Nitroglycerin, rapid release (By mouth)

Brand Name(s)

Nitroquick, Nitrolingual, Nitrostat, NitroMist

There may be other brand names for this medicine.

When This Medicine Should Not Be Used

You should not use this medicine if you have had an allergic reaction to nitroglycerin or similar medicines, such as Isordil®, Monoket®, or Sorbitrate®. You should not use this medicine if you have severe anemia (low iron levels in your blood or low red blood cell count), or if you have a condition that may increase pressure in the head such as severe head injury or a recent stroke. Do not use this medicine if you are also using medicine to treat erectile dysfunction, such as sildenafil, tadalafil, vardenafil, Cialis®, Levitra®, or Viagra®.

How to Use This Medicine

Spray, Tablet

• Your doctor will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• Most people use this medicine as needed.
• At the first sign of chest pain, sit down and get ready to use the medicine.
• Tablets: Wet the tablet with saliva and place it under your tongue or in your cheek. Let the tablet dissolve in your mouth. Do not chew it or swallow it whole.
• There are 2 possible schedules for using this medicine during an angina attack. Follow the schedule that your doctor tells you to.
  • One possible schedule to follow when you have angina is to take 1 tablet, then wait 5 minutes. If you still have pain 5 minutes after you use the medicine or if your pain gets worse, this is an emergency. Call 911 or 0 (operator) for an ambulance to take you to the nearest hospital or clinic. Do not drive yourself.
  • The other possible schedule is to take 1 tablet every 5 minutes until the pain is gone, for up to 15 minutes. Do not take more than 3 tablets in 15 minutes. If your chest pain does not go away after you take a total of 3 tablets, this is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself.
• Spray: Pump the spray 10 times into the air before using it for the first time or 2 sprays if it has not been used in 6 weeks. Do not shake the spray bottle. Open your mouth and hold the spray bottle upright very close to your mouth. Spray the medicine (1 or 2 sprays) onto or under your tongue. Close your mouth right away. Do not inhale the spray or get it in your eyes. Do not spit out the spray or rinse your mouth for at least 5 to 10 minutes. You may administer another spray as needed. Separate each spray by 5 minutes. You must wait 5 minutes to administer a third spray if 2 sprays were used initially. No more than 3 sprays should be given within 15 minutes. If your chest pain does not go away after you administer a total of 3 sprays, this is an emergency. Call 911 or 0 (operator) for an ambulance to get to the nearest hospital or clinic. Do not drive yourself. Replace the cover after using the medicine. Always place the spray bottle in an upright position if not in use. Also, check the fluid level of Nitromist® container regularly. If the fluid reaches the top or middle of the hole on the side of container, you must get a refill. Do not use the spray near heat, open flame, or while smoking.
• You may use this medicine before you engage in an activity that you feel may cause an attack. Use the spray or tablets as directed by your doctor 5 to 10 minutes before you do something that may cause an attack. This may help prevent the attack.
• Do not eat, drink, or smoke for at least 5 to 10 minutes after using this medicine.

How to Store and Dispose of This Medicine

• Store the tablets at room temperature in the original closed glass container, away from heat, moisture, and direct light.
• Store the spray at room temperature, away from heat and fire. Do not break or burn the spray container.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using aspirin, heparin, alteplase (Activase®), reteplase (Retavase®), tenecteplase (TNKase®), diuretics or "water pills" (such as furosemide, hydrochlorothiazide [HCTZ], indapamide, metolazone, spironolactone, torsemide, triamterene, Aldactone®, or Lasix®), or heart or blood pressure medicine (such as atenolol, labetalol, lisinopril, metoprolol, quinapril, verapamil, Accupril®, Cozaar®, Diovan®, Lotrel®, Norvasc®, Toprol®, Trandate®, or Zestril®).
• Make sure your doctor knows if you are also using a phenothiazine medicine (such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®) or ergot medicines (such as dihydroergotamine, Cafergot®, Ergomar®, or Wigraine®).
• Tell your doctor if you are using any medicine that makes your mouth dry, such as medicines that treat depression.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, low blood pressure, congestive heart failure (CHF), an enlarged heart, a recent heart attack, or other heart problems.
• Medicines that treat chest pain sometimes cause headaches. These headaches are a sign that the medicine is working. Do not stop using the medicine or change the time you take it in order to avoid the headaches. If the headache pain is severe, talk with your doctor.
• This medicine may make you dizzy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. You may also feel lightheaded when standing or sitting up straight, so stand up or sit up slowly.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects.

Introduction

Nitroglycerin (nye-troe-GLIS-er-in)

Treats or prevents angina (chest pain). This medicine is a nitrate.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blurred vision
• Severe or ongoing dizziness, lightheadedness, or fainting
• Shortness of breath, cold sweat, and bluish-colored skin or fingernail beds
• Slow heartbeat, or increased chest pain
• Swelling in your hands, ankles, or feet
• Throbbing, severe, or ongoing headache, confusion, low fever, or trouble seeing
• Warmth or redness in your face, neck, arms, or upper chest

If you notice these less serious side effects, talk with your doctor:

• Cough, irritated or runny nose, or sore throat
• Dry mouth
• Joint pain
• Nausea, vomiting, or stomach pain
• Numbness or tingling, or swelling in your hands, ankles, or feet
• Rash or red, swollen skin
• Weakness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088