Side effects of nitroglycerine

Using Nitroglycerin for Angina

Do not take the pulmonary hypertension medicine sildenafil (Revatio) if you are taking nitroglycerin or another nitrate medicine.

How should I store nitroglycerin?

Store nitroglycerin pills in a dark-colored (such as brown), airtight, glass container that you cannot see through. Keep the container tightly closed. Keep nitroglycerin pills and liquid spray away from heat or moisture.

Can nitroglycerin get old and lose potency?

Nitroglycerin can get old. And when it is old, it may not work. If your nitroglycerin supply is past its expiration date, get a new prescription as soon as possible. Keep your nitroglycerin in the container it came in and tightly closed. Do not open your sublingual nitroglycerin until you need a dose. Replace your tablets every 3 to 6 months. A nitroglycerin spray may last up to 2 years before it expires.

You may get a headache when you use nitroglycerin. Or you may feel burning or tingling under your tongue with nitroglycerin that is used under the tongue. But if you don’t have a headache or feel burning or tingling under your tongue, it does not mean the medicine is not working.

Patient Education

Discharge Instructions: Taking Fast-Acting Nitroglycerin

Your healthcare provider prescribed nitroglycerin for you. This medicine relieves chest pain caused by a lack of blood flow to the heart (angina) by getting more oxygen-rich blood to your heart. Fast-acting nitroglycerin can stop an angina attack. Follow the steps below for taking fast-acting nitroglycerin. Note: Your healthcare provider may give you slightly different instructions. If so, follow them carefully.

The name of my fast-acting nitroglycerin medicine is ________________________________.

To stop an angina attack

Sit down before you take your nitroglycerin. The medicine may make you feel dizzy because it lowers blood pressure rapidly.

Using fast-acting tablets

  • Place 1 tablet under your tongue. You can also place it between your lip and gum, or between your cheek and gum.

  • Let the tablet dissolve completely. Don’t swallow or chew the tablet.

  • As the tablet is dissolving, do not eat or drink anything, or smoke or chew tobacco.

Using fast-acting spray

  • Open your mouth and hold the sprayer just in front of your mouth.

  • Press the button on the top. Spray once on or under your tongue. Do not inhale.

  • Close your mouth. Then wait a few seconds before you swallow.

After taking 1 tablet or spraying once

  • Continue sitting for 5 minutes.

  • If the angina goes away completely, rest for a while and continue your normal routine.

Call 911 if your angina lasts longer than 5 minutes and 1 tablet or 1 spray has not relieved it. Don’t delay. You may be having a heart attack (acute myocardial infarction, or AMI)!

After you call 911, take a second tablet. Or, spray a second time. Wait another 5 minutes. If the angina still does not go away, take a third tablet, or spray a third time. Don’t take more than 3 tablets, or spray more than 3 times, within 15 minutes. Stay on the phone with 911 for further instructions.

Precautions

  • Limit the amount of alcohol you drink. Too much alcohol can cause dizziness or fainting.

  • Don’t take phosphodiesterase inhibitors, such as sildenafil. These are medicines used to treat sexual dysfunction in men—at any time if you are on nitroglycerin treatment. The combination of nitroglycerin with these medicines can cause a severe drop in blood pressure. This can lead to dizziness, fainting, heart attack, or stroke.

  • Check the expiration date. Nitroglycerin can lose its effectiveness over time.

  • Tell your healthcare provider if your angina attacks last longer, occur more often, or are more severe.

