Nitroglycerin

The following section is intended to provide guidelines for taking nitroglycerin. Follow your doctor’s instructions carefully for using nitroglycerin in the form prescribed for you.

ADULTS

Sublingual or Buccal Tablets 
At the first sign of chest pain, 1 tablet should be dissolved under the tongue or inside the cheek. You may repeat the dose every 5 minutes until the pain is relieved. If your pain continues after you have taken 3 tablets in a 15-minute period, notify your doctor or seek medical attention immediately.

You may take sublingual or buccal nitroglycerin from 5 to 10 minutes before starting activities that may cause chest pain.

Patch Form
A patch is applied to the skin for 12 to 14 hours. After this time, the patch is removed; it is not applied again for 10 to 12 hours (a “patch-off” period). A new patch should then be applied to a new area on the body that is non-hairy, and is above the waist but below the neck. Apply the patch as soon as you remove it from its protective pouch.

Spray Form
At the first sign of chest pain, spray 1 or 2 pre-measured doses onto or under the tongue 5 minutes apart. You should not use more than 3 doses within a 15-minute period. If your chest pain continues, you should contact your doctor or seek medical attention immediately.

The spray can be used 5 to 10 minutes before activity that might precipitate an attack.

Ointment Form
Your initial dose may be a daily total of 1 inch of ointment. Apply one-half inch on rising in the morning, and the remaining one-half inch 6 hours later. If needed, follow your doctor’s instructions for increasing your dosage. Apply in a thin, uniform layer, regardless of the amount of your dosage. There should be a daily period where no ointment is applied. Usually, the “ointment-off” period will last from 10 to 12 hours.

Absorption varies with site of application–more is absorbed through the chest.

Sustained-Release Capsules or Tablets
The smallest effective amount should be taken 2 or 3 times a day at 8- to 12-hour intervals.

CHILDREN

The safety and effectiveness of nitroglycerin have not been established for children. 

OLDER ADULTS

In general, dosages less than the above adult dosages are recommended, since the elderly may be more susceptible to low blood pressure and headaches.

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