Uses
What is nitroglycerin used for?
Nitroglycerin is commonly used to treat and prevent chest pain caused by a type of heart disease (coronary artery disease).
Nitroglycerin may also be used for other conditions as determined by your healthcare provider.
How does nitroglycerin work (mechanism of action)?
Nitroglycerin relaxes the blood vessels and increases the supply of oxygen and blood to the heart. Chest pain may occur when your heart does not get enough oxygen and blood.
How is nitroglycerin supplied (dosage forms)?
Nitroglycerin is available as Nitrolingual Pumpspray, NitroMist, Nitrostat, and generic nitroglycerin in the following dosage forms that are sprayed or placed into the mouth or under the tongue.
- 0.3 mg sublingual tablets
- 0.4 mg sublingual tablets
- 0.6 mg sublingual tablets
- 400 mcg/spray lingual aerosol
- 400 mcg/spray lingual spray
Nitroglycerin is also available in injectable forms.
How should I store nitroglycerin?
Nitroglycerin 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. Keep nitroglycerin sublingual tablets in the original glass container and make sure to close the lid tightly after each use.
Side Effects
What are the most common side effects of nitroglycerin?
The most common side effects of nitroglycerin are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Headache (see below)
- Dizziness
- Numbness, tingling, or burning in your arms, feet, or face
- Low blood pressure (see below)
- Flushing
There may be other side effects of 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 www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of nitroglycerin?
While less common, the most serious side effects of nitroglycerin are described below, along with what to do if they happen.
Severe Allergic Reactions. Nitroglycerin may cause allergic reactions, which can be serious. Stop using 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
Low Blood Pressure. Nitroglycerin may cause low blood pressure (hypotension), which can sometimes be severe. Low blood pressure can sometimes happen when standing up from a seated or lying position. To help prevent this, be careful not to get up too quickly. If you feel dizzy, sit or lie down right away until the dizziness stops, then take your time getting up again. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Blurred vision
- Confusion
- Feeling weak or tired
Tolerance. Frequent use or using more nitroglycerin than you need can lead to tolerance. Tolerance is when your body no longer responds the same way to a medicine, and it takes a higher dose to have the same effect. Do not use more nitroglycerin than what is needed to prevent or treat your chest pain.
Headache. Nitroglycerin may cause severe headaches, especially when you first start using it or with high doses. Headaches usually occur less often over time.Tell your healthcare provider if you continue to have bothersome headaches while using nitroglycerin.
Warnings & Precautions
Who should not use nitroglycerin?
Allergies to Ingredients. People who are allergic to any of the following should not use nitroglycerin.
- Nitroglycerin
- Nitrolingual
- NitroMist
- Nitrostat
- Any other medicine known as a nitrate or nitrite
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific nitroglycerin products they stock.
Drug Interactions. Nitroglycerin should not be taken while you are using certain other medicines. Before using 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.
Severe Anemia. Nitroglycerin should not be used if you have very low levels of red blood cells.
Increased Pressure in Your Brain. Nitroglycerin should not be used if you have increased intracranial pressure, such as after a head injury or bleeding in your brain.
Shock. Nitroglycerin should not be used if you are in shock, which means your blood pressure is so low that blood and oxygen are not getting to all of your organs, which can lead to injury and death.
What should I know about nitroglycerin before using it?
Do not shake nitroglycerin spray or aerosol. Ask your pharmacist or other healthcare provider to show you how to correctly use and prime your nitroglycerin spray or aerosol.
Follow the “Instructions for Use” that comes with your nitroglycerin when using it for the first time.
Do not use nitroglycerin unless it has been prescribed to you by a healthcare provider. Use it as prescribed. You should sit down before using nitroglycerin because it can sometimes cause low blood pressure or dizziness.
Do not share nitroglycerin with other people, even if they have the same condition as you. It may harm them.
Nitroglycerin tablets should not be chewed, crushed, or swallowed. You should allow them to dissolve underneath your tongue or in your mouth between your gums and the inside of your cheek. If you have a dry mouth, you can drink a little bit of water before using nitroglycerin tablets to help them dissolve better.
Keep nitroglycerin out of the reach of children.
Nitroglycerin spray and aerosol are flammable. Do not forcefully open or burn the container after using the medicine, and do not spray toward a fire.
Nitroglycerin may affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how nitroglycerin affects you.
People who are 65 years of age or older may be at a greater risk for some side effects of nitroglycerin. Talk to your healthcare provider about your risks if you are in this age group.
If you have used 3 doses of nitroglycerin within 15 minutes and you are still having chest pain, get emergency medical help right away.
What should I tell my healthcare provider before using 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 nitroglycerin is right for you.
In particular, make sure that you discuss any of the following.
Hypertrophic Obstructive Cardiomyopathy. Nitroglycerin may increase chest pain if you have hypertrophic obstructive cardiomyopathy.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Low blood pressure
- Heart problems, including a recent heart attack or heart failure
- Anemia
Pregnancy. It is not known if or how nitroglycerin could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. It is not known if nitroglycerin passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use nitroglycerin while breastfeeding.
Interactions
Does nitroglycerin interact with foods or drinks?
There are no known interactions between nitroglycerin and foods or nonalcoholic drinks.
Do not drink alcohol with nitroglycerin. The risk of low blood pressure may be increased if you drink alcohol while using nitroglycerin.
Does 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 nitroglycerin.
- Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
- A phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), or vardenafil (Levitra, Staxyn), which is a medicine used for erectile dysfunction or pulmonary arterial hypertension (PAH)
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- Riociguat (Adempas), which is a medicine used for pulmonary arterial hypertension (PAH)
- A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
- A medicine for high blood pressure
- A nitrate, such as isosorbide dinitrate (Isordil) or transdermal nitroglycerin (Nitro-Dur), which is a medicine used to prevent chest pain caused by a type of heart disease
- A medicine for heart failure
- A medicine to prevent or treat chest pain
- A medicine used to control your heart rate or rhythm (antiarrhythmic)
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- An ergot, such as ergotamine (Ergomar) or dihydroergotamine (Migranal or Trudhesa), which is a medicine used to treat migraine
This may not be a complete list of medicines that can interact with nitroglycerin. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much 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 nitroglycerin?
Nitroglycerin is meant to be used only when needed. Use it as your healthcare provider recommends.
Are you currently using Nitroglycerin?
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