Possible side effects of nitroglycerin

If you have any of these side effects, tell your healthcare provider right away. But don’t stop taking the medicine until your doctor tells you to. Mild side effects include:

  • More gas (flatulence) than normal

  • Bloating

  • Nausea

  • Hair loss

  • Decreased appetite

  • Weight loss

  • Headache

  • Dizziness

  • Flushing (redness of the face, neck, or chest)

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

  • Severe headache

  • Severe dizziness, or fainting

  • Nausea or vomiting

  • Fast heartbeat (higher than 100 beats per minute)

  • Swollen ankles

  • Weakness

  • Angina attacks that last longer, occur more often, or are more severe than in the past or occur at rest

Nitrostat

Medical Editor: John P. Cunha, DO, FACOEP

Last reviewed on RxList 12/17/2018

Nitrostat (nitroglycerin) Sublingual Tablets are nitrates used to treat or prevent attacks of chest pain (angina). Nitrostat is available in generic form. Common side effects of Nitrostat include:

  • headache,
  • weakness,
  • dizziness,
  • lightheadedness,
  • nausea, and
  • flushing as your body adjusts to this medication.

Other side effects of Nitrostat include:

  • mild burning or tingling with the tablet in your mouth, and
  • flushing (warmth, redness, or tingly feeling under your skin).

Tell your doctor if you experience unlikely but serious side effects of Nitrostat including:

  • fainting, or
  • fast/irregular/pounding heartbeat.

The dose of Nitrostat is one tablet dissolved under the tongue or in the buccal (cheek) pouch at the first sign of an acute anginal attack. The dose may be repeated approximately every 5 minutes until relief is obtained. If pain persists after 3 tablets in 15-minutes, or if the pain is different than typically experienced, prompt medical attention is recommended. Nitrostat may interact with alteplase, aspirin or heparin, bladder or urinary medications, blood pressure medication, bronchodilators, dihydroergotamine or ergotamine, erectile dysfunction medications, antidepressants, beta-blockers, calcium channel blockers, irritable bowel medications, medication that causes dry mouth, or medicines to treat psychiatric disorders. Tell your doctor all medications you use. During pregnancy, Nitrostat should be used only when prescribed. It is not known if this drug passes into breast milk or if it may harm a nursing infant. Consult your doctor before breast-feeding.

Our Nitrostat (nitroglycerin) (nitroglycerin) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

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

Nitroglycerin

  • Any sort of head trauma where you might have swelling or bleeding in the head
  • Overactive thyroid condition
  • Low systolic blood pressure (SBP)
  • A drop in blood pressure while standing
  • People who take nitroglycerin for long periods of time may find that they seem to build a tolerance to the drug and that it appears to either have stopped working or become less effective. This is known as nitroglycerin tolerance.

    The best way to avoid this problem is by taking what is called a “drug holiday,” in which you go for a period of at least 10 to 12 hours of not taking the drug. Many patients find it most convenient to take the drug holiday overnight while they are asleep.

    It’s important to note that you should avoid changing brands (even between generic versions) because there any many different dosage forms and strengths of nitroglycerin.

    Make sure that you are getting the exact dose that your doctor intended for you to have of this drug each time you take it.

    Pregnancy and Nitroglycerin

    It’s not clear whether taking nitroglycerin during pregnant will harm the fetus.

    Additionally, it still remains unclear whether nitroglycerin is found in breast milk, so it’s not recommended that breastfeeding mothers take this medication.

    Tell your doctor if you are pregnant or plan to become pregnant before taking this medication.

    You should also alert your physician if you are breastfeeding or plan to breastfeed.

