Nitroglycerin

Brand Name: Gen-Nitro Minitran Nitro-Dur Nitroglycerin in 5% Dextrose Injection Nitrol Nitrolingual Pumpspray Nitrostat Transderm-Nitro Rho-Nitro Pumpspray

Prescription Needed: No unless administered by injection

What is this drug used for?

Nitroglycerin is primarily used to treat chest pain that comes from angina attacks. It is available in many different forms:

  • Pump Sprays and Sublingual (under your tongue) Tablets: Nitroglycerin in a spray or a tablet which can be placed under your tongue works fast and is short acting. These two forms are used when you start to feel the chest pain. Sometimes they can be used just before an activity that you know will cause chest (anginal) pain (e.g. climbing stairs exercise).
  • Slow-release tablets and skin patches: In these forms nitroglycerin is used to prevent chest pain from happening. Both the tablets and patches release the medication into your body over the day to help keep the blood vessels open and prevent chest pain from occurring.
  • Injection/Intravenous solution: This form is used in the hospital to relieve chest pain.

Nitroglycerin is sometimes used to decrease symptoms of congestive heart failure and to decrease blood pressure.

Is there any reason not to take this drug?

You should not take this drug if you are allergic to nitroglycerin. Some forms of the drug should be avoided or used with extreme caution if you have severe anemia recent head trauma or bleeding in the brain severe low blood pressure or conditions called constrictive pericarditis and pericardial tamponade. Tell your doctor if you have or have ever had:

  • problems with low blood pressure (hypotension)
  • headaches
  • a condition called gastric hypermotility (long-acting tablets/capsules should be avoided)
  • glaucoma
  • severe problems with liver or kidney
  • other problems with the heart

What about possible side effects?

The most common side effects are:

  • headache
  • dizziness
  • rash (where the patch is applied)
  • burning stinging tingling (possibly with the sublingual tablets/spray)

These side effects are usually related to dose and should go away with time or with a slower increase to your target dose.

Other less common side effects include:

  • blurred vision
  • dry mouth
  • low blood pressure
  • fast heartbeat
  • heartburn or reflux (if occurs its usually in people who already have problems with reflux)
  • a condition called thrombocytopenia (rare call your doctor immediately if you noticed increased bruising or bleeding)

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

  • other medications to treat high blood pressure (may increase your chances for experiencing low blood pressure)
  • other medications for the heart (may increase your chances for similar side effects)
  • sildenafil tadalafil vardenafil: these combinations must be AVOIDED since it may increase your chances of having severe low blood pressure

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information

How to take: When you take your first dose of nitroglycerin (especially the short-acting forms) it is best taken while sitting down as a drop in blood pressure will likely occur and dizziness and/or fainting may result. As the body gets used to this medication your dose may have to be changed by your doctor.

In the beginning try to get up from a sitting or lying position slowly as you may experience some lightheadedness or dizziness. This should go away with time. If it doesn't go away and it interferes with your ability to sit stand up or walk call your doctor as your dose may need to be changes.

· For acute chest pain: Use 1-2 sprays/1 tablet at the start of chest pain. This can be repeated every 5 minutes to a maximum of 3-6 sprays or tablets. If the chest pain is not gone call 911 or your doctor immediately.

· To prevent chest pain: If you are taking this to prevent chest pain from occurring from a specific activity like exercise or climbing stairs use 1-2 sprays or 1 tablet 5-10 minutes before the planned activity.

If you have headaches: Headaches from this medication are very common and should go away with time. Do not stop this medication without talking to your doctor or pharmacist. If the headaches persist and are bothersome talk to your doctor or pharmacist since there are a few things that can be done to decrease this side effect.

Children: Not typically recommended. Talk to your doctor.

Seniors: Are more sensitive to side effects and lower doses are usually necessary especially at the start of therapy.

Pregnancy: Generally not prescribed. Safer drugs are available. Talk to your doctor.

Women who are nursing: This drug may pass into breast milk. Talk to your doctor.

People who drive or operate machinery: Should not do so until they know how this drug affects them personally; may cause dizziness.

Alcohol: You may become dizzy if alcohol is consumed in excessive amounts. If you drink always drink in moderation.

Overdose: A large overdose of this medicine could cause dizziness vomiting a severe headache and possible loss of consciousness. If you experience any unusual reactions or if you seriously exceed the recommended dosage call your doctor or 911.

Stopping the drug: Talk to your doctor before you stop taking this drug. Stopping abruptly may cause sudden attacks of chest pain (angina). Your doctor will likely want to decrease your dose gradually.

If you miss a dose: Take it as soon as you remember. However if your next dose is within 2 hours take the missed dose and skip the next scheduled dose. Do not take a double dose.

Storage conditions: Closed container; cool dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.

Dietary precautions: No specific recommendations.