nitroglycerin headache، Sublingual nitroglycerin tablets are used to treat episodes of angina (chest pain) in people with coronary artery disease (narrowing of the blood vessels that supply blood to the heart). It is also used just before performing activities that may cause episodes of angina to prevent them from occurring. Nitroglycerin is found in a class of medications called vasodilators. It works by relaxing the blood vessels so that the heart does not work so hard and therefore does not need as much oxygen.
How should this medicine be used?
The presentation of nitroglycerin is in sublingual tablet to place under the tongue. In general, tablets are used as needed, either 5 or 10 minutes before activities that may cause angina attacks or at the first sign of an attack. Carefully follow the instructions on the label of your prescription and ask your doctor or pharmacist to explain any part you do not understand. Take nitroglycerin exactly as directed. Do not take more or less of the medication, or take it more often than prescribed by your doctor.
It is likely that nitroglycerin will not work as well after you have used it for some time or if you have taken many doses. Take the least you need of tablets to relieve the pain of your attacks. If your angina attacks occur more frequently, last longer, or become more severe at any time during your treatment, call your doctor.
Talk with your doctor about how to use nitroglycerin tablets to treat angina attacks. Your doctor will probably tell you to sit down and take a dose of nitroglycerin when the attack begins. If your symptoms do not improve much or if they get worse after taking the dose, you will probably be instructed to call emergency medical help right away. If the symptoms do not completely disappear after taking the first dose, your doctor will tell you to take a second dose after 5 minutes and a third dose 5 minutes after the second dose. Call emergency medical help immediately if chest pain does not go away completely 5 minutes after taking the third dose.
Do not chew, crush or swallow sublingual nitroglycerin tablets. Instead, place the tablet under your tongue or between your cheek and gum and wait for it to dissolve. You may experience a burning or tingling sensation in your mouth as the tablet dissolves. This is normal but it is not an indication that the tablet is working. Do not think that the tablet is not working if you do not experience the sensation of burning or tingling.
What other uses does this medication have?
This medicine may be prescribed for other uses; ask for more information from your doctor or pharmacist.
What special precautions should I follow?
Before taking or using nitroglycerin,
tell your doctor or pharmacist if you are allergic to nitroglycerin patches, capsules, tablets, ointment or spray, any other medication, or any of the ingredients that contain the sublingual nitroglycerin tablets. Ask your pharmacist for a list of the ingredients.
tell your doctor if you are taking riociguat (Adempas) or if you are taking or have recently taken phosphodiesterase (PDE-5) inhibitors such as avanafil (Strendra), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis) and vardenafil ( Levitra, Staxyn). Your doctor may tell you not to take nitroglycerin if you are taking one of these medicines.
Tell your doctor and pharmacist what prescription and non-prescription 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”);
ergoloid drugs such as bromocriptine (Cycloset, Parlodel), cabergoline, dihydroergotamine (DHE 45, Migranal), ergoloid mesylates (Hydergine), ergotamine (in Cafergot, in Migergot), and methylergonovine (Methergine);
You should know that sublingual nitroglycerin tablets are not likely to 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 syndrome,
motion sickness, Parkinson’s disease, ulcers or urinary problems. If this occurs, use a product of artificial saliva or chewing gum to increase the amount of saliva in your mouth so that the tablet dissolves.
Tell your doctor if you have recently had a heart attack and if you have anemia (low red blood cell count) or any condition that causes increased pressure in the brain. 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 had heart failure, low blood pressure, or hypertrophic cardiomyopathy (thickening of the heart muscles).
Tell your doctor if you are pregnant, are planning 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 your doctor or dentist that you are taking nitroglycerin.
Consult your doctor about the safe use of alcoholic beverages while taking nitroglycerin. Alcohol can worsen the side effects of nitroglycerin.
You should know that nitroglycerin can cause dizziness, lightheadedness, and fainting when you wake up too fast while lying down, or at any time, especially if you have been drinking alcoholic beverages. To avoid this problem, get up slowly, resting your feet on the ground for a few minutes before getting up. Take extra precautions to avoid falling during nitroglycerin treatment.
You should know that you may experience headaches during your treatment with nitroglycerin. These headaches can be an indication that the medication is working well. Do not try to change the number of times you take nitroglycerin to avoid headaches, since it is likely that the medication does not work well.