    Nitroglycerin Sublingual

  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aspirin; beta blockers such as atenolol (Tenormin), carteolol , labetalol (Trandate, in Normozide, in Trandate HCT), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), propranolol (Hemangeol, Inderal, Innopran), sotalol (Betapace, Sorine), and timolol; calcium channel blockers such as amlodipine, diltiazem (Cardizem, Cartia, Diltzac, others), felodipine (Plendil), isradipine (DynaCirc), nifedipine (Adalat, Afeditab CR, Procardia), and verapamil (Calan, Covera, Verelan, in Tarka); diuretics (water pills); ergot-type medications such as bromocriptine (Cycloset, Parlodel), cabergoline, dihydroergotamine (D.H.E. 45, Migranal), ergoloid mesylates (Hydergine), ergotamine (in Cafergot, in Migergot), and methylergonovine (Methergine) heparin; medications for high blood pressure, heart failure, or an irregular heartbeat. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • you should know that nitroglycerin sublingual tablets may not dissolve easily in your mouth if you are taking medications that cause dry mouth such as antihistamines; antidepressants including amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Silenor), imipramine (Tofranil), nortriptyline (Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); ipratropium (Atrovent); or medications for irritable bowel disease, motion sickness, Parkinson’s disease, ulcers, or urinary problems. If this happens, use an artificial saliva product or chew gum to increase the amount of saliva in your mouth so that the tablet will dissolve.
  • tell your doctor if you have recently had a heart attack and if you have anemia (low number of red blood cells) or any condition that causes increased pressure in your skull. Your doctor may tell you not to take nitroglycerin.
  • tell your doctor if you think you may be dehydrated and if you have or have ever had heart failure, low blood pressure, or hypertrophic cardiomyopathy (thickening of the heart muscles).
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking nitroglycerin, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking nitroglycerin.
  • ask your doctor about the safe use of alcoholic beverages while you are taking nitroglycerin. Alcohol can make the side effects from nitroglycerin worse.
  • you should know that nitroglycerin may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position, or at any time, especially if you have been drinking alcoholic beverages. To avoid this problem, get up slowly, resting your feet on the floor for a few minutes before standing up. Take extra precautions to avoid falling during your treatment with nitroglycerin.
  • you should know that you may experience headaches during your treatment with nitroglycerin. These headaches may be a sign that the medication is working as it should. Do not try to change the times that you take nitroglycerin in order to avoid headaches because then the medication may not work as well.
  • Nitroglycerin Side Effects

    Medically reviewed by Drugs.com. Last updated on Feb 16, 2019.

    • Overview
    • Side Effects
    • Dosage
    • Professional
    • Tips
    • Interactions
    • More

    For the Consumer

    Applies to nitroglycerin: capsule extended release, packet, spray, tablet

    Other dosage forms:

    • intravenous solution
    • rectal ointment
    • transdermal ointment, transdermal patch extended release

    Along with its needed effects, nitroglycerin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur while taking nitroglycerin:

    Less common

    • Bloating or swelling of the face, arms, hands, lower legs, or feet
    • burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
    • difficult or labored breathing
    • feeling faint, dizzy, or lightheadedness
    • feeling of warmth or heat
    • flushing or redness of the skin, especially on the face and neck
    • headache
    • rapid weight gain
    • sweating
    • tightness in the chest
    • tingling of the hands or feet
    • unusual weight gain or loss

    Rare

    • Bluish-colored lips, fingernails, or palms
    • dark urine
    • fever
    • 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
    • cough
    • cracks in the skin
    • difficulty with swallowing
    • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
    • fainting
    • fast, irregular, pounding, or racing heartbeat or pulse
    • feeling of constant movement of self or surroundings
    • feeling of warmth
    • hives, itching, or rash
    • increased sweating
    • loss of heat from the body
    • nausea or vomiting
    • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
    • red, swollen skin
    • redness of the face, neck, arms, and occasionally, upper chest
    • scaly skin
    • sensation of spinning
    • weakness

    Get emergency help immediately if any of the following symptoms of overdose occur while taking nitroglycerin:

    Symptoms of overdose

    • Bluish-colored lips, fingernails, or palms
    • 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
    • dark urine
    • difficulty breathing
    • disturbed color perception
    • dizziness or lightheadedness
    • double vision
    • fever
    • flushed skin
    • halos around lights
    • headache, severe and throbbing
    • increased sweating
    • loss of appetite
    • loss of consciousness
    • night blindness
    • overbright appearance of lights
    • pale skin
    • paralysis
    • slow or irregular heartbeat
    • sore throat
    • tunnel vision
    • unusual bleeding or bruising
    • unusual tiredness or weakness

    Some side effects of nitroglycerin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    Less common

    • Abdominal or stomach pain
    • body aches or pain
    • congestion
    • hoarseness
    • lack or loss of strength
    • runny nose
    • sneezing
    • stuffy nose
    • tender, swollen glands in the neck
    • voice changes

    For Healthcare Professionals

    Applies to nitroglycerin: buccal tablet extended release, intravenous solution, oral capsule extended release, rectal ointment, sublingual powder, sublingual spray, sublingual tablet, transdermal film extended release, transdermal ointment

    General

    The most common side effect is headache.

