Nitroglycerin (Intravenous)

Nitroglycerin injection is used to treat high blood pressure during surgery or to manage congestive heart failure in patients who have had a heart attack. It may also be used to lower blood pressure during surgery. Nitroglycerin injection is sometimes used to treat chest pain in patients who have not responded well to other treatments.

Nitroglycerin is part of a group of medicines called nitrates. It helps by relaxing blood vessels and increasing blood and oxygen flow to the heart while decreasing its workload.

This medicine should only be given by or under the direct supervision of your doctor.

It is very important that your doctor check your progress closely while you are receiving this medicine to ensure it is working properly.

Do not take riociguat (Adempas®), sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) while you are using this medicine. Using these medicines together may cause blurred vision, dizziness, lightheadedness, or fainting. If you are taking these medicines and you experience an angina attack, you must go to the hospital right away.

Dizziness, lightheadedness, or faintness may occur, especially when you get up quickly from a lying or sitting position. Getting up slowly may help.

This medicine may cause headaches. These headaches are a sign that the medicine is working. If you have severe pain, talk with your doctor.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

In deciding to use a medicine, you and your doctor need to consider the risks and benefits. For this medicine, keep the following in mind:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies have not been done to understand how age affects the use of nitroglycerin injection in children. Its safety and effectiveness have not been established.

Geriatric

Current studies have not shown any specific problems in older adults that would limit the use of nitroglycerin injection. However, older patients are more likely to have age-related liver, kidney, or heart issues, which may require caution and a dose adjustment for those receiving nitroglycerin injection.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication while breastfeeding. Weigh the potential benefits against the potential risks before using this medication during breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others can be used together with caution. Your doctor may need to adjust the dose or take other precautions if you are taking any of the medicines listed below while receiving this medicine. The following interactions are significant but not necessarily a complete list.

Using this medicine with any of the following medicines is not recommended. Your doctor may choose not to treat you with this medication or change some of the other medicines you take.

• Avanafil
• Riociguat
• Sildenafil
• Tadalafil
• Vardenafil

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Alteplase, Recombinant
• Heparin

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both may be the best option for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Acetylcysteine
• Apomorphine
• Aspirin
• Dihydroergotamine
• Pancuronium

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken at the same time as food or certain types of food due to potential interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions are significant but not necessarily a complete list.

Other Medical Problems

Other medical issues may impact the use of this medicine. Be sure to tell your doctor about any other medical problems you have, especially:

• Allergy to corn or corn products or
• Constrictive pericarditis (a heart disease) or
• Pericardial tamponade (a heart disease) or
• Restrictive cardiomyopathy (a heart disease)—Should not be used in patients with these conditions.

• Diabetes or
• Hypertrophic cardiomyopathy (a heart disease) or
• Hypotension (low blood pressure) or
• Hypovolemia (low amount of blood)—Use with caution. May worsen these conditions.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may require medical attention.

Check with your doctor or nurse right away if any of the following side effects occur:

Rare

• Bluish-colored lips, fingernails, or palms
• dark urine
• difficulty with breathing
• dizziness or lightheadedness
• fever
• headache
• pale skin
• rapid heart rate
• sore throat
• unusual bleeding or bruising
• unusual tiredness or weakness

Incidence not known

• Arm, back, or jaw pain
• blurred vision
• chest pain or discomfort
• chest tightness or heaviness
• confusion
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• fainting
• fast or irregular heartbeat
• sweating

Get emergency help right away if any of the following symptoms of overdose occur:

Symptoms of overdose

• Blurred or loss of vision
• bulging soft spot on the head of an infant
• change in consciousness
• change in the ability to see colors, especially blue or yellow
• cold, clammy skin
• convulsions
• disturbed color perception
• double vision
• feeling of constant movement of self or surroundings
• flushed skin
• halos around lights
• headache, severe and throbbing
• increased sweating
• loss of appetite
• loss of consciousness
• nausea or vomiting
• night blindness
• overbright appearance of lights
• paralysis
• sensation of spinning
• slow or irregular heartbeat
• tunnel vision

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Nitro-Bid
• NITRONAL

Available Dosage Forms:

• Solution

Therapeutic Class: Coronary Vasodilator

Chemical Class: Nitrate

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins.

• How do you take GoNitro to treat an angina attack (chest pain)?
• What is the shelf life of nitroglycerin tablets?