nitroglycerin
Nitroglycerin (Nitro-Dur) patch is a nitrate medication. It prevents angina (chest pain) by opening up your blood vessels to allow more blood to flow to the heart. Nitroglycerin (Nitro-Dur) comes as a transdermal patch that's applied directly on your skin once daily for 12 to 14 hours, then removed. Some common side effects of this medication include headache and low blood pressure. Avoid taking nitroglycerin (Nitro-Dur) patch with sildenafil (Viagra) or other similar medications because doing so can lead to dangerously low blood pressure.
What is Nitroglycerin (Nitro-Dur) patch?
What is Nitroglycerin (Nitro-Dur) patch used for?
- Prevention of angina (chest pain)
How Nitroglycerin (Nitro-Dur) patch works
Nitroglycerin (Nitro-Dur) patch is a nitrate that opens the blood vessels in your heart. This helps blood reach the heart better, which puts less stress on the heart and relieves heart-related chest pain.
Drug facts
Side effects of Nitroglycerin (Nitro-Dur) patch
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 (63%)
- Lightheadedness (6%)
- Low blood pressure and/or fainting (4%)
Less Common Side Effects
- Skin irritation
Nitroglycerin (Nitro-Dur) patch serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Dangerously low blood pressure: dizziness, lightheadedness, pale skin, feeling faint
The following Nitroglycerin (Nitro-Dur) patch side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Lightheadedness
Less common
Arm, back, or jaw pain
blurred vision
chest pain or discomfort
chest tightness or heaviness
confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fainting
fast or irregular heartbeat
sweating
unusual tiredness or weakness
Rare
Bluish-colored lips, fingernails, or palms
dark urine
difficulty with breathing
headache
pale skin
rapid heart rate
unusual bleeding or bruising
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Blurred or loss of vision
bulging soft spot on the head of an infant
change in consciousness
change in the ability to see colors, especially blue or yellow
cold, clammy skin
disturbed color perception
double vision
feeling of constant movement of self or surroundings
halos around lights
headache, severe and throbbing
loss of consciousness
night blindness
overbright appearance of lights
paralysis
sensation of spinning
tunnel vision
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare
Burning, itching, redness, skin rash, swelling, or soreness at the application site
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Nitroglycerin (Nitro-Dur) patch
Pros
- Each patch can be applied for 10 to 12 hours (as long as the patch is being worn)
- Option for people who don't want to take medications by mouth
- Available as a generic
Cons
- Not the best choice for older adults because of risk of falls
- Only prevents (but can't treat) chest pain
- Must remove the patch after 12 to 14 hours or less the medication might not work well over time
Pharmacist tips for Nitroglycerin (Nitro-Dur) patch
- Wear nitroglycerin (Nitro-Dur) patch for 12 to 14 hours every day, then take it off for 10 to 12 hours. It might help to set an alarm, so you remember to remove it after the right amount of time.
- Nitroglycerin (Nitro-Dur) patch is only for preventing chest pain; it doesn't treat chest pain that has already started. Your provider might also prescribe nitroglycerin (Nitrostat) sublingual tablet) or Nitrolingual (nitroglycerin lingual spray) for treating chest pain. If you have to take either of these for active chest pain, make sure to sit down first to avoid side effects like sudden low blood pressure and dizziness.
- Nitroglycerin (Nitro-Dur) patch can cause headaches as a side effect. To prevent headaches, get up slowly from a sitting or lying position. Also, avoid drinking alcohol. If the headaches are too bothersome for you, ask your provider if it's safe for you to take a pain medication, such as acetaminophen (Tylenol).
- Nitroglycerin (Nitro-Dur) patch can lower your blood pressure, which can lead to dizziness, lightheadedness, or fainting. Avoid alcohol because it can worsen dizziness and lower your blood pressure more.
- Make sure to tell your provider the name of all the medications you take. This is because you can’t use nitroglycerin (Nitro-Dur) patch if you’re also taking medications like Adempas (riociguat), sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca), vardenafil (Levitra), or Stendra (avanafil). When taken together, your blood pressure can become dangerously low.
Tips for how to use nitroglycerin (Nitro-Dur) patch:
- Wash your hands before and after applying a new nitroglycerin (Nitro-Dur) patch. This helps avoid spreading medication to other people or places.
- Apply nitroglycerin (Nitro-Dur) patch to clean, dry, hairless skin. Avoid applying nitroglycerin (Nitro-Dur) patch below the knee, below the elbow, or on skin that has folds, scar tissue, injuries, or irritation.
- Apply nitroglycerin (Nitro-Dur) patch to a different area of the body every day to help prevent skin irritation. Fold back the remaining side of the patch to remove the backing. Then wash your hands.
- You can shower or bathe with nitroglycerin (Nitro-Dur) patch on.
- To remove nitroglycerin (Nitro-Dur) patch, press down on the center of the patch to raise the edges and slowly peel away from your skin. Then, wash the skin area with soap and water and dry with a towel. Then wash your hands.
- Your skin might feel warm and red after removing nitroglycerin (Nitro-Dur) patch. This should go away after a short amount of time. If your skin is dry, you can use lotion. Contact your provider if you have redness or a rash that isn't going away.
- Used nitroglycerin (Nitro-Dur) patches still contain medication. Make sure you throw away used patches in a place that is out of reach of children and pets.
