Nitroglycerin - Warnings and Precautions
The following warnings and precautions are taken directly from the US FDA-approved drug label for Nitroglycerin. This is the same information dispensing pharmacists read.
5 WARNINGS AND PRECAUTIONS Tolerance: Excessive use may lead to tolerance.
Hypotension: Severe hypotension may occur.
5.1 Tolerance Excessive use may lead to the development of tolerance.
Only the smallest dose required for effective relief of the acute angina attack should be used.
A decrease in therapeutic effect of sublingual nitroglycerin may result from use of long-acting nitrates.
5.2 Hypotension Severe hypotension, particularly with upright posture, may occur with small doses of nitroglycerin particularly in patients with constrictive pericarditis, aortic or mitral stenosis, patients who may be volume-depleted, or are already hypotensive.
Hypotension induced by nitroglycerin may be accompanied by paradoxical bradycardia and increased angina pectoris.
Symptoms of severe hypotension (nausea, vomiting, weakness, pallor, perspiration and collapse/syncope) may occur even with therapeutic doses.
5.3 Hypertrophic Obstructive Cardiomyopathy Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy.
5.4 Headache Nitroglycerin produces dose-related headaches, especially at the start of nitroglycerin therapy, which may be severe and persist but usually subside with continued use.
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