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Gonitro

nitroglycerin
Used for Heart Failure, Angina
Used for Heart Failure, Angina

GoNitro (nitroglycerin) is a powder that goes under your tongue. It works fast to relieve angina, a specific type of chest pain, but it's expensive because it's brand-name only. As a precaution, make sure to sit down while taking it because it can make you lightheaded and dizzy.

Reviewed by:
reviewer
Aileen Chu, PharmD, BCPS
reviewer
Allison Gourley, PharmD
Last reviewed on March 31, 2021
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageAlternativesLatest newsPricesMedicare
basics-icon

What is GoNitro (nitroglycerin)?

What is GoNitro (nitroglycerin) used for?

  • Angina (chest pain due to tight blood vessels in the heart)

  • Prevention of angina

How GoNitro (nitroglycerin) works

GoNitro (nitroglycerin) is a type of nitrate. Nitrates are vasodilators, which means that they work to relax your blood vessels. This makes the heart pump more easily and allows for better blood flow to the heart muscles, which relieves heart-related chest pain.

Are you looking for information on Nitrostat (nitroglycerin sublingual tablet) or
Nitrolingual (nitroglycerin lingual spray) instead?

Drug Facts

Common BrandsGoNitro
Drug ClassNitrate
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of GoNitro (nitroglycerin)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Headache
  • Dizziness
  • Tingling or prickling sensation

Other Side Effects

  • Dizziness or feel like the room is spinning
  • Weakness
  • Abnormal heart rate
  • Fainting
  • Allergic reaction (especially if have had a previous allergy to nitroglycerin, nitrates, or nitrites)

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • Headache, unusual weakness or fatigue, shortness of breath, nausea, vomiting, rapid heartbeat, blue skin or lips, which may be signs of methemoglobinemia
  • Increased pressure around the brain—severe headache, blurry vision, change in vision, nausea, vomiting
  • Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
  • Slow heartbeat—dizziness, feeling faint or lightheaded, confusion, trouble breathing, unusual weakness or fatigue
  • Worsening chest pain (angina)—pain, pressure, or tightness in the chest, neck, back, or arms

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

  • Dizziness
  • Flushing
  • Headache
pros-and-cons

Pros and cons of GoNitro (nitroglycerin)

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Pros

Is a first choice treatment option for quick relief of heart-related chest pain (angina)

Can also be used to prevent chest pain from happening before an activity like exercise

Comes in single-dose packets that are easy to carry around and can be kept in many places at once

thumbs-down

Cons

Headaches are a known side effect and can be very bothersome for some people.

Can cause low blood pressure that leads to dizziness, lightheadedness, or even fainting

You can develop tolerance to this medication over time, which means that the same dose may not work as well for you after a while.

Is a lot more expensive than other forms of nitroglycerin that are used to treat chest pain quickly

pharmacist-tips

Pharmacist tips for GoNitro (nitroglycerin)

pharmacist

  • Keep packets of GoNitro (nitroglycerin) with you at all times, since chest pain can happen at any time or when you aren't expecting it.

    • To use a packet of GoNitro (nitroglycerin), tear it open along the red arrows and pour all of the powder under your tongue. Close your mouth and breathe through your nose and try not to swallow until the powder is fully dissolved. To make sure the medication fully absorbs, don't spit or rinse your mouth for 5 minutes after dosing.

      • Don't use more than 3 packets within 15 minutes. Call 911 or go to the hospital if you're still having chest pain after 3 packets or if the pain is different from usual.

        • GoNitro (nitroglycerin) can cause low blood pressure, which can lead to dizziness, lightheadedness, or fainting. Sit down before and after taking this medication to avoid side effects and also to rest your heart if you are already having chest pain.

          • You may get a headache, especially after the first few times taking GoNitro (nitroglycerin). This is a known side effect and usually goes away with time.

            • Erectile dysfunction medications (Viagra, Levitra, Cialis) cannot be taken while you are on GoNitro (nitroglycerin). It can cause your blood pressure to become dangerously low. If you are having chest pain but recently took an erectile dysfunction medication, it's best to get emergency help right away and avoid taking GoNitro (nitroglycerin) unless a healthcare provider says it's safe to do so.

              faqs

              Frequently asked questions about GoNitro (nitroglycerin)

