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Supplement × Prescription·Evidence index

NAC and Nitroglycerin: what the research found

PubMed indexes 8 records that name NAC and Nitroglycerin together, either in the title or in an interaction, co-administration, or pharmacokinetic context. The key findings come first, in the authors’ own words, followed by every study with its design and PubMed link.

A summary of published research, not medical advice. A pharmacist can check any combination against your full list of medicines and supplements.

Key findings

What the studies concluded.

Reviews and human studies first. Each quote is the authors’ own conclusion about their study, not a NutriStack assessment, and a single study is not a consensus.

“In patients with CAD, external augmentation of sulfhydryl availability did not affect the depressed response to nitroglycerin in the large epicardial coronary artery. Although nicorandil acts as an NO donor, similar to nitroglycerin, in dilating the epicardial coronary artery, other effects, such as the opening of K(ATP) channel, play a more important role in the nicorandil-induced vasodilation of resistance vessels.”

Nishikawa et al. · 1998 · Human study · details

“The combination of nitroglycerin and N-acetylcysteine, associated with conventional medical therapy in the long-term treatment of patients with unstable angina, reduces the occurrence of outcome events. However, the high incidence of side effects limits the clinical applicability of this therapeutic strategy at least at the dosage used in the present study.”

Ardissino et al. · 1997 · Human study · details

“NAC in combination with NTG and streptokinase appeared to be safe for the treatment of evolving AMI and was associated with significantly less oxidative stress, a trend toward more rapid reperfusion, and better preservation of left ventricular function.”

The research

8 studies naming NAC and Nitroglycerin.

Strongest relevance first: papers naming both substances in the title, then human trials and systematic reviews.

Differential effects of N-acetylcysteine on nitroglycerin- and nicorandil-induced vasodilation in human coronary circulation.

Journal of cardiovascular pharmacology · 1998 · PMID 9676716

Clinical TrialComparative Study

“In patients with CAD, external augmentation of sulfhydryl availability did not affect the depressed response to nitroglycerin in the large epicardial coronary artery. Although nicorandil acts as an NO donor, similar to nitroglycerin, in dilating the epicardial coronary artery, other effects, such as the opening of K(ATP) channel, play a more important role in the nicorandil-induced vasodilation of resistance vessels.”

Nishikawa et al. · From the abstract

Names both NAC and Nitroglycerin in its title.

Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris.

Journal of the American College of Cardiology · 1997 · PMID 9120179

Clinical TrialRandomized Controlled Trial

“The combination of nitroglycerin and N-acetylcysteine, associated with conventional medical therapy in the long-term treatment of patients with unstable angina, reduces the occurrence of outcome events. However, the high incidence of side effects limits the clinical applicability of this therapeutic strategy at least at the dosage used in the present study.”

Ardissino et al. · Authors' conclusion

Names both NAC and Nitroglycerin in its title.

N-acetylcysteine in combination with nitroglycerin and streptokinase for the treatment of evolving acute myocardial infarction. Safety and biochemical effects.

Circulation · 1995 · PMID 7586252

Clinical TrialRandomized Controlled Trial

“NAC in combination with NTG and streptokinase appeared to be safe for the treatment of evolving AMI and was associated with significantly less oxidative stress, a trend toward more rapid reperfusion, and better preservation of left ventricular function.”

Arstall et al. · Authors' conclusion

Names both NAC and Nitroglycerin in its title.

Altered peripheral vasodilator profile of nitroglycerin during long-term infusion of N-acetylcysteine.

Journal of the American College of Cardiology · 1994 · PMID 8277075

Clinical TrialRandomized Controlled Trial

“The results suggest that coadministration of nitroglycerin and N-acetylcysteine in humans 1) potentiates and preserves nitroglycerin-induced venodilation and 2) augments the effect of nitroglycerin on small resistance vessels (regulating subcutaneous blood flow) without affecting the response to nitroglycerin in middle-sized arteries.”

Boesgaard et al. · Authors' conclusion

Names both NAC and Nitroglycerin in its title.

N-acetylcysteine enhances nitroglycerin-induced headache and cranial arterial responses.

Clinical pharmacology and therapeutics · 1992 · PMID 1505148

Clinical TrialComparative StudyRandomized Controlled Trial

“The potentiation was most pronounced after the first nitroglycerin infusion (12% versus 4.5% compared with placebo). A prolonged dilation of the temporal artery was observed only after the first nitroglycerin infusion, when high levels of N-acetylcysteine were present.”

Iversen · From the abstract

Names both NAC and Nitroglycerin in its title.

Limitations

What this evidence cannot tell you.

Search-based evidence indexes have real limits, and it is worth being explicit about them:

How to read this page

A literature summary, not guidance.

NutriStack

Track what you actually take.

NutriStack is a free iPhone app for organising a supplement routine: what you take, when, and what the published record says about it. Its exploratory interaction checker covers NAC, Nitroglycerin, and several hundred other substances.

Log your routine, get reminders at the times you choose, and scan a label to add a product. The checker is a research and organisation tool, not a clinical decision aid.

NutriStack is an informational and organizational tool, not a medical service, and not a substitute for professional advice. Always consult a qualified healthcare professional before starting, stopping, or changing any supplement or medication.