Nitroglycerin Sublingual Powder

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): GONITRO

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

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

• Anemia
• Bleeding in the brain
• Head injury
• Heart disease
• Liver disease
• 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. Follow the directions exactly as written on the prescription label. Hold the packet upright with the notch and red arrow line at the top of the packet. Tap the bottom of the packet so the powder settles at the bottom. Hold the packet at the notch and hold as close to your mouth as possible. Tear along the red arrow line. Lift up your tongue. Pour all the powder in the packet under your tongue. Close your mouth tight right away and breathe normally through your nose. Allow the powder to dissolve before you swallow. Do not rinse your mouth or spit for 5 minutes after taking this medication. Sit down when taking 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 not for regular use.

What may interact with this medication?

Do not take this medication with any of the following:

• Certain medications for erectile dysfunction like avanafil, sildenafil, tadalafil, and vardenafil
• Ergot alkaloids like dihydroergotamine, ergonovine, ergotamine, methylergonovine
• Riociguat

This medication may also interact with the following:

• Certain medications for 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 your symptoms do not start to get better or if you feel worse.

Keep this medication with you at all times. Sit 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.

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 between 5 and 40 degrees C (41 and 104 degrees F). 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.