Nitroglycerin ointment (patient information)

Why is this medication prescribed

Nitroglycerin ointment is used to prevent chest pain (angina). It works by relaxing the blood vessels to the heart, so the blood and oxygen supply to the heart is increased.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used

Nitroglycerin comes as an ointment to apply to the skin. It usually is applied three to six times a day. Your doctor may tell you to remove the ointment at a certain time each day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use nitroglycerin ointment exactly as directed. Do not apply more or less of it or use it more often than prescribed by your doctor.

Nitroglycerin ointment controls chest pain but does not cure it. Continue to use nitroglycerin ointment even if you feel well. Do not stop using nitroglycerin ointment without talking to your doctor. Stopping the drug abruptly may cause chest pain.

Nitroglycerin ointment comes with paper with a ruled line for measuring the dose (in inches). Squeeze the ointment onto the paper, carefully measuring the amount specified on your prescription label. Use the paper to spread the ointment in a thin layer on a relatively hair-free area of skin (at least 2 inches by 3 inches) such as your chest. Do not rub in the ointment. Leave the paper on top of the ointment and hold it in place with an elastic bandage, hosiery, or tape. Wash your hands after applying the ointment; try not to get the ointment on your fingers.

Nitroglycerin can lose its effectiveness when used for a long time. This effect is called tolerance. If your angina attacks happen more often, last longer, or are more severe, call your doctor.

Other uses for this medicine

Nitroglycerin is also used to improve circulation in patients with Raynaud's disease. Talk to your doctor about the possible risks of using this drug for your condition.

What special precautions should I follow

Before using nitroglycerin ointment

• tell your doctor and pharmacist if you are allergic to nitroglycerin ointment, tablets, or patches; isosorbide (Imdur, Isordil, Sorbitrate); or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin; beta blockers such as atenolol (Tenormin), carteolol (Cartrol), labetalol (Normodyne,Trandate), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and timolol (Blocadren); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem), felodipine (Plendil), isradipine (DynaCirc), nifedipine (Procardia), and verapamil (Calan); dihydroergotamine (D.H.E. 45); sildenafil (Viagra); and vitamins.
• tell your doctor if you have or have ever had low red blood cell counts (anemia), glaucoma, or recent head trauma.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using nitroglycerin ointment, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using nitroglycerin ointment.
• you should know that this drug may make you drowsy and dizzy. Do not drive a car or operate machinery until you know how it affects you.
• ask your doctor about the safe use of alcoholic beverages while you are using nitroglycerin ointment. Alcohol can make the side effects from nitroglycerin ointment worse.

What should I do if I forget a dose

Apply the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not apply a double dose to make up for a missed one.

Side effects

Mild side effects

Side effects from nitroglycerin ointment are common. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• skin irritation or rash
• dizziness
• upset stomach
• headache
• flushing (feeling of warmth)

Severe side effects

If you experience any of the following symptoms, call your doctor immediately:

• blurred vision
• dry mouth
• chest pain
• fainting

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine

Keep this medication out of reach of children and away from toothpaste or other ointments and creams. Close the ointment tube tightly after each use. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know

Keep all appointments with your doctor and the laboratory.

Nitroglycerin ointment should not be used for acute angina attacks. Continue to use nitroglycerin tablets or spray to relieve chest pain that has already started.

If headache continues, ask your doctor if you may take acetaminophen. Your nitroglycerin dose may need to be adjusted. Do not take aspirin or any other medication for headache while using nitroglycerin ointment unless you doctor tells you to.

If skin irritation continues, apply the ointment to a different area of skin.

Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Nitro-Bid®