* Nitroglycerin relaxes smooth muscle contained within the walls of
blood vessels (particularly veins) which dilates (widens) them.
This helps to relieve chest pain that is caused by a narrowing of
the blood vessels, and also reduces how hard the heart has to work
to pump blood around the body, reducing blood pressure.
* Nitroglycerin belongs to a group of medicines called nitrates.
Upsides
* Nitroglycerin sublingual spray or tablets may be used to relieve
symptoms of angina (chest pain) in suitable people.
* Nitroglycerin injection may be given by a doctor's office or before
surgery to treat or lower high blood pressure, to control heart
failure associated with a heart attack, or to treat angina in
suitable patients.
* Nitroglycerin rectal ointment may be used to treat anal fissure
pain.
* Available as a buccal tablet, a sublingual spray or tablet, a
transdermal ointment or film, a rectal ointment, a sublingual
powder, an intravenous solution, and an oral capsule.
* Generic nitroglycerin is available.
Downsides
If you are between the ages of 18 and 60, take no other medication or
have no other medical conditions, side effects you are more likely to
experience include:
* Dizziness, light-headedness, headache, and low blood pressure may
occur. This may affect a person's ability to drive or operate
machinery. Alcohol, hot weather, and exercise may worsen these
effects and result in fainting. Blurred vision may also occur.
* Rarely, allergic reactions, flushing, severe dizziness or a
headache or persistent nausea or vomiting may occur. Seek urgent
medical help.
* Alcohol toxicity has been reported when high-dose nitroglycerin
injection has been given in conjunction with alcohol, or when
certain medications (such as disulfiram, cephalosporin antibiotics)
are taken at the same time as nitroglycerin and alcohol. Do not
drink alcohol while using nitroglycerin.
* Tolerance can develop to nitroglycerin's effect (tolerance is when
the same dose no longer produces the same effect). To prevent this
from developing, nitroglycerin-free intervals of 10-12 hours
between doses are recommended. However, if you are experiencing
chest pain, which is unrelieved by one nitroglycerin dose, it is
acceptable to have another dose and call for urgent medical help.
* May not be suitable for some people including the elderly; those
with a history of stroke or bleeding in the brain; with anemia,
glaucoma, migraines or swelling of the heart sac; on medication for
erectile dysfunction; or where blood flow back to the heart is
restricted.
* May interact with a number of other medications including medicines
used to treat erectile dysfunction (such as sildenafil and
tadalafil), topical anesthetics, antidepressants and
antipsychotics, riociguat, diuretics, ergot derivatives, and
tizanidine. Alcohol may increase the side effects of nitroglycerin.
May affect the results of some medical tests.
* Nitroglycerin can be toxic to children and pets. Keep well out of
reach.
Notes: In general, seniors or children, people with certain medical
conditions (such as liver or kidney problems, heart disease, diabetes,
seizures) or people who take other medications are more at risk of
developing a wider range of side effects. For a complete list of all
side effects, [84]click here.
Bottom Line
Nitroglycerin dilates veins, relieving chest pain and lowering blood
pressure. It has a very short duration of action and may not be
suitable for some people.
Tips
* If you are taking this medicine to relieve symptoms of angina, keep
it on hand at all times. Always refill your prescription before you
run out of nitroglycerin.
* Take nitroglycerin spray or sublingual tablets at the first sign of
chest pain. Sit down if you can before taking a dose. Place the
sublingual tablet under your tongue and allow it to dissolve
slowly. Take exactly as directed by your doctor. Do not use more
than three tablets in 15 minutes.
* Nitroglycerin spray needs to be primed before use or if it has not
been used for six weeks. Spray the dose of Nitrolingual preferably
onto or under the tongue; do not inhale. Close your mouth after the
spray. Avoid rinsing the mouth for five to ten minutes after. Keep
the spray canister away from heat or flames because it may explode.
* Talk to your doctor about taking nitroglycerin five to ten minutes
before any activity that typically causes you chest pain.
* If you develop severe chest pain or symptoms of a heart attack, or
if your chest pain lasts more than five minutes, seek emergency
medical attention.
* Always sit or stand up slowly when rising from a lying down or
seated position as nitroglycerin may cause a drop in blood
pressure.
* Contact your doctor immediately if you develop a slow heartbeat or
new or worsening chest pain after using nitroglycerin.
* Sometimes nitroglycerin will cause a burning or stinging in your
mouth. This is not a sign that the medicine is working. Do not use
more nitroglycerin just because you didn't notice the burning or
stinging.
* Tell other health professionals (such as your dentist) that you
take nitroglycerin.
* Do not take medicines for erectile dysfunction (ED), such as
Viagra, Cialis or Levitra, while you are taking nitroglycerin as
the combination may dangerously drop your blood pressure. Talk to
your doctor or pharmacist before taking any other medications with
nitroglycerin, because some may not be compatible with
nitroglycerin.
* Do not take nitroglycerin if you have circulation problems, are in
shock, have severe anemia, or a feeling of pressure inside your
head.
Response and Effectiveness
* Nitroglycerin acts in the body for an extremely short period of
time, although it is metabolized to longer-lived active
metabolites. However, these are less effective vasodilators than
nitroglycerin.
References
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