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What is nitroglycerin?

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.


Precautions

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.

You should not use this medication if you are allergic to nitroglycerin, isosorbide mononitrate (Imdur), or isosorbide dinitrate (BiDil, Isordil), or 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);
  • severe anemia (a lack of red blood cells); or
  • a brain injury, hemorrhage, or tumor.

Before taking nitroglycerin, tell your doctor if you are allergic to any drugs, or if you have:

  • congestive heart failure;
  • a history of heart attack, stroke, or head injury;
  • low blood pressure;
  • glaucoma;
  • migraine headaches;
  • liver disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take nitroglycerin.

FDA pregnancy category C. This medication may be harmful to an unborn baby. 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.

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.

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Instructions

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of nitroglycerin can be fatal.

Overdose symptoms may include a severe throbbing headache, confusion, fever, fast or pounding heartbeats, dizziness, vision problems, nausea, vomiting, bloody diarrhea, trouble breathing, cold or clammy skin, feeling light-headed, fainting, and seizures.

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.

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Side-effects

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.

Stop using nitroglycerin and 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;
  • feeling light-headed, nausea, vomiting, sweating, pale skin fainting; 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. Tell your doctor about any unusual or bothersome side effect.

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Interactions

Before taking nitroglycerin, tell your doctor if you are using any of the following drugs:

  • 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);
  • antidepressants 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 may be 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.

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Disclaimer

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2004 Cerner Multum, Inc. Version 2.05. Revision date 8/23/04

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