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Nitroglycerin

Generic Name: nitroglycerin (oral/buccal/sublingual/spray)
Brands: Nitro-Time, Nitrocot, Nitrogard, Nitroglyn E-R, Nitrolingual, Nitroquick, Nitrostat


What is the most important information I should know about Nitroglycerin?

· If you experience chest pain that worsens or lasts more than 5 minutes, especially if you feel short of breath, weak, nauseated, or lightheaded, call 911 or your local emergency services number.

· Use Nitroglycerin exactly as directed. If you do not understand these directions, ask your pharmacist, nurse or doctor to explain them to you.

· Follow your doctor's instructions especially about the timing of doses. The blood should be free of Nitroglycerin for a certain period of time every day for the medicine to continue working.

· You may develop a headache because of this medicine, but do not stop taking it. Taking aspirin, acetaminophen (Tylenol), or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, others), naproxen (Aleve, others), and others may alleviate the headache Ask your doctor which is best for you. This side effect may decrease as treatment with Nitroglycerin continues.

· If you take oral or buccal Nitroglycerin on a regular schedule (rather than as needed), do not stop taking it suddenly. Stopping suddenly could cause a severe attack of angina (chest pain).

· Avoid alcohol. It also widens blood vessels and may cause dizziness, drowsiness, and low blood pressure. It could be dangerous to combine alcohol with Nitroglycerin.

· If you use the sublingual tablets, the chewable tablets, or the spray, keep them nearby so that you can reach the medication easily if you have an angina attack.

 

What is Nitroglycerin?

· Nitroglycerin is in a class of drugs called nitrates. Nitroglycerin dilates (widens) blood vessels (arteries and veins). When blood vessels are dilated, it is easier for the heart to pump and for blood to flow to the heart.

· Nitroglycerin is used to prevent angina attacks (oral tablets, buccal tablets) and to treat attacks once they have started (sublingual tablets, chewable tablets, spray).

· Nitroglycerin may also be used for purposes other than those listed in this medication guide.

 

What should I discuss with my healthcare provider before taking Nitroglycerin?

· Do not use sildenafil (Viagra), a drug used to treat impotence, while taking Nitroglycerin without first talking to your doctor. The combination could cause severe or life-threatening low blood pressure.

· Before taking this medication, tell your doctor if you     ·have had a heart attack;     ·have congestive heart failure;     ·have low blood pressure;     ·have had a stroke, a transient ischemic attack (TIA, or mini-stroke), or a serious head injury;     ·have anemia;     ·have glaucoma;     ·suffer from migraines; or     ·have liver disease.

 

· You may not be able to take Nitroglycerin, or you may require a dosage adjustment or special monitoring during therapy.

· Nitroglycerin is in the FDA pregnancy category C. This means that it is not known whether Nitroglycerin will be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment.

· It is not known whether Nitroglycerin passes into breast milk. Do not take Nitroglycerin without first talking to your doctor if you are breast-feeding a baby.

 

How should I take Nitroglycerin?

· Take Nitroglycerin exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

· If you experience chest pain that worsens or lasts more than 5 minutes, especially if you feel short of breath, weak, nauseated, or lightheaded, call 911 or your local emergency services number.

· Follow your doctor's instructions especially about the timing of doses. The blood should be free of Nitroglycerin for a certain period of time every day for the medicine to continue working.

· To prevent injury, take Nitroglycerin while sitting. Dizziness and fainting are possible after a dose of Nitroglycerin.

· The sublingual tablets or the spray should be used at the first sign of chest pain or, if directed by your doctor, 5 to 10 minutes before activity that may cause chest pain. The sublingual tablet should be placed under the tongue and allowed to dissolve (approximately 20 to 30 seconds). Do not chew or swallow it. Use one or two sprays under, or preferably, on the tongue. The canister should be held upright and with the spray opening as close to the mouth as possible. Close your mouth after each spray. Do not inhale the spray.

· If you are still having chest pain 5 minutes after taking the Nitroglycerin, call 911 or your local emergency services number.

· Some stinging may occur when you start using the tablets under your tongue. This side effect may disappear with time. The absence of the side effect does not mean that the tablets have stopped working. Continue to take Nitroglycerin as directed by your doctor.

