nitroglycerin, Nitro-Bid, Nitro-Dur, Nitrostat, Transderm-Nitro, Minitran, Deponit, Nitrol (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes (for some dosage forms)

PREPARATIONS:

  • Tablets: 0.3, 0.4, 0.6 mg;
  • Capsules: 2.5, 6.5, 9 mg; Spray: 0.4 mg/spray;
  • Transdermal Patch: 0.1, 0.2, 0.3, 0.4, 0.6, 0.8 mg/hour;
  • Ointment: 2%;
  • Infusion Solution: 25, 50, 100 mg/250 ml
  • Injectable solution: 5 mg/ml.

STORAGE: All formulations should be kept at room temperature, 15 C to 30 C (59 F to 86 F). The sublingual tablets are especially susceptible to moisture. They should NOT be kept in bathrooms or kitchens because of the greater moisture in these rooms. Care should be taken to replace the sublingual tablets every six months.

PRESCRIBED FOR: Nitroglycerin is used for the treatment and prevention of angina caused by coronary artery disease. Sublingual nitroglycerin and nitroglycerin spray are used to treat acute anginal attacks. Transdermal nitroglycerin, nitroglycerin ointment and capsules do not act rapidly enough to be used for acute anginal attacks.

Nitroglycerin also is used intravenously to treat congestive heart failure associated with heart attack and high blood pressure during surgery.

DOSING: For the treatment of acute angina attacks or for acute prevention (for example, immediately before encountering situations likely to bring on an anginal attack), one tablet is allowed to dissolve under the tongue or between the cheek and gums, or one spray is given of the lingual spray. Sublingual, spray and buccal nitroglycerin are rapidly absorbed from the lining of the mouth for immediate effects. This may be repeated every 5 minutes as needed. If angina is not relieved after a total of 3 doses, the patient should be taken to a hospital or a doctor should be contacted. If lingual spray is used, the canister of spray should not be shaken prior to use, and it should be sprayed onto or under the tongue and then the mouth closed.

For prevention of angina, ointment may be applied using special dose-measuring application papers provided with the ointment. The usual dose is 1/2 to 2 inches applied every 4-6 hours. The appropriate amount of ointment is squeezed as a thin layer onto the paper, and the paper is used to spread the ointment onto a non-hairy area of the skin. The ointment should not be allowed to come into contact with the hands where it can be absorbed.

Transdermal patches also are used for prevention. The usual dose is 0.2-0.8 mg/hr applied for 12 hours and then removed. An additional 12 hours should be allowed before applying the next patch because a 12 hour nitroglycerin free period reduces the occurrence of tolerance to the effects (reduced effectiveness) of nitroglycerin. Patches may be applied to any hairless site but should not be applied to areas with cuts or calluses which can alter absorption. Firm pressure should be used over the patch to ensure contact with the skin. The patch should not be cut or trimmed. Patches are waterproof and should not be affected by showering or bathing.

Medically Reviewed by a Doctor on 11/24/2014


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