What is nitroglycerin (oral/sublingual)?
Nitroglycerin is in a group of drugs called nitrates. Nitroglycerin dilates (widens) blood vessels,
making it easier for blood to flow through them and easier for the heart to pump.
Nitroglycerin is used to treat or prevent attacks of chest pain (angina).
Nitroglycerin may also be used for other purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking nitroglycerin (oral/sublingual)?
Do not use nitroglycerin if you are taking sildenafil (Viagra). Serious, life-threatening side
effects can occur if you take nitroglycerin while you are using sildenafil.
Do not use this medication without the advice of a doctor if you have early signs of a heart
attack (chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill
feeling).
Seek emergency medical attention if you have symptoms of a heart attack.
You should not use this medication if you are allergic to nitroglycerin, isosorbide
mononitrate (Imdur), or isosorbide dinitrate (BiDil, Isordil), or if you have:
-
severe anemia (a lack of red blood cells); or
-
a brain injury, hemorrhage, or tumor.
If you have certain conditions, you may need a dose adjustment or special
tests to safely take this medication. Before you take nitroglycerin, tell your doctor if you have:
-
congestive heart failure;
-
a history of heart attack, stroke, or head injury;
-
low blood pressure;
-
glaucoma;
-
migraine headaches; or
-
liver disease.
FDA pregnancy category C. It is not known whether this medication is
harmful to an unborn baby. Before you take nitroglycerin, tell your doctor if you are pregnant or plan
to become pregnant during treatment.
It is not known whether nitroglycerin passes into breast milk or if it could harm a nursing
baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Nitroglycerin can cause severe headaches, especially when you first start using it. These
headaches may gradually become less severe as you continue to use nitroglycerin. Do not stop taking
the medication. Ask your doctor before using any headache pain medication.
How should I take nitroglycerin (oral/sublingual)?
Take this medication exactly as it was prescribed for you. Do not take the medication in larger
amounts, or take it for longer than recommended by your doctor. Follow the directions on your
prescription label.
If possible, try to rest or stay seated when you use this medication. Nitroglycerin can cause
dizziness or fainting.
If you use nitroglycerin
sublingual spray
to treat an angina attack: At the first
sign of an attack, apply the spray directly on or under your tongue. Close your mouth after each spray.
Do not inhale the spray. Do not shake the spray before or during use. You may use additional sprays
every 5 minutes, but not more than 3 sprays in 15 minutes.
You may use nitroglycerin spray within 5 to 10 minutes before an activity you think might cause
chest pain. Follow your doctor's instructions.
The nitroglycerin
sublingual tablet
should be placed under your tongue and
allowed to dissolve slowly. Do not chew or swallow it.
You may feel a slight burning or stinging in your mouth when you use this medication.
However, this sensation is not a sign of how well the medication is working. Do not use more
medication just because you do not feel a burning or stinging.
Do not crush, chew, break, or open an
extended-release
capsule.
Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or
opening the pill would cause too much of the drug to be released at one time.
Seek emergency medical attention if your chest pain gets worse or lasts more than 5
minutes, especially if you have trouble breathing or feel weak, dizzy, or nauseated, or lightheaded.
This medication can cause you to have unusual results with certain medical tests. Tell any
doctor who treats you that you are using nitroglycerin.
It is important to keep this medicine on hand at all times in case of an angina attack. Get your
prescription refilled before you run out of medicine completely.
If you take nitroglycerin on a regular schedule to prevent angina, do not stop taking it
suddenly or you could have a severe attack of angina.
Store nitroglycerin tablets in the glass container at room temperature, away from moisture
and heat. Keep the spray away from open flame or high heat, such as in a car on a hot day. The
canister may explode if it gets too hot.
What happens if I miss a dose of nitroglycerin (oral/sublingual)?
Since nitroglycerin is often used only as needed, you may not be on a dosing schedule. If you
are using the medication regularly, use the missed dose as soon as you remember. If your next dose is
less than 2 hours away, skip the missed dose and use the medicine at your next regularly scheduled
time.
Do not
use extra medicine to make up the missed dose.
Where can I get more information about nitroglycerin (oral/sublingual)?
Your pharmacist has information about nitroglycerin (oral/sublingual) written for health professionals that you may read.
What are the possible side effects of nitroglycerin (oral/sublingual)?
Get emergency medical help if you have any of these
signs of an allergic
reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
-
fast, slow, pounding, or uneven heart rate;
-
blurred vision or dry mouth;
-
nausea, vomiting, sweating, pale skin, feeling like you
might pass out; or
-
fever, sore throat, and headache with a severe blistering,
peeling, and red skin rash.
Less serious side effects may include:
-
mild burning or tingling with the tablet in your mouth;
-
warmth, redness, or tingly feeling under your skin; or
-
feeling weak or dizzy.
This is not a complete list of side effects and others may occur. Call your
doctor for medical advice about side effects. You may report side effects to FDA at
1-800-FDA-1088. You may report side effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about nitroglycerin (oral/sublingual)?
Do not use nitroglycerin if you are taking sildenafil (Viagra). Serious, life-threatening side
effects can occur if you take nitroglycerin while you are using sildenafil.
Nitroglycerin can cause severe headaches, especially when you first start using it. These
headaches may gradually become less severe as you continue to use nitroglycerin. Do not stop taking
the medication. Ask your doctor before using any headache pain medication.
What should I avoid while taking nitroglycerin (oral/sublingual)?
Nitroglycerin can cause side effects that may impair your thinking or reactions. Be careful if
you drive or do anything that requires you to be awake and alert.
Avoid drinking alcohol. It can increase some of the side effects of nitroglycerin, such as
dizziness, drowsiness, feeling light-headed, or fainting.
What other drugs will affect nitroglycerin (oral/sublingual)?
Many drugs can interact with nitroglycerin. Below is just a partial list. Tell your doctor if you
are using:
-
alteplase (Activase);
-
aspirin or heparin;
-
bladder or urinary medications such as oxybutynin
(Ditropan) or tolterodine (Detrol);
-
blood pressure medication;
-
bronchodilators such as ipratropium (Atrovent) or
tiotropium (Spiriva);
-
dihydroergotamine (D.H.E. 45, Migranal) or ergotamine
(Ergomar, Cafergot, and others);
-
an erectile dysfunction medication such as tadalafil (Cialis)
or vardenafil (Levitra);
-
an antidepressant such as amitriptyline (Elavil, Etrafon),
clomipramine (Anafranil), imipramine (Tofranil), and others;
-
a beta-blocker such as atenolol (Tenormin), carvedilol
(Coreg), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol
(Betapace), and others;
-
a calcium channel blocker such as diltiazem (Tiazac,
Cardizem), nifedipine (Procardia), nimodipine (Nimotop), verapamil (Calan, Covera, Verelan),
and others;
-
irritable bowel medications such as dicyclomine (Bentyl),
hyoscyamine (Anaspaz, Cystospaz, and others), or propantheline (Pro-Banthine);
-
any medication that causes dry mouth; or
-
medicines to treat psychiatric disorders, such as
chlorpromazine (Thorazine), haloperidol (Haldol), thioridazine (Mellaril), and others.
This list is not complete and there are many other drugs that
can interact with nitroglycerin.
Tell your doctor about all the prescription and
over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs
prescribed by other doctors. Do not start using a new medication without telling your doctor.
What happens if I have an overdose of nitroglycerin (oral/sublingual)?
