Nitroglycerin Spray

What is this medication?

NITROGLYCERIN (nye troe GLI ser in) prevents and treats chest pain (angina). It works by relaxing blood vessels, which decreases the amount of work the heart has to do. It belongs to a group of medications called nitrates.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Nitrolingual, NitroMist

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Liver disease
• Recent heart attack
• An unusual or allergic reaction to nitroglycerin, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is only for use in the mouth. Use at the first sign of an attack. You can also use this medication 5 to 10 minutes before an event likely to produce chest pain. Follow the directions exactly as written on the prescription label. Do not shake the container. Remove the plastic cover. Before using this medication for the first time, you must prime the bottle by spraying the pump 5 times into the air away from yourself. If this medication has not been used for 6 weeks, you must re-prime the bottle by spraying once into the air away from yourself. Hold the container upright and spray either onto or underneath the tongue. Do not breathe in the spray. After each spray, close your mouth but do not swallow or rinse. Sit down to take this medication.

In an angina attack, you should feel better within 5 minutes after your first dose. You can take a dose every 5 minutes up to a total of 3 doses. If you do not feel better or feel worse after 1 dose, call 9-1-1 at once. Do not take more than 3 doses in 15 minutes. Your care team might give you other directions. Follow those directions if they do. Do not take your medication more often than directed.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply. This medication is only used as needed.

What may interact with this medication?

Do not take this medication with any of the following:

• Certain migraine medications like ergotamine and dihydroergotamine (DHE)
• Medications used to treat erectile dysfunction like sildenafil, tadalafil, and vardenafil
• Riociguat

This medication may also interact with the following:

• Medications for high blood pressure

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Tell your care team if you feel your medication is no longer working.

Keep this medication with you at all times. Sit or lie down when you take your medication to prevent falling if you feel dizzy or faint after using it. Try to remain calm. This will help you to feel better faster. If you feel dizzy, take several deep breaths and lie down with your feet propped up, or bend forward with your head resting between your knees.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can make you more drowsy and dizzy. Avoid alcoholic drinks.

Do not treat yourself for coughs, colds, or pain while you are taking this medication without asking your care team for advice. Some ingredients may increase your blood pressure.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Headache, unusual weakness or fatigue, shortness of breath, nausea, vomiting, rapid heartbeat, blue skin or lips, which may be signs of methemoglobinemia
• Increased pressure around the brain—severe headache, blurry vision, change in vision, nausea, vomiting
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
• Worsening chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Dizziness
• Flushing
• Headache

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F). Do not spray near flames. Do not forcefully open or burn the container. Throw away any unused medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.