Nitroglycerin (oral/sublingual)

Nitroglycerin is used in adults to treat or prevent chest pain (angina).

Nitroglycerin may also be used for other reasons that are not mentioned in this medication guide.

Get emergency medical help if you still have chest pain after using a total of 3 doses in 15 minutes, or if you have chest pain that feels unusual.

You should not use nitroglycerin if you are allergic to it.

You may not be able to use nitroglycerin if you have:

• severe anemia (very low red blood cells);
• increased pressure inside the skull;
• blood circulation problems or if your heart cannot pump blood properly; or
• if you also take riociguat, vericiguat, or medicines such as avanafil (Strendra), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis) or vardenafil (Levitra, Staxyn).

Tell your doctor if you have or have ever had:

• a heart attack or other heart problems; or
• low blood pressure.

Tell your doctor if you are pregnant or breastfeeding.

Get emergency medical help if you have signs of an allergic reaction: hives, trouble breathing, swelling of your face, lips, tongue, or throat.

Nitroglycerin may cause serious side effects. Call your doctor right away if you have:

• severe or throbbing headaches that do not get better with continued use of nitroglycerin;
• pounding heartbeats or fluttering in your chest;
• slow heart rate;
• feeling like you might faint; or
• new or worsening chest pain.

Common side effects of nitroglycerin may include:

• headache, dizziness; or
• numbness, tingling, burning pain.

This is not a complete list of side effects and others may happen. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

You may use nitroglycerin sublingual within 5 to 10 minutes before an activity that might cause chest pain.

Use nitroglycerin sublingual at the first sign of chest pain. Use another dose every 5 minutes as needed, up to a total of 3 doses within a 15-minute period.

Sublingual spray:

• Before your first use, prime with 5 to 10 sprays into the air, away from your face. Prime again if has not been used within 6 weeks with one to two sprays, or if it has not been used within 3 months with up to 5 sprays.
• Spray one or two sprays on or under the tongue and avoid swallowing. Do not rinse your mouth or spit out nitroglycerin for 5 to 10 minutes after use. The spray should not be inhaled.

Sublingual tablet: Place one tablet under the tongue and allow it to dissolve without swallowing. Do not swallow, chew, or suck the sublingual tablet.

Sublingual powder: Empty one or two packet contents under your tongue, allowing the powder to dissolve without swallowing. Do not rinse your mouth or spit for 5 minutes after use.

Capsule: Take by mouth as directed by your doctor, usually 3 to 4 times a day. Do not take the capsule to treat sudden chest pain.

Get emergency medical help if you still have chest pain after using a total of 3 doses in 15 minutes, or if your chest pain seems unusual.

This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using nitroglycerin.

Your condition may get worse if you stop using nitroglycerin suddenly. Ask your doctor before stopping the medicine.

Store this medicine in the original container at room temperature away from moisture and heat.

Keep the spray away from open flame or high heat. Do not puncture or burn an empty canister.

Nitroglycerin is used as needed. If you follow a dosing schedule and miss a dose, skip it. Do not take two doses at the same time.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An overdose can be deadly.

Signs of an overdose may include a severe headache, confusion, strong heartbeats, vision issues, vomiting, bloody diarrhea, sweating, clammy skin, blue lips, weak or shallow breathing, loss of movement, seizures, or fainting.

Do not stand up too quickly from a sitting or lying down position, or you may feel dizzy.

Drinking alcohol with nitroglycerin can cause side effects.

Tell your doctor about all the other medicines you are taking, especially:

• heart or blood pressure medication; or
• migraine headache medicine such as dihydroergotamine, ergotamine, ergonovine, methylergonovine.

This list is not complete. Other drugs may affect nitroglycerin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.