Nitroglycerin skin patches (patient information)

Why is this medication prescribed?

Nitroglycerin skin patches are used to prevent chest pain (angina). They work by relaxing the blood vessels to the heart, so the blood flow 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 a patch you apply to the skin. It is usually applied once a day. Your doctor may tell you to remove the patch 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 the nitroglycerin skin patch exactly as directed. Do not apply it more or less often than prescribed by your doctor.

Nitroglycerin skin patches control chest pain but do not cure it. Continue to use the nitroglycerin skin patch even if you feel well. Do not stop using the nitroglycerin skin patch without talking to your doctor. Stopping the drug abruptly may cause chest pain.

Apply the patch to clean, dry skin that is relatively free of hair (above your knee) or upper arm (above your elbow). Avoid irritated, scarred, broken, and calloused skin. Select a different area each day to avoid skin irritation. Be sure to remove the patch before you apply another one.

If the patch loosens or falls off, replace it with a fresh one. Fold the used patch in half with the sticky sides together and dispose of it carefully. The patch still contains active medication that could be harmful to children or pets.

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.

What special precautions should I follow

Before using a nitroglycerin skin patch

• tell your doctor and pharmacist if you are allergic to nitroglycerin skin patches, tablets, capsules, or ointment; 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, Isoptin); 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 a nitroglycerin skin patch, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using a nitroglycerin skin patch.
• you should know that this drug may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this drug affects you.
• ask your doctor about the safe use of alcoholic beverages while you are using a nitroglycerin skin patch. Alcohol can make the side effects from the nitroglycerin skin patch worse.

What should I do if I forget a dose

Apply the missed patch as soon as you remember it. Do not apply two patches to make up for a missed one.

Side effects

Mild side effects

Side effects from nitroglycerin skin patches 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
• 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. 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 skin patches 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 skin patches unless you doctor tells you to.

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

Brand names

• Deponit®
• Minitran®
• Nitrek®
• Nitro-Dur®