacific: Rapid growth potential owing to urbanization, increasing cardiovascular disease burden, and improving healthcare access.

Future Market Projection

Forecast Overview

Between 2023 and 2030, the Nitroglycerin market is projected to grow at a compound annual growth rate (CAGR) of approximately 3-4%, reaching an estimated USD 8 billion globally. The growth trajectory is driven by:

  • Innovations in Delivery and Formulations: Enhanced transdermal patches, sublingual sprays, and nanoparticle-based systems bear promise for increased adoption.
  • Expansion in Emerging Markets: Growing healthcare infrastructure and awareness in Asia and Latin America bolster expansion.
  • Clinical Validation of Combination and Adjunct Therapies: New trial data supporting safety and efficacy will reinforce market stability.

Impact of Regulatory and Technological Trends

Regulatory agencies' increasing emphasis on safety profiles will motivate pharmaceutical developers to refine formulations. Additionally, digital health integration (e.g., connected delivery systems) may enhance adherence, further supporting growth.

Competitive Landscape

Major pharmaceutical players, including Pfizer, Novartis, and Teva, maintain substantial portfolios of Nitroglycerin formulations. Emerging biotech firms focusing on nanotechnology and drug delivery systems pose potential competitive threats and innovation opportunities.


Conclusion

While Nitroglycerin remains a mainstay in cardiovascular therapy, its market dynamics are evolving amid technological advances and newer therapeutic options. Clinical trials continue to refine its delivery and safety, with ongoing R&D promising incremental improvements. The global market is poised for steady growth driven by demographic trends and healthcare infrastructure expansion, especially in emerging markets.


Key Takeaways

  • Clinical Focus: Current trials aim to optimize delivery methods, reduce side effects, and address nitrate tolerance, with promising nanoparticle-based systems in development.
  • Market Resilience: Despite the rise of newer drugs, Nitroglycerin's entrenched position and low-cost formulations sustain robust demand.
  • Growth Outlook: The market is projected to grow at a CAGR of 3-4%, reaching approximately USD 8 billion by 2030, driven by technological innovations and expanding healthcare access.
  • Innovation Opportunities: Development of novel delivery systems and combination therapies could unlock further market potential.
  • Regulatory Environment: Evolving safety standards will influence product development and patent strategies.

FAQs

1. What are the latest developments in Nitroglycerin delivery systems?
Recent clinical trials investigate transdermal patches, sublingual sprays, and nanoparticle-based formulations aimed at improving onset, duration, and tolerability.

2. How is Nitroglycerin’s patent landscape evolving?
Most formulations are off-patent, with manufacturers focusing on incremental device innovations and improved delivery methods rather than new chemical entities.

3. What factors could threaten Nitroglycerin’s market share in the future?
Emergence of alternative therapies, adverse effects like nitrate tolerance, and regulatory challenges could influence its market position.

4. How significant is the role of emerging markets in Nitroglycerin’s future growth?
High growth potential exists as healthcare systems expand and awareness increases, especially in Asia-Pacific and Latin America.

5. Are there any ongoing efforts to develop nitrate-free alternatives?
Yes, research focuses on non-nitrate vasodilators and novel mechanisms, but none have yet threatened Nitroglycerin’s dominance in angina treatment.


References

[1] Global Cardiovascular Drugs Market, 2021. Market Research Future.
[2] Combination Therapy in Angina Management, Journal of Cardiovascular Pharmacology, 2022.

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