    Nervous system

    Very common (10% or more): Headache (up to 64%)

    Common (1% to 10%): Dizziness, lightheadedness, syncope, vertigo, drowsiness

    Rare (0.1% to 0.01%): Severe and prolonged headache

    Very rare (less than 0.01%): Cerebral ischemia

    Frequency not reported: Faintness, somnolence

    Cardiovascular

    Common (1% to 10%): Hypotension, angina increased, paradoxical bradycardia, tachycardia, orthostatic hypotension, blood pressure decreased, facial flushing

    Uncommon (0.1 to 1%): Circulatory collapse

    Rare (less than 0.1%): Bradycardia, cyanosis, flushing, heart rate increase

    Frequency not reported: Crescendo angina, rebound hypertension, palpitations, hypertension, decreased arterial oxygen tension, severe arterial hypotension with bradycardia, transient flushing

    Gastrointestinal

    Common (1% to 10%): Nausea, vomiting

    Rare (0.01% to 0.1%): Dry mouth

    Very rare (less than 0.01%): Heartburn, halitosis

    Frequency not reported: Abdominal pain, retching, lip and tongue swelling

    Dermatologic

    Uncommon (0.1% to 1%): Dermatitis contact, erythema, pruritus, burning, irritation, eczema, urticaria

    Rare (0.01 to 0.1%): Allergic skin reactions, rash

    Very rare (less than 0.01%): Exfoliative dermatitis, drug rash

    Frequency not reported: Cutaneous flushing, diaphoresis, angioedema

    Postmarketing reports: Rash generalized

    Other

    Common (1% to 10%): Asthenia, weakness

    Frequency not reported: Retrosternal discomfort

    Hypersensitivity

    Rare (less than 0.1%): Hypersensitivity reactions, anaphylaxis

    Frequency not reported: Allergic reaction, anaphylactoid reaction

    Psychiatric

    Common (1% to 10%): Restlessness

    Frequency not reported: Apprehension

    Respiratory

    Very rare (less than 0.01%): Impairment of respiration

    Frequency not reported: Hypoxemia, dyspnea

    Hematologic

    Very rare (less than 0.01%): Methemoglobinemia

    Ocular

    Rare (less than 0.1%): Blurred vision

    Frequency not reported: Increased ocular pressure

    Musculoskeletal

    Frequency not reported: Muscle twitching

    1. “Product Information. Nitrolingual (nitroglycerin).” First Horizon Pharmaceutical Corporation, Alpharetta, GA.

    2. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0

    3. Cerner Multum, Inc. “Australian Product Information.” O 0

    4. “Product Information. Tridil (nitroglycerin).” DuPont Pharmaceuticals, Wilmington, DE.

    5. “Product Information. Nitrostat (nitroglycerin).” Parke-Davis, Morris Plains, NJ.

    Further information

    Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

    Some side effects may not be reported. You may report them to the FDA.

    Related questions

    • What is the shelf life of nitroglycerin tablets?

    Medical Disclaimer

    More about nitroglycerin

    • During Pregnancy or Breastfeeding
    • Dosage Information
    • Patient Tips
    • Drug Images
    • Drug Interactions
    • Compare Alternatives
    • Support Group
    • Pricing & Coupons
    • 37 Reviews
    • Drug class: antianginal agents
    • FDA Alerts (1)

    Consumer resources

    • Nitroglycerin oral/sublingual
    • Nitroglycerin rectal
    • Nitroglycerin topical
    • Nitroglycerin transdermal
    • Nitroglycerin Sublingual Tablets
    • … +11 more

