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The following information outlines important safety warnings associated with the use of nitroglycerin (Nitrostat). It is crucial to review these details thoroughly and discuss any concerns with your healthcare provider to ensure safe usage.

• Tolerance Development: Over time, your body may become accustomed to nitroglycerin, leading to decreased efficacy, known as tolerance or tachyphylaxis. This is more likely if you have used long-acting nitrates such as isosorbide mononitrate or isosorbide dinitrate, or if you frequently use nitroglycerin. Increased doses may not improve effectiveness. Use nitroglycerin only as prescribed and consult your doctor if you experience increased chest pain.

• Low Blood Pressure: Nitroglycerin can cause a significant drop in blood pressure, resulting in dizziness, fatigue, or lightheadedness. It is recommended to sit down when taking the medication to prevent fainting. If you experience symptoms such as irregular heartbeat, nausea, vomiting, weakness, vision changes, sweating, cold or clammy skin, or more severe chest pain, seek emergency medical attention. Risks are higher if taken while standing, with certain heart conditions, dehydration, concurrent use of erectile dysfunction or blood pressure medications, or alcohol consumption.

• Increased Chest Pain: In rare cases, nitroglycerin may exacerbate chest pain in individuals with hypertrophic cardiomyopathy, a condition where the heart muscles are abnormally thick. If diagnosed with this condition, consult your healthcare provider to determine if nitroglycerin is suitable for you. If your chest pain worsens after taking nitroglycerin, seek immediate medical assistance.

• Headache: Nitroglycerin can cause headaches, which may be severe and last up to an hour. These headaches are more common upon initial use or at higher doses but often become less frequent as your body adjusts. If headaches persist or become troublesome, consult your healthcare provider for alternative options.

Contraindications indicate when nitroglycerin should not be used due to potential health risks. Consult your healthcare provider if any of the following apply to you:

• Use of PDE-5 inhibitors such as sildenafil (Viagra, Revatio).
• Use of sGC stimulators like riociguat (Adempas).
• Severe anemia.
• History of increased intracranial pressure (e.g., brain bleed, traumatic brain injury).
• Allergy to nitrates like isosorbide mononitrate or isosorbide dinitrate.
• Circulatory failure or shock.

Always ensure to follow medical advice and report any adverse effects or concerns to your healthcare provider promptly.

Common side effects:

• Headache
• Low blood pressure
• Tingling or burning sensation in the mouth
• Dizziness
• Flushing

Serious side effects:

• Fainting
• Fast or irregular heartbeat
• Severe dizziness
• Rash
• Itching
• Swelling (particularly of the face, tongue, or throat)
• Trouble breathing

Interactions with high risk of serious adverse effects and should be avoided:

• Avanafil
• Riociguat
• Sildenafil
• Tadalafil
• Vardenafil

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Alteplase, Recombinant

Interactions with low risk that usually do not require a change in therapy:

• Acetylcysteine
• Apomorphine
• Aspirin
• Dihydroergotamine
• Pancuronium