Nitroglycerin

Nitroglycerin | Fast-Acting Tablet for Chest Pain (Angina)

What is this medication?

Nitroglycerin sublingual tablets contain nitroglycerin, a fast-acting nitrate medication used to relieve chest pain (angina). Angina occurs when the heart muscle does not receive enough oxygen-rich blood, often due to narrowed or constricted blood vessels.

Nitrates like nitroglycerin work by relaxing and widening blood vessels throughout the body. This allows blood to flow more easily to the heart while also reducing the amount of work the heart must perform. As a result, the heart requires less oxygen, and chest pain can be relieved quickly.

This medication is commonly used for:

  • sudden episodes of chest pain (angina attacks)

  • prevention of chest pain before physical activity or stress

  • management of known coronary artery disease symptoms

Sublingual nitroglycerin tablets are placed under the tongue, where they dissolve and are rapidly absorbed through the tissues of the mouth. This allows the medication to enter the bloodstream quickly and begin working within minutes during an episode of chest pain.

This medication is intended for rapid relief and short-term use and should only be used exactly as prescribed by a licensed healthcare provider.

    • Keep medication in its original glass container to maintain potency 

    • Store at room temperature (68°F to 77°F) 

    • Protect from heat, light, and moisture

    • Keep tablets tightly sealed between uses

    • Carry medication with you at all times

    • Do not store in pill organizers (may reduce effectiveness)

    • Keep in your carry-on bag when traveling

When should this medication be used?

Your provider may recommend using this medication if you experience symptoms consistent with angina, including:

  • pressure, tightness, or squeezing in the chest

  • pain that may spread to the shoulders, arms, neck, jaw, or back

  • chest discomfort triggered by physical activity, emotional stress, or exertion

  • chest pain that improves with rest

Nitroglycerin may also be used shortly before activities that commonly trigger chest pain, such as walking uphill, heavy exertion, or emotional stress.

Some patients are instructed to take nitroglycerin 5 to 10 minutes before activities known to cause angina in order to help prevent symptoms. 

If chest pain is severe, sudden, or different from your typical angina symptoms, seek immediate medical care.

  • Follow the directions on your prescription label and your provider’s instructions.

    If you experience chest pain:

    1. Stop activity and sit down before taking the medication to reduce the risk of dizziness or fainting

    2. Place one tablet under your tongue or in your mouth and allow it to dissolve

    3. Do not chew, crush, or swallow the tablet

    4. Wait 5 minutes, allow the medication to dissolve completely without drinking or eating during this time

    5. Relief often occurs within a few minutes

    Nitroglycerin tablets are designed to dissolve under the tongue for rapid absorption.

    If chest pain continues:

    • A second tablet may be taken approximately 5 minutes after the first

    • A third tablet may be taken another 5 minutes later if symptoms persist

    • If chest pain continues after three tablets within 15 minutes, seek emergency medical care immediately

    You may feel a mild burning or tingling sensation under the tongue when taking this medication. This is a normal effect of the tablet dissolving. 

    Remain seated for several minutes after taking nitroglycerin, as the medication can lower blood pressure and cause dizziness.

  • This medication is typically used as needed, not on a fixed schedule.

    • Use it at the first sign of chest pain or as directed before activity

    • Do not take extra doses to make up for a missed use

    If you are unsure how to use your medication, contact your provider.

  • While using nitroglycerin:

    • Always sit or rest when taking a dose to reduce fall risk

    • Stand up slowly after use to avoid dizziness

    • Avoid alcohol, which can worsen low blood pressure

    • Do not start new medications without consulting your provider

    • Avoid taking other medications that significantly lower blood pressure unless directed by your provide

    • Keep the medication with you at all times for emergency use

    Risks while taking nitroglycerin include:

    • low blood pressure (hypotension)

    • dizziness or fainting

    • worsening symptoms in certain heart conditions

    • development of tolerance with excessive use

  • Nitroglycerin may interact with other medications and cause serious side effects.

    Tell your healthcare provider about all medications you take.

    Important interactions include:

    • Erectile dysfunction medications (sildenafil, tadalafil, vardenafil): Can cause a life-threatening drop in blood pressure 

    • Guanylate cyclase stimulators (such as riociguat): Can cause severe hypotension 

    • Blood pressure medications or diuretics: May increase risk of dizziness or fainting

    • Alcohol: Can significantly lower blood pressure

    Always check with your provider before starting any new medications or supplements.

Important Safety Information

  • Nitroglycerin can cause significant lowering of blood pressure. This effect may cause dizziness, fainting, weakness, or lightheadedness, particularly when standing up quickly. 

