GENERIC NAME: NITROGLYCERIN - SUBLINGUAL (nye-troh-GLISS-er-in) BRAND NAME(S): Nitrostat Medication Uses | How To Use | Side Effects | Precautions | Drug Interactions | Overdose | Notes | Missed Dose | Storage | Medical Alert USES: This medication is a nitrate used to relieve and prevent chest pain (angina). Nitroglycerin relaxes blood vessels allowing more blood to flow through. This reduces the workload on the heart and improves blood flow to the heart. HOW TO USE: At the first sign of chest pain, sit down and place one tablet under the tongue or between your cheek and gum allowing it to dissolve. The drug is absorbed directly through the lining of the mouth. Do not chew or swallow the tablet. Do not eat, drink or smoke while the nitroglycerin is in your mouth. Relief of symptoms should begin in 1 to 3 minutes. If after 5 minutes there is no relief of chest pain, use another tablet. If after an additional 5 minutes there is no relief, use a third tablet. If after another 5 minutes there is no relief, go to a hospital emergency room immediately. To prevent an angina attack, take one tablet 5-10 minutes before activities that you feel may cause an angina attack, such as exercise or sexual intercourse; or as directed by your doctor. Carry this medication with you at all times. SIDE EFFECTS: Burning or tingling under the tongue, headache, dizziness, flushing, or restlessness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position. Tell your doctor immediately if any of these serious side effects occur: blurred vision, dry mouth, nausea, pale skin, rapid heartbeat. Headache is often a sign the medication is working. Treat headaches with an aspirin or non-aspirin pain reliever as recommended by your doctor. If the headaches continue or become severe, notify your doctor. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist. PRECAUTIONS: Before taking nitroglycerin, tell your doctor or pharmacist if you are allergic to it; or to other nitrates; or if you have any other allergies. Before using this medication, tell your doctor or pharmacist your medical history, especially of: anemia, glaucoma, head injury or surgery, heart problems, severe kidney disease, liver problems, thyroid conditions. This drug may make you dizzy; use caution engaging in activities requiring alertness such as driving or using machinery. Avoid alcoholic beverages while using this medication. Alcoholic beverages may increase the risk of fainting or dizziness. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding. DRUG INTERACTIONS: This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: drugs to treat impotence (e.g., sildenafil, vardenafil, tadalafil). If you are currently using any of these medications, tell your doctor or pharmacist before starting nitroglycerin. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: alteplase, aspirin, drugs for high blood pressure (e.g., ACE inhibitors such as fosinopril or lisinopril, alpha blockers such as prazosin or doxazosin, beta-blockers such as propranolol), certain migraine drugs (ergot alkaloids such as ergotamine). This product can affect the results of certain lab tests. Make sure laboratory personnel and your doctors know you use this drug. Do not start or stop any medicine without doctor or pharmacist approval. OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include a persistent, throbbing headache; severe dizziness; confusion; weakness; sweating; changes in heart rate; changes in vision; flushing; severe nausea and vomiting. NOTES: Do not share this medication with others. Some persons may develop a tolerance to the effects of this medication over time. Notify your doctor if the medication appears to be losing its effectiveness or if the chest pain continues while taking this drug. Always have this medication readily available. Do not keep it in your pants or shirt pockets. Your body heat may decrease the effectiveness of this medication. Keep the bottle loose and away from you body in a jacket pocket, tote bag, or purse. MISSED DOSE: This medication is used only at the onset of an attack of chest pain or 10 to 15 minutes before engaging in an activity that may cause chest pain. This medication is not for routine use. STORAGE: If the bottle of tablets contains cotton, remove it and throw the cotton away. Replacing the cotton in the bottle may cause the medication to lose its effectiveness. Store this medication at room temperature away from heat, moisture and sunlight. Keep it in the original screw-cap glass bottle with the cap tightly closed. Otherwise, this drug will not be as effective and may not work as well. Once you have opened the bottle, the expiration date may not apply. Ask your pharmacist for specific storage instructions and about your brand s open bottle expiration date. Do not store in the bathroom. Keep all medicines away from children and pets. MEDICAL ALERT: Your condition can cause complications in a medical emergency. For enrollment information call MedicAlert at 1-800-854-1166 (USA), or 1-800-668-1507 (Canada).