Precautions
The maximum daily dosage is 75 mg (12.5 cm as squeezed from the tube). The ointment is applied in a thin layer covering approximately 2 to 3 inches of skin, but should not be massaged into the skin.
What is the maximum dose of nitroglycerin?
The usual dose of nitroglycerin is one or two tablets every four to six hours as needed for chest pain. Larger doses may be required if the patient is having severe symptoms or if there is a delay between taking the tablet and relief from pain or other symptoms. The maximum recommended daily dose is 12 tablets.
How often can you take nitroglycerin pills?
It can help in the following circumstances:
- Brisk walking
- Cold, windy weather
- Exertion
- After a heavy meal
- Working under the pressure of a deadline
- Speaking in public
- During sexual intercourse
- During worry, tension or anger
When to take nitroglycerin tabs?
- Do not chew, crush, or swallow Nitroglycerin Sublingual Tablets.
- You should sit down when taking Nitroglycerin Sublingual Tablets and use caution when you stand up. ...
- One tablet should be dissolved under the tongue or in the oral cavity at the first sign of chest pain.
How to take nitroglycerin sublingual?
What are the dosages of nitroglycerin?
Adults—2.5 to 6.5 milligrams (mg) 3 to 4 times a day. Your doctor may increase your dose as needed. Children—Use and dose must be determined by your doctor.
What is the maximum doses of nitroglycerin?
Adults—1 or 2 packets placed under the tongue at the first sign of an angina attack. 1 packet may be used every 5 minutes as needed, for up to 15 minutes. Do not take more than 3 packets in 15 minutes. Children—Use and dose must be determined by your doctor.
What does nitroglycerin 0.4 mg do?
This medication is used to relieve chest pain (angina) in people that have a certain heart condition (coronary artery disease). It may also be used before physical activities (such as exercise, sexual activity) to help prevent chest pain.
What medication should not be taken with nitroglycerin?
Drugs you should not use with nitroglycerin Examples of these drugs include: Sildenafil, tadalafil, vardenafil, and avanafil. Taking any of these drugs with nitroglycerin can cause very low blood pressure.
What does it mean if chest pain is relieved by Nitro?
If the heart muscle can't get enough oxygen because of a blockage in blood flow, the strain causes the pain of angina. The pain is relieved by stopping the event that caused the strain, or by taking nitroglycerin. Nitroglycerin widens the coronary arteries to allow more oxygen-rich blood to flow to the heart.
What is the most serious side effect of nitroglycerin?
Many people using this medication do not have serious side effects. Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, fast/irregular/pounding heartbeat. A very serious allergic reaction to this drug is rare.
What is the fastest way to cure angina?
Typically your doctor will prescribe medication and lifestyle changes before they suggest surgery. However, if you have severe angina, you may need to undergo an angioplasty or stenting. The fastest way to treat angina is by getting rest and making lifestyle changes.
Is it safe to take nitroglycerin daily?
Do not take more than 3 nitroglycerin tablets over 15 minutes. If you take this medicine often to relieve symptoms of angina, your doctor or health care professional may provide you with different instructions to manage your symptoms.
What is the most serious side effect of nitroglycerin?
Many people using this medication do not have serious side effects. Tell your doctor right away if any of these unlikely but serious side effects occur: fainting, fast/irregular/pounding heartbeat. A very serious allergic reaction to this drug is rare.
How much does nitroglycerin lower BP?
At 5 and 10 min after sublingual nitroglycerin, mean reduction of mean arterial blood pressure by 12.3 and 16.3% was achieved.
What to do if nitroglycerin does not work?
If your doctor has prescribed nitroglycerin for angina: Take 1 dose of nitroglycerin and wait 5 minutes. If your symptoms don't improve or if they get worse,call 911 or other emergency services....If you do not have nitroglycerin:Call 911 or other emergency services now. ... Stay on the phone. ... Wait for an ambulance.
How long does nitroglycerin last in your system?
6. Response and effectiveness. Nitroglycerin acts in the body for an extremely short period (the half-life is 1 to 4 minutes), although it is metabolized to longer-lived active metabolites. However, these are less effective vasodilators than nitroglycerin.
How much nitroglycerin should I take per hour?
Patch. Nitroglycerin patches come in doses ranging from 0.1 milligrams per hour (mg/hr) to 0.8 mg/hr. A person places the patch on their skin anywhere except the areas below the knee and elbow. Most people place the patch on their chest.
How often can you use nitroglycerin?
A person can apply nitroglycerin ointment to the skin twice a day. People can apply nitroglycerin ointment to their skin using a dose-measuring applicator that comes with the tube. A person will measure the desired dose onto the measuring applicator and then place the applicator ointment side down on the skin.
Why does nitroglycerin decrease blood flow?
Most often, the reason for the decrease in blood flow is plaque formation and narrowing of the arteries supplying blood to the heart. Nitroglycerin helps to open up the blood vessels and allow blood to flow. People also use nitroglycerin to treat chronic anal fissures.
