Generic name: nitroglycerin (sublingual) (NYE troe GLI ser in (OR al/sub LIN gwal))
Brand name: Nitrostate
Drug class: Antianginal agents, Vasodilators
Nitrostat (nitroglycerin) is a nitrate that dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.
Nitrostat sublingual tablets are used to treat a type of chest pain called angina.
Angina is a pain or discomfort that keeps coming back when part of your heart does not get enough blood. Angina feels like a pressing or squeezing pain, usually in your chest under the breastbone. Sometimes you can feel it in your shoulders, arms, neck, jaws, or back. Nitrostat can relieve this pain.
Nitrostat is a white, round, flat-faced tablet available in 3 strengths. 0.3 mg, 0.4 mg, and 0.6 mg.
Warnings
You should not use Nitrostat if you are also using medicine to treat pulmonary arterial hypertension (PAH). Do not take erectile dysfunction medicine (Viagra, Cialis, Levitra and others) while you are using Nitrostat.
You should not use sublingual Nitrostat if you have severe anemia, increased pressure inside your skull, circulation problems, chest pain that spreads to your jaw or shoulder, or signs of shock (pale skin, suddenly feeling light-headed).
Seek emergency medical attention if you have early symptoms of a heart attack (chest pain or pressure, pain spreading to your jaw or shoulder, sweating, general ill feeling).
Get emergency medical help if you still have chest pain after using a total of 3 doses in 15 minutes, or if you have chest pain that seems unusual.
Before using this medicine
You may not be able to use Nitrostat if you have:
- severe anemia (low red blood cells);
- increased pressure inside the skull;
- circulation problems or shock (pale or clammy skin, cold sweat, numbness or tingling, fast or irregular heartbeats, or feeling like you might pass out); or
- if you also take riociguat or vericiguat.
Do not use erectile dysfunction medicine (such as Viagra, Cialis, or Levitra) or you could have a sudden and serious decrease in blood pressure.
To make sure Nitrostat is safe for you, tell your doctor if you have ever had:
- an allergic reaction to nitroglycerin;
- a heart attack or other heart problems; or
- low blood pressure.
Tell your doctor if you are pregnant or breastfeeding.
Nitrostat is not approved for use by anyone younger than 18 years old.
How should I use Nitrostat?
Use Nitrostat exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Try to rest or stay seated when you use Nitrostat (may cause dizziness or fainting).
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Use this medicine at the first sign of chest pain. Use another dose every 5 minutes as needed, up to a total of 3 doses.
Get emergency medical help if you still have chest pain after using a total of 3 doses in 15 minutes, or if your chest pain seems unusual.
You may use Nitrostat within 5 to 10 minutes before an activity that might cause chest pain.
This medicine can affect the results of certain medical tests. Tell any doctor who treats you that you are using Nitrostat.
If you use Nitrostat on a regular schedule to prevent angina, do not stop using it suddenly or you could have a severe attack of angina. Keep this medicine on hand at all times. Get your prescription refilled before you run out of medicine completely.
Store Nitrostat at room temperature away from moisture and heat.
Keep the spray away from open flame or high heat, such as in a car on a hot day. The canister may explode if it gets too hot.
Dosing information
Usual Adult Dose for Angina Pectoris:
0.3 to 0.6 mg sublingually or in the buccal pouch every 5 minutes as needed, up to 3 doses in 15 minutes; if pain persists after maximum dose, prompt medical attention is recommended.
Usual Adult Dose for Angina Pectoris Prophylaxis:
0.3 to 0.6 mg sublingually or in the buccal pouch 5 to 10 minutes prior to engaging in activities that might precipitate an acute attack
Comments:
-Administer while sitting due to rapid onset.
-Advise patient not to chew or swallow this medication.
What happens if I miss a dose?
If you use Nitrostat on a regular schedule, skip any missed dose if it's almost time for your next dose. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of nitroglycerin can be fatal.
Overdose symptoms may include a throbbing headache, confusion, pounding heartbeats, vision problems, vomiting, bloody diarrhea, sweating, clammy skin, blue lips, weak or shallow breathing, loss of movement, seizure, or fainting.
What should I avoid while using Nitrostat?
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.
Drinking alcohol can increase certain side effects such as dizziness, drowsiness, feeling light-headed, or fainting.
Nitrostat side effects
Get emergency medical help if you have signs of an allergic reaction to Nitrostat: hives, sweating, pale skin; nausea, vomiting; feeling weak or light-headed; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- severe or throbbing headaches that do not become less severe with continued use of Nitrostat;
- pounding heartbeats or fluttering in your chest;
- slow heart rate;
- a light-headed feeling, like you might pass out;
- blurred vision or dry mouth; or
- heart attack symptoms - chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating.
Nitroglycerin can cause severe headaches that should become less severe as you continue to use the medicine.
Common Nitrostat side effects may include:
- flushing (sudden warmth, redness, or tingly feeling);
- feeling light-headed, fainting;
- headache, dizziness; or
- numbness, tingling, burning pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Nitrostat?
Tell your doctor about all your current medicines, especially:
- aspirin, heparin;
- a diuretic (water pill);
- any medicine to treat erectile dysfunction;
- medicine to treat depression or psychiatric illness;
- medicine used to treat blood clots;
- heart or blood pressure medicine; or
- migraine headache medicine, such as ergot medicine (dihydroergotamine, ergotamine, ergonovine, methylergonovine).
This list is not complete and many other drugs may interact with nitroglycerin. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.