              Does GoNitro (nitroglycerin) stop a heart attack?
              GoNitro (nitroglycerin) doesn't stop heart attacks. It's often given by healthcare providers when someone is having a heart attack; however it only helps with the pain symptom and doesn't prevent heart damage or death from a heart attack. Only take GoNitro (nitroglycerin) as instructed. If you are having heart-related chest pain (angina) that is different or worse than usual, or if it hasn't gotten better after 3 doses of GoNitro (nitroglycerin), get emergency medical help right away because you may be experiencing something more serious.
              Does GoNitro (nitroglycerin) work like Viagra?
              GoNitro (nitroglycerin) and erectile dysfunction medications (Viagra, Levitra, Cialis) work on a similar pathway in the body to relax blood vessels. This is why it's dangerous to combine the two classes of medications - your blood vessels may become too relaxed, causing very low blood pressure. GoNitro (nitroglycerin) doesn't help with erectile dysfunction because not enough of it reaches the penis. There has been research into nitroglycerin formulations that can be put directly on the penis, however none have been FDA-approved for that use.
              How often can I use GoNitro (nitroglycerin)?
              There are no clear guidelines for how often you can take GoNitro (nitroglycerin). However, if you are having chest pain that doesn't go away after 3 packets within 15 minutes, get emergency medical help right away because you may be experiencing a serious problem with your heart. If you use GoNitro (nitroglycerin) throughout the day for many days in a row, you could develop tolerance, which means that the same dose may not work as well for you after a while. Tell your provider if your chest pain is happening more often because you may benefit from longer-acting medications to prevent the chest pain.
              Do you give aspirin or GoNitro (nitroglycerin) first?
              When you are taking aspirin and GoNitro (nitroglycerin) on a routine basis, the order of these medications doesn't really matter. However, if you or someone you know may be having a heart attack, aspirin should be given first as long as they're not allergic to it. This is because aspirin is the most important medication to help someone survive a heart attack. GoNitro (nitroglycerin) helps with the pain symptoms but doesn't prevent heart damage or death from a heart attack.
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              What are the risks and warnings for GoNitro (nitroglycerin)?

              GoNitro (nitroglycerin) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Tolerance

              • Risk factors: Use of long-acting nitrates

                Your body can get used to GoNitro (nitroglycerin), which means the same amount of medication may no longer work as well as it used to. This is called tolerance and it cannot be fixed by raising the dose of the medication. Tolerance is more likely to happen if you take other, longer-acting forms of nitroglycerin or nitroglycerin-like medications (like isosorbide mononitrate or dinitrate). Still, make sure to take GoNitro (nitroglycerin) only when you need it and talk to your provider if you notice your chest pain starts to get worse.

                risk-warning

                Low blood pressure

                • Risk factors: Taking GoNitro (nitroglycerin) while standing | Problems with the outside of the heart or heart valves | Dehydration | Use of erectile dysfunction medications | Use of blood pressure-lowering medications | Alcohol use

                  GoNitro (nitroglycerin) can cause dangerously low blood pressure in some people. When you take GoNitro (nitroglycerin), sit down for the first few minutes to avoid dizziness or fainting. Change positions slowly until your body is used to the medication. Get emergency help if you feel like like you are going to pass out and are experiencing an irregular heartbeat, nausea, vomiting, weakness, changes in vision, sweating, cold and clammy skin, or if your chest pain gets worse.

                  risk-warning

                  Worse chest pain

                  • Risk factors: Hypertrophic obstructive cardiomyopathy

                    In some rare cases, taking GoNitro (nitroglycerin) can cause your chest pain to get worse. Check with your provider to make sure that GoNitro (nitroglycerin) is right for you, especially if you have been diagnosed with hypertrophic obstructive cardiomyopathy, a condition where your heart muscles become too thick and don't pump as well. Contact your provider right away if GoNitro (nitroglycerin) makes your chest pain worse.

                    risk-warning

                    Headache

                    GoNitro (nitroglycerin) can cause headaches, especially when you first start taking this medication or if you take higher doses. The headaches can get pretty bad, but should get better after you've used GoNitro (nitroglycerin) for a few times and your body gets used to it. If the headaches are causing you too many problems, talk to your healthcare provider about other options.

                    dosage

                    GoNitro (nitroglycerin) dosage forms

                    box
                    Box
                    DosageQuantityPrice as low asPrice per unit
                    36 packets of 400mcg1 box$254.47$254.47

                    Typical dosing for GoNitro (nitroglycerin)

                    To take a packet of GoNitro (nitroglycerin), pour all of the powder under the tongue, close your mouth, and breathe normally.

                    If you are experiencing angina (chest pain), use 1 or 2 packets. You may repeat a dose after 5 minutes if the pain continues, but don't use more than 3 packets within 15 minutes.

                    For prevention of angina, use 1 or 2 packets 5 to 10 minutes before you do any activity that could cause chest pain.

                    alternatives

                    What are alternatives to GoNitro (nitroglycerin)?

                    There are a number of medications that your doctor can prescribe in place of GoNitro (nitroglycerin). Compare a few possible alternatives below.
                    GoNitro (nitroglycerin)
                    Used for:

                    • Angina (chest pain due to tight blood vessels in the heart)

                    • Prevention of angina

                    $254.47 Lowest GoodRx priceView Prices
                    Nitroglycerin (Nitrolingual) spray
                    Used for:

                    • Prevention and treatment of angina (chest pain due to tight blood vessels in the heart)

                    $55.64 Lowest GoodRx priceView Prices
                    Nitroglycerin (Nitrostat)
                    Used for:

                    • Prevention and treatment of angina (chest pain due to tight blood vessels in the heart)

                    $9.00 Lowest GoodRx priceView Prices

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