Nitroglycerin spray and tablets are used to treat episodes of angina (chest pain) in people who have coronary artery disease (narrowing of the blood vessels that supply blood to the heart). The spray and tablets may also be taken just before activities that may cause episodes of angina in order to prevent the angina from occurring. Nitroglycerin extended-release (long-acting) capsules are used to prevent episodes of angina in people who have coronary artery disease. The extended-release capsules can only be used to prevent angina attacks; they cannot be used to treat an attack once it has begun. Nitroglycerin is in a class of medications called vasodilators. It works by relaxing the blood vessels so the heart does not need to work as hard and therefore does not need as much oxygen.
Nitroglycerin comes as a sublingual tablet, an extended-release (long-acting) capsule, and a spray. The extended-release capsules are usually taken by mouth three to four times a day. The tablets and spray are usually taken as needed, either 5-10 minutes before activities that may cause attacks of angina or at the first sign of an attack. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take nitroglycerin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Nitroglycerin extended-release capsules help prevent angina but do not cure coronary artery disease. Continue to take nitroglycerin capsules even if you feel well. Do not stop taking nitroglycerin capsules without talking to your doctor.
Nitroglycerin may not work as well after you have used it for some time or if you have taken many doses. If you are taking the capsules, your doctor will schedule your doses so that there is a period of time when you are not exposed to nitroglycerin every day. If you are taking the tablets or spray, you should take the fewest tablets or use the fewest number of sprays needed to relieve the pain of your attacks. If your angina attacks happen more often, last longer, or become more severe at any time during your treatment, call your doctor.
Talk to your doctor about how to use nitroglycerin tablets or spray to treat angina attacks. Your doctor will probably tell you to sit down and take one dose of nitroglycerin when an attack begins. If your symptoms do not improve very much or if they worsen after you take this dose you may be told to call for emergency medical help right away. If your symptoms do not go away completely after you take the first dose, your doctor may tell you to take a second dose after 5 minutes have passed and a third dose 5 minutes after the second dose. Call for emergency medical help right away if your chest pain has not gone away completely 5 minutes after you take the third dose.
Do not chew or swallow nitroglycerin tablets. Instead, place the tablet under your tongue or between your cheek and gum and wait for it to dissolve. You may feel burning or tingling in your mouth as the tablet dissolves. This is normal but is not a sign that the tablet is working. Do not be concerned that the tablet is not working if you do not feel the burning or tingling.
Sit down if possible, and hold the container without shaking it. Remove the plastic cap.
If you are using the container for the first time, hold the container upright so that it is pointed away from yourself and others, and press the button 10 times to prime the container. If you are not using the container for the first time but have not used it in 6 weeks or longer, press the button 2 times to re-prime the container.
Open your mouth. Hold the container upright, as close to your mouth as possible.
Use your forefinger to press the button firmly. This will release a spray into your mouth. Do not inhale the spray.
Close your mouth. Do not spit out the medication or rinse your mouth for 5-10 minutes.
Replace the plastic cap on the container.
Check the level of liquid in the container from time to time to be sure that you will always have enough medication on hand. Hold the container upright while you are checking. If the liquid reaches the top or middle of the hole on the side of the container, you should order more medication. If the liquid is at the bottom of the hole, the container will no longer dispense full doses of medication.
Do not try to open the container of nitroglycerin spray. This product may catch fire, so do not use near an open flame, and do not allow the container to be burned after use.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Unless your doctor tells you otherwise, continue your normal diet.
Nitroglycerin tablets and spray are usually taken as needed. If you miss a dose of nitroglycerin extended-release capsules, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
rash, blistering, or peeling of the skin
difficulty breathing or swallowing
Nitroglycerin may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
slow or pounding heartbeat
shortness of breath
cold, clammy skin
loss of ability to move the body
coma (loss of consciousness for a period of time)
Keep all appointments with your doctor
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking nitroglycerin.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Revised - 08/01/2010
AHFS® Consumer Medication Information. © Copyright, 2013. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.