Uses
What is transdermal nitroglycerin used for?
Transdermal nitroglycerin is commonly used to prevent chest pain caused by a type of heart disease (coronary artery disease).
Transdermal nitroglycerin may also be used for other conditions as determined by your healthcare provider.
How does transdermal nitroglycerin work (mechanism of action)?
Transdermal nitroglycerin relaxes the blood vessels and increases oxygen and blood supply to the heart. Chest pain can occur when your heart does not get enough oxygen and blood.
How is transdermal nitroglycerin supplied (dosage forms)?
Transdermal nitroglycerin is available as Nitro-Dur and generic transdermal nitroglycerin in the following dosage forms that are applied to the skin.
- 0.1 mg/hr transdermal patch
- 0.2 mg/hr transdermal patch
- 0.3 mg/hr transdermal patch
- 0.4 mg/hr transdermal patch
- 0.6 mg/hr transdermal patch
- 0.8 mg/hr transdermal patch
- 2% ointment
How should I store transdermal nitroglycerin?
Topical Patch. Transdermal nitroglycerin patch should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place. Do not refrigerate.
Topical Ointment. Transdermal nitroglycerin ointment should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Keep the tube tightly closed.
Side Effects
What are the most common side effects of transdermal nitroglycerin?
The most common side effects of transdermal nitroglycerin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Headache
- Lightheadedness or dizziness
There may be other side effects of transdermal nitroglycerin that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at https://www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at https://www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of transdermal nitroglycerin?
While less common, the most serious side effects of transdermal nitroglycerin are described below, along with what to do if they happen.
Severe Allergic Reactions. Transdermal nitroglycerin can cause allergic reactions, which can be serious. Stop using transdermal nitroglycerin and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Decreased Blood Pressure (Hypotension). Transdermal nitroglycerin may cause low blood pressure. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Warnings & Precautions
Who should not use transdermal nitroglycerin?
Allergies to Ingredients. People who are allergic to any of the following should not use transdermal nitroglycerin.
- Nitro-Dur
- Nitroglycerin
- Acrylic-based polymer adhesives (topical patch)
- Any other medicine known as nitrates or nitrites
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific transdermal nitroglycerin products they stock.
Drug Interactions. Transdermal nitroglycerin should not be used while you are using certain other medicines. Before using transdermal nitroglycerin, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.
What should I know about transdermal nitroglycerin before using it?
Do not use transdermal nitroglycerin unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share transdermal nitroglycerin with other people, even if they have the same condition as you. It may harm them.
Keep transdermal nitroglycerin including used patches out of the reach of children. Used patches still contain medicine.
Do not use transdermal nitroglycerin to treat chest pain. Get help right away if you develop chest pain.
Wash your hands and apply transdermal nitroglycerin to clean skin without a lot of hair. Do not apply below the knee or elbow, in skin folds, or on injured skin.
Transdermal nitroglycerin can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how transdermal nitroglycerin affects you.
Slowly rise from a seated or lying position. Hold onto a chair or bed in case you get dizzy.
People who are 65 years of age or older can be at greater risk for some side effects of transdermal nitroglycerin. Talk to your healthcare provider about your risks if you are in this age group.
What should I tell my healthcare provider before using transdermal nitroglycerin?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if transdermal nitroglycerin is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Low blood pressure
- Heart problems including recent heart attack or heart failure
- Anemia
- Increased intracranial pressure such as after head injury or bleeding in the brain
Pregnancy. It is not known if or how transdermal nitroglycerin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use transdermal nitroglycerin while you are pregnant or trying to get pregnant.
Breastfeeding. It is not known if transdermal nitroglycerin passes into breast milk and if it can harm your baby. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use transdermal nitroglycerin while breastfeeding.
Interactions
Does transdermal nitroglycerin interact with foods or drinks?
There are no known interactions between transdermal nitroglycerin and foods or nonalcoholic drinks.
It is unknown if drinking alcohol will affect transdermal nitroglycerin. The risk of dizziness may be increased if you drink alcohol while using transdermal nitroglycerin. It is best to limit the amount of alcohol you drink.
Does transdermal nitroglycerin interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using transdermal nitroglycerin.
- A type of medicine called a phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), or vardenafil (Staxyn), which are used for erectile dysfunction or pulmonary arterial hypertension (PAH)
- Riociguat (Adempas), which is used to treat high blood pressure in the lungs
- A medicine for high blood pressure
- A beta-blocker, which is a medicine usually used to reduce blood pressure and for certain other heart conditions
- Aspirin, which is contained in many prescription and OTC products for pain, swelling, and fever
- Ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which are medicines used to treat migraine
Overdose/Missed Dose
What should I do if I accidentally use too much transdermal nitroglycerin?
If you or someone else has used too much nitroglycerin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of transdermal nitroglycerin?
If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.
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