    Most serious warnings may include:

    • severe drop in blood pressure

    • fainting or collapse

    • worsening chest pain in certain heart conditions

    • severe headache related to blood vessel dilation

    • allergic reactions to nitrates or nitrites

    • complications in patients with severe anemia or head injury

    Do NOT take nitroglycerin if you are using medications for erectile dysfunction such as sildenafil, tadalafil, vardenafil, or avanafil. Combining these medications can cause a dangerous and potentially life-threatening drop in blood pressure. 

    Nitroglycerin should also not be used with certain medications called soluble guanylate cyclase stimulators, such as riociguat.

  • Seek emergency medical care immediately if you experience:

    • chest pain that does not improve after taking nitroglycerin

    • severe dizziness or fainting

    • difficulty breathing

    • swelling of the face, lips, tongue, or throat

    • severe weakness or confusion

  • This medication should not be used in patients who have:

    • severe anemia

    • increased pressure inside the skull (such as from head injury or bleeding in the brain)

    • circulatory failure or shock

    • known allergy to nitrates or nitrites 

  • Tell your healthcare provider if you:

    • have a history of low blood pressure

    • have heart valve disease or cardiomyopathy

    • have anemia or blood disorders

    • have experienced a recent heart attack

    • have a history of head injury or brain bleeding

    • take medications for erectile dysfunction

    • take medications that lower blood pressure

    • take diuretics (water pills)

    • take medications for heart rhythm disorders or angina

    • take migraine medications such as ergotamine

    • are pregnant or planning to become pregnant

    • are breastfeeding 

    Your provider should review all medications and supplements you take before prescribing nitroglycerin.

    Avoid starting new prescription or non-prescription medications without consulting your healthcare provider.

  • Common side effects may include:

    • headache

    • dizziness

    • vertigo

    • flushing or warmth of the skin

    • nausea or vomiting

    • weakness

    • paleness

    • sweating

    • heart palpitations

    • low blood pressure when standing

    Severe symptoms such as fainting or collapse may occur if blood pressure drops too low. 

    You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch or call 1-800-FDA-1088.

  • Symptoms of nitroglycerin overdose may include:

    • severe headache

    • extreme dizziness

    • fainting

    • confusion

    • low blood pressure

    • rapid or irregular heartbeat

    Seek emergency medical care immediately if overdose is suspected.

    • Do not share this medication with others

    • Dispose of unused medication through a take-back program if available

    • Keep medication out of reach of children and pets

Disclaimers

  • This prescription may have been issued through a telemedicine consultation with a licensed healthcare provider. If you experience severe symptoms, worsening illness, or any concerning reactions while using this medication, contact your prescribing clinician immediately or seek emergency medical care.

  • This medication guide summarizes important safety information derived from pharmacy labeling, medication manufacturers, and prescribing references. It is intended to help patients understand the safe use of medications included in the Superior Health & Wellness Travel Medical Kit.

    This guide does not contain the complete prescribing information for Nitroglycerin. Always follow the directions provided by your healthcare provider and the instructions on the pharmacy label that accompanies your prescription.

    Medications included in travel medical kits are prescribed only after a clinical evaluation by a licensed healthcare provider. Prescriptions are issued based on your medical history, current medications, allergies, and overall health needs. Not all patients will qualify for every medication or kit configuration, and the contents of each kit may vary based on provider discretion and patient suitability.

    Some medications included in travel medical kits are commercially manufactured medications dispensed through licensed pharmacies. In certain cases, a medication may be provided as a compounded formulation prepared by a licensed compounding pharmacy when a provider determines that a compounded version is medically appropriate for a patient. Compounded medications are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or effectiveness but are prepared by licensed pharmacies in accordance with applicable pharmacy regulations.

    Travel Medical Kits are intended to provide limited medication support during travel when timely access to medical care may be difficult. These kits are not a substitute for routine medical care, primary care services, or emergency medical treatment. Purchasing a Travel Medical Kit does not establish a primary care relationship with Superior Health & Wellness and does not include ongoing medical supervision beyond the initial provider evaluation used to determine eligibility for the kit.

    Patients experiencing severe illness, worsening symptoms, medication reactions, or medical emergencies should seek immediate medical care or contact a licensed healthcare professional.

    Medical services and prescriptions offered through Superior Health & Wellness are provided by licensed healthcare professionals in accordance with applicable state and federal laws. Prescription medications are dispensed by licensed pharmacies following a valid provider prescription.

    Patients are encouraged to report negative side effects of prescription medications to the U.S. Food and Drug Administration (FDA). Visit MedWatch or call 1-800-FDA-1088.

Previous

EpiPen