Nitroglycerin
Known brand names include Nitrostat.
A fast-acting nitrate tablet dissolved under the tongue. It relieves an angina attack within minutes and can be taken just before activity that tends to bring on chest pain.
Known brand names include Nitrostat.
A fast-acting nitrate tablet dissolved under the tongue. It relieves an angina attack within minutes and can be taken just before activity that tends to bring on chest pain.
Nitroglycerin releases nitric oxide, which sets off a chain of chemical steps inside the muscle cells of blood vessel walls that makes them relax. Veins widen most, so more blood pools in them and less returns to the heart, which lightens the load the heart must pump. It also relaxes small arteries, which lowers blood pressure and the resistance the heart pumps against. Together these changes lower the heart's need for oxygen, which eases the pain.
Under the tongue it is absorbed quickly, begins widening blood vessels within 1 to 3 minutes, reaches its full effect by about 5 minutes, and keeps working for at least 25 minutes. Many people feel burning or tingling in the mouth as it dissolves, but that feeling does not show whether it is working. Because it lowers blood pressure, it can cause a sharp drop, especially when standing, with weakness, sweating, or fainting. Using it too often can make it work less well over time.
Nitroglycerin tablets dissolve under the tongue to relieve an attack of angina, or chest pain, in people with coronary artery disease. In that disease, the blood vessels that supply the heart have narrowed. The aim is to ease the pain quickly by letting the heart do its work with less oxygen.
They are taken at the first sign of an attack, ideally while sitting, and left to dissolve under the tongue or against the cheek rather than swallowed. They can also be taken a few minutes before an activity that tends to bring on chest pain, to keep an attack from starting. Chest pain that keeps going despite the tablets, or that feels different from usual, needs emergency help right away. Their safety and effectiveness have not been established in children.
A throbbing headache is the side effect people notice most, and it often fades with continued use. Dizziness, tingling, flushing, weakness, a pounding heartbeat, and a burning feeling under the tongue are also common. The label treats a sharp drop in blood pressure with fainting as dangerous, along with a slow heartbeat and worse chest pain, losing its effect with overuse, a blood problem at large doses, and severe skin reactions.