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.

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.

Gonitro

nitroglycerin

Used for Angina, Heart Failure

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:

Aileen Chu, PharmD, BCPS

Allison Gourley, PharmD

Last reviewed on March 31, 2021

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 Brands	GoNitro
Drug Class	Nitrate
Controlled Substance Classification	Not a controlled medication
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

GoNitro

Drug Class

Nitrate

Controlled Substance Classification

Not a controlled medication

Generic Status

No lower-cost generic available

Availability

Prescription only

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

Less Common 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 GoNitro (nitroglycerin) 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

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Avg retail price

$394.090

$394.09

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Pros and cons of GoNitro (nitroglycerin)

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

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 for GoNitro (nitroglycerin)

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.

Common questions about Gonitro

Gonitro 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 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, get emergency medical help right away because you may be experiencing something more serious.

Gonitro 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 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.

There are no clear guidelines for how often you can take Gonitro. 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 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.

When you are taking aspirin and Gonitro 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 helps with the pain symptoms but doesn't prevent heart damage or death from a heart attack.

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.

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.

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.

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.

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.

GoNitro (nitroglycerin) dosage

The average cost for 1 box of 36 packets of 400mcg of GoNitro (nitroglycerin) is $394.09 with a free GoodRx coupon. This is 0.00% off the average retail price of $394.09.

Box

Dosage	Quantity	Price as low as	Price per unit
36 packets of 400mcg	1 box	$394.09	$394.09

Typical dosage 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.