    Other brands: Nitrostat, Nitro-Dur, NitroQuick, Nitro-Bid, … +11 more

    Professional resources

    • Nitroglycerin (AHFS Monograph)
    • … +10 more

    Related treatment guides

    • Anal Fissure and Fistula
    • Angina
    • Angina Pectoris Prophylaxis
    • Heart Attack
    • … +3 more

    Nitroglycerin (oral/sublingual)

    You should not use sublingual nitroglycerin if you have:

    • severe anemia (low red blood cells);

    • increased pressure inside the skull;

    • circulation problems or shock (pale skin, cold sweat, fast or irregular heartbeats, sudden weakness or feeling like you might pass out); or

    • heart attack symptoms–chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.

    Tell your doctor if you have ever had:

    • a heart attack or other heart problems;

    • a stroke or head injury;

    • low blood pressure; or

    • headaches.

    Tell your doctor if you are pregnant or breastfeeding.

    Nitroglycerin (oral/sublingual) is not approved for use by anyone younger than 18 years old.

    How should I take nitroglycerin?

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

    If you use too much nitroglycerin, it might not work as well in controlling your symptoms.

    Nitroglycerin is usually taken at the first sign of chest pain. You may use nitroglycerin sublingual within 5 to 10 minutes before an activity you think might cause chest pain. Try to rest or stay seated when you take nitroglycerin (may cause dizziness or fainting).

    Do not rinse or spit nitroglycerin powder for 5 minutes after using the medicine.

    Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

    Seek emergency medical attention if your chest pain gets worse or lasts more than 5 minutes, especially if you have trouble breathing or feel weak, dizzy, or nauseated, or lightheaded.

    You may feel a slight burning or stinging in your mouth when you use nitroglycerin. This is not a sign of how well the medicine is working. Do not use more just because you do not feel a burning or stinging.

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

    If you take nitroglycerin on a regular schedule to prevent angina, do not stop taking it suddenly or you could have a severe attack of angina. Keep this medicine on hand at all times. Get your prescription refilled before you run out of medicine completely.

    Store nitroglycerin at room temperature away from moisture and heat.

    Keep the spray away from open flame or high heat, such as in a car on a hot day. The canister may explode if it gets too hot.

    What happens if I miss a dose?

    Since nitroglycerin is used when needed, you may not be on a dosing schedule. If you are on a schedule, the medicine as soon as you can, but skip the missed dose if your next dose is due in less than 2 hours. Do not use two doses at one time.

    What happens if I overdose?

    Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of nitroglycerin can be fatal.

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

    What should I avoid while taking nitroglycerin?

    Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

    Drinking alcohol can increase certain side effects such as dizziness, drowsiness, feeling light-headed, or fainting.

    Nitroglycerin side effects

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

    Call your doctor at once if you have:

    • severe or throbbing headaches that do not become less severe with continued use of nitroglycerin;

    • pounding heartbeats or fluttering in your chest;

    • slow heart rate;

    • a light-headed feeling, like you might pass out;

    • blurred vision or dry mouth; or

    • heart attack symptoms–chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.

    Nitroglycerin can cause severe headaches. These headaches may gradually become less severe as you continue to use nitroglycerin. Do not stop taking nitroglycerin. Ask your doctor before using any headache pain medication.

    Common side effects may include:

    • headache, dizziness; or

    • numbness, tingling, burning pain.

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

    What other drugs will affect nitroglycerin?

    Tell your doctor about all your current medicines, especially:

    • aspirin, heparin;

    • medicine used to treat blood clots;

    • blood pressure medication; or

    • ergot medicine–dihydroergotamine, ergotamine, ergonovine, methylergonovine.

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

    Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

    Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

    Copyright 1996-2018 Cerner Multum, Inc. Version: 15.01.

    • What is the shelf life of nitroglycerin tablets?