How long before an activity can you take nitroglycerin?
People can also take fast-acting nitroglycerin formulations 5 to 10 minutes before doing an activity that may cause an angina attack.
Why does my chest hurt when I take nitroglycerin?
Most often, the reason for the decrease in blood flow is plaque formation and narrowing of the arteries supplying blood to the heart .
What is the process of breaking down nitroglycerin?
The body breaks nitroglycerin down into nitric oxide. Nitric oxide causes the smooth muscle within the blood vessels to relax. This allows the arteries and veins to open up, allowing more blood to flow through. Healthcare professionals call this action vasodilation.
Where to place angina pain medication?
At the first signs of angina pains, a person should place the tablet under their tongue or between the gums and the cheek. The tablet will dissolve and absorb through the tissues of the mouth.
How long after nitroglycerin injection can you drive?
Do not drive yourself and call 911, if necessary. You may administer 1 or 2 sprays of Nitroglycerin oral spray at the onset of chest pain. If the pain continues after 5 minutes, a third spray may be used. You must wait 5 minutes after the first 1 or 2 sprays before using a third spray.
How long after taking Nitroglycerin can you spit?
Do not rinse or spit for 5 minutes after taking this medicine. Do not take more than 3 packets in 15 minutes. If you still have pain after you take a total of 3 packets, this is an emergency. Call 911. Do not drive yourself to the hospital. Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed.
How to use a sanitizer spray?
Press the button firmly with the forefinger to release the spray 1 or 2 times onto or under the tongue. Do not inhale or breathe in the spray. Release the button and close your mouth, but do not swallow right away. Do not spit out the spray or rinse your mouth for at least 5 to 10 minutes.
How to store sublingual powder?
Sublingual tablets should be kept in the original glass bottle. Screw the cap on tightly after each use and store the bottle at room temperature, away from heat, moisture, and direct light.
How long after taking a syringe can you take a second syringe?
However, if the pain is not relieved, you may use a second tablet 5 minutes after you take the first tablet. If the pain continues for another 5 minutes , a third tablet may be used. If you still have chest pain after a total of 3 tablets, contact your doctor or go to a hospital emergency room right away.
Can you chew nitroglycerin?
Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed. They work much faster when absorbed through the lining of the mouth. Place the tablet under the tongue or between the cheek and gum, and let it dissolve. Do not eat, drink, smoke, or use chewing tobacco while a tablet is dissolving.
How it works
Nitroglycerin belongs to a class of drugs called vasodilators. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
Drugs you should not use with nitroglycerin
You should not take certain drugs with nitroglycerin. Doing so can cause dangerous effects in your body. Examples of these drugs include:
Interactions that can make your drugs less effective
When you take nitroglycerin with certain drugs, nitroglycerin may not work as well to treat your condition. This is because the amount of nitroglycerin in your body may be decreased. Examples of these drugs include:
Alcohol interaction
Drinking alcohol can increase your risk of very low blood pressure from this drug. If you drink alcohol, talk to your doctor.
Allergy warning
Allergic reactions to nitroglycerin are extremely rare, but they do occur. Symptoms can include:
Warnings for people with certain health conditions
For people with a history of heart attack or heart failure: It isn’t known if this drug will help you during a heart attack. A heart attack may cause severe, crushing pain that comes on suddenly. If you have signs of a heart attack, call 911 right away. It also isn’t known if this drug helps people with heart failure.
How hot is nitroglycerin?
Early in its history, liquid nitroglycerin was found to be " desensitized " by freezing it, at a temperature below 45 to 55 °F (7 to 13 °C) depending on its purity.
Where was nitroglycerin made?
This amount required at least 336 tonnes of nitroglycerin per week (assuming no losses in production). The Royal Navy had its own factory at the Royal Navy Cordite Factory, Holton Heath, in Dorset, England. A large cordite factory was also built in Canada during World War I. The Canadian Explosives Limited cordite factory at Nobel, Ontario, was designed to produce 1,500,000 lb (680 t) of cordite per month, requiring about 286 tonnes of nitroglycerin per month.
What is nitroglycerin explosive?
Nitroglycerin is an oily liquid that may explode when subjected to heat, shock, or flame. Alfred Nobel developed the use of nitroglycerin as a blasting explosive by mixing nitroglycerin with inert absorbents, particularly " Kieselguhr ", or diatomaceous earth. He named this explosive dynamite and patented it in 1867.
How does nitroglycerin deflagrate?
Nitroglycerin and any diluents can certainly deflagrate (burn). The explosive power of nitroglycerin derives from detonation: energy from the initial decomposition causes a strong pressure wave that detonates the surrounding fuel. This is a self-sustained shock wave that propagates through the explosive medium at 30 times the speed of sound as a near-instantaneous pressure-induced decomposition of the fuel into a white-hot gas. Detonation of nitroglycerin generates gases that would occupy more than 1,200 times the original volume at ordinary room temperature and pressure. The heat liberated raises the temperature to about 5,000 °C (9,000 °F). This is entirely different from deflagration, which depends solely upon available fuel regardless of pressure or shock. The decomposition results in much higher ratio of energy to gas moles released compared to other explosives, making it one of the hottest detonating high explosives .
