Nitroglycerin 0.3mg Sl Tabs 100

Nitroglycerin is an organic nitrate that acts as a vasodilator. It is converted to nitric oxide (NO) in vascular smooth muscle cells. NO activates guanylate cyclase, leading to an increase in cyclic guanosine monophosphate (cGMP). Increased cGMP causes dephosphorylation of myosin light chains, resulting in relaxation of vascular smooth muscle. This leads to venodilation (predominantly) and arterial dilation, reducing preload and to a lesser extent afterload, thereby decreasing myocardial oxygen demand. It also causes redistribution of coronary blood flow to ischemic areas.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Abnormal heartbeat (fast, slow, or irregular)
Flushing
Blurred vision
Dry mouth
Excessive sweating
Pale skin
Severe nausea or vomiting
Restlessness
Feeling extremely tired or weak

Other Possible Side Effects

Like all medications, this drug can cause side effects. Although many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms that bother you or persist, contact your doctor for advice:

Dizziness or headache
Mouth tingling
Burning sensation

This list is not exhaustive, and you may experience other side effects not mentioned here. If you have questions or concerns about side effects, don't hesitate to reach out to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
Certain health conditions, including:
+ Anemia
+ Elevated intracranial pressure (e.g., due to bleeding in the brain or a head injury)
+ Recent heart attack
+ Heart problems
+ Low blood volume (hypovolemia)
Concurrent use of specific medications, such as:
+ Phosphodiesterase type 5 inhibitors: avanafil, riociguat, sildenafil, tadalafil, or vardenafil
+ Ergot alkaloids: dihydroergotamine, ergonovine, ergotamine, or methylergonovine
Other prescription or over-the-counter (OTC) medications, natural products, or vitamins you are taking, as this is not an exhaustive list of potential interactions.

To ensure your safety, it is crucial to discuss all your medications and health problems with your doctor and pharmacist. They will help determine whether it is safe to take this medication with your existing treatments and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, avoid driving and other activities that require alertness and clear vision until you understand how it affects you. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when climbing stairs.

Follow your healthcare provider's instructions for monitoring your blood pressure. Additionally, be aware that this medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug.

Avoid consuming alcohol while on this medication. If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

Be aware that taking more of this medication than prescribed or taking it more frequently can lead to reduced effectiveness, a phenomenon known as tolerance. If you find that the medication is no longer working as well as it should, consult your doctor. Do not exceed the recommended dosage.

If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential benefits and risks of this medication with your doctor to make an informed decision about its use.

• Phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil, vardenafil, avanafil) - concurrent use can cause profound hypotension, myocardial ischemia, and death.
• Riociguat (soluble guanylate cyclase stimulator) - concurrent use can cause profound hypotension.

• Other vasodilators (e.g., alpha-blockers, calcium channel blockers, ACE inhibitors, ARBs) - increased risk of hypotension.
• Alcohol - increased risk of hypotension and dizziness.
• Ergot alkaloids (e.g., ergotamine, dihydroergotamine) - nitrates may enhance the vasoconstrictive effects of ergot alkaloids, leading to severe vasoconstriction and ischemia.

• Antihypertensives (general) - additive hypotensive effects.
• Tricyclic antidepressants (TCAs) - may cause orthostatic hypotension.
• Phenothiazines - may cause orthostatic hypotension.

• Aspirin - may increase nitroglycerin levels and effects (though clinical significance is often minor).

• Headache (common, often indicates drug is working)
• Dizziness
• Lightheadedness
• Flushing
• Nausea
• Palpitations
• Blurred vision
• Syncope (fainting)

Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown adverse effects at high doses, but human data are limited.

It is not known whether nitroglycerin is excreted in human milk. Caution should be exercised when nitroglycerin is administered to a nursing woman. Consider the benefit of breastfeeding versus the potential risk to the infant.

Safety and effectiveness in pediatric patients have not been established. Not recommended for use in children.

Elderly patients may be more susceptible to the hypotensive effects of nitroglycerin. Start with the lowest effective dose and titrate carefully. Increased risk of falls due to orthostatic hypotension.

• Patients should be instructed to sit down before taking nitroglycerin to minimize the risk of syncope due to hypotension.
• A tingling or burning sensation under the tongue after administration indicates the tablet is potent; absence of this sensation does not necessarily mean the tablet is inactive.
• Tablets should be stored in their original amber glass bottle, tightly capped, and protected from light, moisture, and extreme temperatures. Do not transfer to plastic pillboxes, as the drug can be absorbed by plastic.
• Patients should be advised to call 911 immediately if chest pain is not relieved after 3 doses in 15 minutes.
• Headache is a very common side effect and often indicates the drug is working. It can be managed with acetaminophen or ibuprofen, but patients should be aware of it.
• Tolerance to the effects of nitroglycerin can develop with continuous or frequent use. This is less common with intermittent sublingual use for acute angina.

• Isosorbide dinitrate (oral, sublingual)
• Isosorbide mononitrate (oral)
• Ranolazine (for chronic angina)
• Beta-blockers (for chronic angina prophylaxis)
• Calcium channel blockers (for chronic angina prophylaxis)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.