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The following safety information outlines potential risks and necessary precautions when using the nitroglycerin (Nitro-Dur) patch. Please read carefully and discuss any concerns with your healthcare provider.

• Low Blood Pressure: The use of nitroglycerin (Nitro-Dur) patches may cause a significant drop in blood pressure, particularly when transitioning from sitting or lying down to standing. This can result in dizziness, fatigue, or lightheadedness, with older adults and new users being more susceptible. To prevent falls, change positions slowly. Seek immediate medical attention if you experience symptoms such as fainting, irregular heartbeat, nausea, vomiting, weakness, vision changes, cold and clammy skin, or worsening chest pain. Those at increased risk include older adults, individuals with dehydration, and those on medications that may lower blood pressure.

• Worsening Chest Pain: Rarely, nitroglycerin (Nitro-Dur) patches can exacerbate chest pain due to hypertrophic cardiomyopathy, a condition characterized by thickened heart muscles. If diagnosed with this condition, consult your healthcare provider to ensure this medication is appropriate for you. In case of heightened chest pain after using the patch, seek emergency assistance immediately.

• Decreased Effectiveness: Over time, your body may develop a tolerance to nitroglycerin (Nitro-Dur) patches, making them less effective in preventing chest pain. Your healthcare provider may advise periodic breaks from nitrates to maintain effectiveness. Report any issues with chest pain or reduced exercise capacity during these breaks to your provider.

• Headache: Initial use of nitroglycerin (Nitro-Dur) patches may lead to headaches, especially when moving to a standing position. These headaches typically diminish as your body adjusts. Consult your provider if headaches persist or become bothersome.

Contraindications: Before using nitroglycerin (Nitro-Dur) patches, consult your healthcare provider if any of the following conditions apply, as they may pose serious health risks:

• Concurrent use of PDE-5 inhibitors such as sildenafil (Viagra, Revatio).
• Use of sGC stimulators like Adempas (riociguat).
• Allergy to other nitrates including isosorbide mononitrate (Monoket) or isosorbide dinitrate (Isordil).
• Allergy to adhesives.

For any questions or uncertainties regarding these warnings or contraindications, please reach out to your healthcare provider for guidance.

When taking this medication, some individuals may experience common side effects such as headaches, dizziness, lightheadedness, nausea, and flushing. These are generally mild and may occur as your body adjusts to the treatment. For headaches, often a sign the medication is working, over-the-counter pain relief like acetaminophen or aspirin may be helpful. To minimize dizziness and lightheadedness, rise slowly from sitting or lying down.

Occasionally, users report skin irritation. While these side effects are often mild, it's important to inform your healthcare provider if they persist or worsen. More serious side effects, although rare, include fainting, fast or irregular heartbeat, and dangerously low blood pressure, which may manifest as dizziness, lightheadedness, pale skin, or feeling faint. Immediate medical attention is necessary if these occur.

An allergic reaction to this medication is rare but serious. Symptoms include rash, itching, swelling (particularly of the face, tongue, or throat), severe dizziness, and difficulty breathing. Seek urgent medical help if you notice these symptoms. While this list includes several potential side effects, it's not exhaustive. If you experience any other unusual effects, consult your healthcare provider.

When using the Nitroglycerin (Nitro-Dur) patch, it’s important to be aware of potential interactions with other medications. Inform your doctor and pharmacist about all the medications and supplements you are currently taking, including over-the-counter drugs, vitamins, and herbal supplements.

Some medications, particularly those used for erectile dysfunction or pulmonary hypertension, such as Sildenafil, Tadalafil, Vardenafil, Avanafil, and the drugs Riociguat and Vericiguat, are not recommended to be used with Nitroglycerin. These combinations may lead to serious health risks, and your doctor may choose to avoid prescribing these together.

In some cases, combining Nitroglycerin with other medications, like Alteplase, Recombinant, may not be ideal, but could be necessary depending on your treatment plan. Your doctor may adjust dosages or administration schedules if both are needed.

Additionally, using Nitroglycerin with medications such as Acetylcysteine, Apomorphine, Aspirin, Dihydroergotamine, and Pancuronium might increase the risk of side effects. However, your doctor will weigh the benefits and may decide that using both medications is the best option for you, adjusting doses as required.

Finally, Nitroglycerin may affect certain laboratory test results, such as blood cholesterol levels. It is crucial to inform all healthcare providers, including lab personnel, that you are using this medication to prevent false test results.