What is nitrocellulose powder used for?
Nitroglycerin has been used for over 130 years in medicine as a potent vasodilator (dilation of the vascular system) to treat heart conditions, such as angina pectoris and chronic heart failure.
What is smokeless powder?
A range of smokeless powders that contains both nitrocellulose and nitroglycerin, known as double -base propellants, were also developed. Smokeless powders were originally supplied only for military use, but they were also soon developed for civilian use and were quickly adopted for sports.
Can nitroglycerin cause methemoglobinemia?
Overdoses may generate methemoglobinemia. Nitroglycerin is available in tablets, ointment, solution for intravenous use, transdermal patches, or sprays administered sublingually. Some forms of nitroglycerin last much longer in the body than others.
Overview
This medication is used to relieve chest pain (angina) in people that have a certain heart condition (coronary artery disease). It may also be used before physical activities (such as exercise, sexual activity) to help prevent chest pain.
May Treat: Acute myocardial infarction · Acute episode of anginal pain · Anal fissure · Induction of intraoperative hypotension · Left ventricular dysfunction following MI and more
Brand Names: Nitrolingual · Nitrostat · Minitran · Nitro-Dur · Nitro-Bid and more
Drug Class: Anal Fissure Pain/Treatment Agents - Nitrates · Antianginal - Coronary Vasodilators (Nitrates)
Availability: Prescription Required
Pregnancy: Consult a doctor before using
May Treat: Acute myocardial infarction · Acute episode of anginal pain · Anal fissure · Induction of intraoperative hypotension · Left ventricular dysfunction following MI and more
Brand Names: Nitrolingual · Nitrostat · Minitran · Nitro-Dur · Nitro-Bid and more
Drug Class: Anal Fissure Pain/Treatment Agents - Nitrates · Antianginal - Coronary Vasodilators (Nitrates)
Availability: Prescription Required
Pregnancy: Consult a doctor before using
Lactation: Consult a doctor before using
Alcohol: Limit intake while taking this medication
Driving: May cause drowsiness or dizziness. Use caution
- Tell Dr. of all drugs as some drugs may interact
- Be careful not to stand up too quickly
- Limit its use
- Tell Dr. of all drugs as some drugs may interact
- Be careful not to stand up too quickly
- Limit its use
- Do not swallow whole or chew
- For aerosol, spray products : Get exact instructions for use from MD. If available, read the patient package insert. Do not shake the container. Spray onto or under the tongue. Do not inhale. Use at first sign of chest pain. After 1st dose, call 911 if pain is not improved. Caution.
- For capsule, extended release products : Swallow whole. Do not break/chew/crush/dissolve. Take doses regularly, even when feeling well. This medicine is usually not taken at night. Do not use to stop angina attack. Use regularly. May make you dizzy. Use caution when driving. May cause headache. May cause flushing.
- For ointment products : Know how to use before taking. For rectal use only. This medicine is usually not used at night. Alcohol can affect blood pressure. Check warnings on OTC medications. Close container tightly when not in use.
- For patch, transdermal 24 hours products : Apply to skin on abdomen upper arms, or shoulders. Dispose patch by folding sticky sides together. If having MRI, check if patch should be removed. MD may need to reduce the dose before you stop it.
- For powder in packet products : Read instructions carefully. Open with dry hands and place under the tongue. Store in a cool and dry place at room temperature.
- For tablet, sublingual products : Dissolve under tongue. Store tightly closed in the original container.
History
Instability and desensitization
Detonation
Manufacturing
Use as an explosive and a propellant
Nitroglycerin was the first practical explosive produced that was stronger than black powder. It was first synthesized by the Italian chemist Ascanio Sobrero in 1847, working under Théophile-Jules Pelouze at the University of Turin. Sobrero initially called his discovery pyroglycerine and warned vigorously against its use as an explosive.
Medical use
In its undiluted form, nitroglycerin is a contact explosive, with physical shock causing it to explode. If it has not been adequately purified during manufacture it can degrade over time to even more unstable forms. This makes nitroglycerin highly dangerous to transport or use. In its undiluted form, it is one of the world's most powerful explosives, comparable to the more recently developed RDX and PETN.
Industrial exposure
Nitroglycerin and any diluents can certainly deflagrate (burn). The explosive power of nitroglycerin derives from detonation: energy from the initial decomposition causes a strong pressure wave that detonates the surrounding fuel. This is a self-sustained shock wave that propagates through the explosive medium at 30 times the speed of sound as a near-instantaneous pressure-induced decomposition of the fuel into a white-hot gas. Detonation of nitroglycerin generates gases that …