    Medical Disclaimer

    • Side Effects
    • During Pregnancy or Breastfeeding
    • Dosage Information
    • Patient Tips
    • Drug Images
    • Drug Interactions
    • Compare Alternatives
    • Support Group
    • Pricing & Coupons
    • 37 Reviews
    • Drug class: antianginal agents
    • FDA Alerts (1)
    • Nitroglycerin rectal
    • Nitroglycerin topical
    • Nitroglycerin transdermal
    • Nitroglycerin Sublingual Tablets
    • Nitroglycerin Controlled-Release Capsules
    • … +10 more

    Other brands: Nitrostat, Nitro-Dur, NitroQuick, Nitro-Bid, … +11 more

    • Nitroglycerin (AHFS Monograph)
    • … +10 more
    • Anal Fissure and Fistula
    • Angina
    • Angina Pectoris Prophylaxis
    • Heart Attack
    • … +3 more

    What to know about nitroglycerin

    The following table lists the different formulations of nitroglycerin.

    Form of nitroglycerin How to use
    aerosol solution
    packet
    pumpspray
    tablet
    dissolve under the tongue
    ointment
    24-hour patch
    apply to the skin
    rectal ointment rectal use only

    Angina

    When someone is having intense chest pain, it is vitalto resolve this symptom as quickly as possible. People can also take fast-acting nitroglycerin formulations 5 to 10 minutes before doing an activity that may cause an angina attack.

    The aerosol spray, pumpspray, packet, and tablet are all fast-acting forms of nitroglycerin.

    Aerosol spray and pumpspray

    People can use these devices by giving one or two sprays on or under the tongue once a person feels angina pains. They should not inhale the spray.

    Packet

    A sublingual packet of nitroglycerin contains 400 micrograms (mcg) of nitroglycerin powder. A person places the contents of the packet under their tongue when angina pains begin.

    Tablet

    At the first signs of angina pains, a person should place the tablet under their tongue or between the gums and the cheek. The tablet will dissolve and absorb through the tissues of the mouth.

    People who use the aerosol spray, pumpspray, packet, or tablet should not swallow the drug. Nitroglycerin will absorb through the mouth tissues. This provides faster relief than swallowing the medicine.

    People should also avoid rinsing or spitting for 5 minutes after administering the dose.

    A person can take each of these forms of fast-acting nitroglycerin at 5-minute intervals. If they do not feel relief from the intense chest pain, they can take two more doses 5 minutes apart.

    If someone has taken three doses of either fast-acting formulations and does not experience any pain relief, they should seek medical attention immediately.

    There are also two other formulations of nitroglycerin that can prevent angina attacks. These are not fast-acting, and people should not use them to stop an attack when it is happening.

    Patch

    Nitroglycerin patches come in doses ranging from 0.1 milligrams per hour (mg/hr) to 0.8 mg/hr.

    A person places the patch on their skin anywhere except the areas below the knee and elbow.

    Most people place the patch on their chest. The area should be clean, dry, and hairless to allow the nitroglycerin to absorb across the skin.

    A person should leave the patch on the skin for 12 to 14 hours and remove it for 10 to 12 hours. People will usually have the patch on during the day and remove it during sleep.

    Ointment

    Share on PinterestA person can apply nitroglycerin ointment to the skin twice a day.

    People can apply nitroglycerin ointment to their skin using a dose-measuring applicator that comes with the tube. A person will measure the desired dose onto the measuring applicator and then place the applicator ointment side down on the skin.

    They then spread the ointment across the skin. The person should not rub the medicine in but allow the ointment to absorb across the skin.

    Finally, they tape the applicator to the skin.

    People take two doses of ointment each day. Doctors will tell people to use the ointment first thing in the morning and then reapply it 6 hours later.

    Anal fissures

    The rectal ointment for anal fissures contains 0.4% nitroglycerin. A person will insert the ointment into their anus every 12 hours for up to 3 weeks.

    To apply the rectal ointment, a person will cover their finger with plastic wrap and squeeze out 1 inch of ointment along the finger.

    They then insert the finger into the anal canal up to the first finger joint. The person will then smear the ointment around the area.

    If this is too painful, the person may apply the ointment to the outside of the anus instead.

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