· If you use the sublingual tablets or the spray, keep them nearby so that you can reach the medicine easily if you have an angina attack.

· The sublingual tablets act faster in a moist mouth. If you have a history of dry mouth, ask your doctor about the use of chewing gum, artificial saliva products, or other methods to moisten the mouth before taking the sublingual tablets.

· Take each oral dose on an empty stomach (30 minutes before or 1 to 2 hours after meals), with a full glass of water.

· Swallow the extended-release forms of Nitroglycerin whole. Do not crush or chew them.

· Use the buccal tablets as directed. Place one tablet under your upper lip or between your cheek and gum and let it dissolve slowly over 3 to 5 hours. Do not swallow the tablet before it dissolves. If the tablet is accidentally swallowed before it dissolves, it can be replaced with a new tablet. To ensure that the tablet dissolves properly, avoid hot liquids and try not to touch the tablet with your tongue.

· If you take oral or buccal Nitroglycerin on a regular schedule (not if you use it as needed for angina), do not stop it suddenly. Stopping suddenly could cause a severe attack of angina (chest pain).

· You may develop a headache because of this medicine, but do not stop taking it. Taking aspirin, acetaminophen (Tylenol), or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, others), naproxen (Aleve, others), and others may alleviate the headache Ask your doctor which is best for you. This side effect may decrease as treatment with Nitroglycerin continues.

· Store the tablets and spray at room temperature away from moisture and heat. Store the sublingual tablets in the original glass container. Remove the cotton from the bottle after opening and keep the bottle tightly capped. Throw away any unused medication on the expiration date printed on the bottle.

 

What happens if I miss a dose?

· If you are taking Nitroglycerin only as needed, missing a dose is not a problem. Use Nitroglycerin only when you experience an angina attack.

· If you are taking Nitroglycerin to prevent angina attacks, take the missed dose as soon as you remember. If you are taking the regular tablets (not the extended-release tablets) and your next regularly scheduled dose is within 2 hours, skip the dose you missed and take only the next dose. If you are taking the extended-release tablets and your next regularly scheduled dose is within 6 hours, also skip the missed dose and take only the next dose.

· Do not take a double dose of this medication.

 

What happens if I overdose?

· Seek emergency medical attention.

· Symptoms of a Nitroglycerin overdose include a severe throbbing headache, difficult or slow breathing, muscle cramps, nausea, vomiting, diarrhea, fever, dizziness, fainting, an irregular or slow heartbeat, changes in vision, confusion, flushing, and seizures.

 

What should I avoid while taking Nitroglycerin?

· Use caution when driving, operating machinery, or performing other hazardous activities. Also, stand up slowly from a sitting or lying position. Nitroglycerin may cause dizziness. If you experience dizziness, avoid hazardous activities.

· Avoid alcohol. It also widens blood vessels and may cause dizziness, drowsiness, and low blood pressure. It could be dangerous to combine alcohol with Nitroglycerin.

 

What are the possible side effects of Nitroglycerin?

· If you experience any of the following serious side effects, stop taking Nitroglycerin and seek emergency medical attention or contact your doctor immediately:     ·an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);     ·an irregular heartbeat;     ·blurred vision or dry mouth; or     ·fainting.

· Other, less serious side effects may be more likely to occur. Continue to take Nitroglycerin and talk to your doctor if you experience     ·headache or dizziness;     ·flushing (redness of the face, neck, and chest);     ·nausea or vomiting;     ·fast heartbeat;     ·swollen ankles; or     ·weakness.

· Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

 

What other drugs will affect Nitroglycerin?

· Do not use sildenafil (Viagra), a drug used to treat impotence, while taking Nitroglycerin without first talking to your doctor. The combination could cause severe or life-threatening low blood pressure.

· Before taking Nitroglycerin, tell your doctor if you are taking any of the following medicines:     ·dihydroergotamine (D.H.E. 45, Migranal) or ergotamine (Ergomar, Cafergot, Ercaf, others); or     ·any other heart medicines, especially those used to treat high blood pressure or irregular heartbeats.

· You may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

· Drugs other than those listed here may also interact with Nitroglycerin or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including herbal products.

 

Where can I get more information?

· Your pharmacist has additional information about Nitroglycerin written for health professionals that you may read.


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