Nitroglycerin, Oral

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KEY POINTS

• This medicine is taken by mouth to reduce the frequency of attacks of angina. Take it exactly as directed.
• Keep all appointments for checkups to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Taking certain medicines with this medicine can cause severe or life-threatening low blood pressure.

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What are other names for this medicine?

Type of medicine: nitrate; vasodilator

Generic and brand names: nitroglycerin, oral; Nitro-Time

What is this medicine used for?

This medicine is used to reduce the frequency of attacks of angina (chest pain). Because it works slowly, it may not stop an attack that has already started.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• A head or brain injury
• Anemia
• Glaucoma
• Heart attack, heart failure, or other heart disease
• Low blood pressure or high blood pressure that you take medicine to treat.

Tell your provider if you take avanafil (Stendra), riociguat (Adempas), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), or vardenafil (Levitra, Staxyn). These medicines may cause severe or life-threatening low blood pressure while you are taking this medicine.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more, or less, or take it at different times than directed. You must take this medicine at the proper times in order to prevent chest pains. Do not stop taking this medicine without your healthcare provider's approval. You may have to reduce your dosage gradually to avoid more chest pain.

Check with your healthcare provider before using this medicine in children under age 18.

This medicine is an extended-release capsule. Swallow the capsules whole with a full glass of water. Do not break, crush, or chew them.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: severe headache, confusion, fast, slow, or pounding heartbeat, dizziness, weakness, nausea, vomiting, diarrhea, cold clammy skin, sweating, flushing, fever, vision problems, lightheadedness, fainting, trouble breathing, seizures, coma.

What should I watch out for?

Do not take avanafil (Stendra), riociguat (Adempas), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), or vardenafil (Levitra, Staxyn) while you are taking this medicine. Using these medicines together may cause severe or life-threatening low blood pressure. Taken with high blood pressure medicines, this medicine may cause extreme low blood pressure. Tell your provider about all the medicines you take.

Your healthcare provider will want to regularly to see how this medicine affects you. Keep all appointments.

Do not stop taking this medicine without your healthcare provider's approval. You may have to reduce your dosage gradually to avoid more chest pain.

You may have a headache for a short time after you take a dose of this medicine. It is a sign that the medicine is working. If you try to eliminate the headaches by reducing your dosage, you will reduce the effectiveness of the medicine. Ask your healthcare provider whether you should take aspirin or acetaminophen (Tylenol) to relieve these headaches.

This medicine may make you dizzy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. Also, drinking alcohol may make it worse. Do not drink alcohol unless your healthcare provider approves.

Tell your provider if your chest pain does not improve or gets worse after taking the medicine. Over time, your body may stop responding to the medicine. This is called developing tolerance. Tell your healthcare provider if you think this medicine is not working as well for you as when you first started taking it.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat); fast, slow, or irregular heartbeat; fainting; increased chest pain.

Serious (Report these to your healthcare provider right away.): Severe headache, dry mouth, severe dizziness, blurred vision, seizures, severe confusion, trouble breathing, bluish coloring of the skin, unusual tiredness or weakness.

Other: Mild dizziness, brief headache, flushing, nausea, vomiting.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• Aliskiren (Tekturna) and aliskiren/hydrochlorothiazide (Tekturna HCT)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), tamsulosin (Flomax), and terazosin
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), clozapine, iloperidone (Fanapt), lurasidone (Latuda), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol, carvedilol (Coreg), esmolol (Brevibloc), metoprolol (Lopressor, Toprol), nadolol (Corgard), nebivolol (Bystolic), pindolol, sotalol (Betapace, Sorine), and timolol
• Blood pressure medicines such as hydralazine, methyldopa, minoxidil, and reserpine
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), felodipine, isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Clonidine (Catapres, Kapvay)
• Diuretics (water pills) such as amiloride, bumetanide, chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide), spironolactone (Aldactone), torsemide (Demadex), and triamterene (Dyrenium)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn). Using these medicines together is life threatening.
• Ergot medicines such as dihydroergotamine (D.H.E. 45, Migranal), ergotamine (Ergomar), and methylergonovine
• Medicines to treat or prevent blood clots such as alteplase (Activase) and heparin
• Medicines to treat pulmonary hypertension such as riociguat (Adempas), sildenafil (Revatio), and tadalafil (Adcirca). Using these medicines together is life threatening.
• Natural remedies such as bayberry, black cohosh, ephedra, ginger, ginseng, golden seal, gotu kola, hawthorn, and licorice
• Obinutuzumab (Gazyva)
• Propranolol (Hemangeol, Inderal, InnoPran)
• Rosiglitazone (Avandia)

Do not drink alcohol while you are taking this medicine unless your healthcare provider approves.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.