Common questions about Nitroglycerin (Nitro-Dur) patch
Sometimes, people experience chest pain (angina) because there isn't enough blood flowing to the heart. Nitroglycerin (Nitro-Dur) patch prevents chest pain by opening up the blood vessels so that the blood flows better. Keep in mind that nitroglycerin (Nitro-Dur) patch is applied to the skin once daily to prevent chest pain. But this medication doesn't work quickly enough to relieve chest pain if you're already experiencing symptoms.
Yes, nitroglycerin (Nitro-Dur) patch can cause low blood pressure as a side effect. Your risk is higher if you're an older adult, dehydrated, or are taking other medications that can lower blood pressure. Having low blood pressure can lead to symptoms such as dizziness and lightheadedness, which can make you feel off-balance. To prevent falls, hold on to something stable when you're going from a sitting to standing position. Also, consider removing or securing any rugs you have around the home that might be a tripping hazard. If the dizziness is very bothersome and you're having trouble going through the day, talk with your provider about other medication options besides nitroglycerin (Nitro-Dur) patch.
Nitroglycerin (Nitro-Dur) patch is typically worn for 12 to 14 hours and taken off for 10 to 12 hours.
Removing nitroglycerin (Nitro-Dur) patch allows your body to have a "nitroglycerin-free" period. This is so you don't build a tolerance (also known as tachyphylaxis) to the medication. Otherwise, it might not work as well to prevent chest pain.
Yes, nitroglycerin (Nitro-Dur) patch can expire. Never use nitroglycerin (Nitro-Dur) patch past the written expiration date because it might not work as well to help with your chest pain. The expiration date should be written on the outer wrap of the patch. Contact your provider or pharmacist for a refill if your patches are expired.
After you put on a nitroglycerin (Nitro-Dur) patch, it takes about 2 hours for the patch to start delivering the full dose of the medication. Your body will continue to receive this dose for the next 10 to 12 hours.
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Risks and warnings for Nitroglycerin (Nitro-Dur) patch
Nitroglycerin (Nitro-Dur) patch 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.
Low blood pressure
- Risk factors: Older adults | Not enough fluids in the body | Taking other medications that can lower blood pressure
Nitroglycerin (Nitro-Dur) patch can cause dangerously low blood pressure in some people, especially when you're getting up from a sitting or lying position. This can lead to dizziness, fatigue, and lightheadedness. The risk is higher for older adults and for people starting nitroglycerin (Nitro-Dur) patch for the first time. Change positions slowly until your body is used to this medication to avoid falling and hurting yourself. Get emergency help if you feel like like you are going to pass out and are experiencing an irregular heart beat, nausea, vomiting, weakness, changes in vision, cold and clammy skin, or if your chest pain gets worse.
Don't take nitroglycerin (Nitro-Dur) patch with phosphodiesterase inhibitors, such as sildenafil (Viagra). Doing so can lead to dangerously low blood pressure.
Worsening chest pain
- Risk factors: Hypertrophic cardiomyopathy
Although rare, taking nitroglycerin (Nitro-Dur) patch can worsen chest pain that's caused by a heart problem called hypertrophic cardiomyopathy. This is a condition where your heart muscles are too thick and can't pump blood as well. If you’ve been diagnosed with hypertrophic cardiomyopathy, check with your provider to make sure that nitroglycerin (Nitro-Dur) patch is right for you. If you take nitroglycerin (Nitro-Dur) patch and it worsens your chest pain, get emergency help right away.
Not working well to ease chest pain
- Risk factors: Using nitroglycerin (Nitro-Dur) patch continuously over a longer period of time
Your body can get used to nitroglycerin (Nitro-Dur) patch over time. When this happens, the same amount of medication might no longer work as well as it used to prevent chest pain. This is called tolerance or tachyphylaxis. Your provider will likely tell you to avoid taking nitrates (e.g., isosorbide mononitrate (Monoket) or isosorbide dinitrate (Isordil)) for a certain amount of time every day to give your body a 'break' from it. Let your provider know if you experience problems with chest pain or exercise abilities during the times you are not wearing your nitroglycerin (Nitro-Dur) patch patch.
Headache
- Risk factors: First starting nitroglycerin (Nitro-Dur) patch | Higher doses of nitroglycerin (Nitro-Dur) patch | Drinking alcohol
Some people experience daily headaches after starting nitroglycerin (Nitro-Dur) patch. Sometimes, these headaches happen as you go from a sitting or lying position to a standing position. The headaches often ease or go away after you've used nitroglycerin (Nitro-Dur) patch a few times and your body gets used to the medication. If the headaches are bothersome, talk to your healthcare provider about other options.
Nitroglycerin (Nitro-Dur) patch dosage
Patch| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 0.2mg | 30 patches | $26.94 | $0.90 |
| 0.4mg | 30 patches | $20.97 | $0.70 |
| 0.6mg | 30 patches | $23.06 | $0.77 |
| 0.1mg | 30 patches | $23.86 | $0.80 |
Typical dosage for Nitroglycerin (Nitro-Dur) patch
- Adults: The typical starting dose is 1 patch (ranging from 0.2 mg/hr to 0.4 mg/hr) applied to the skin once daily for 12 to 14 hours, then taken off for 10 to 12 hours.
Interactions between Nitroglycerin (Nitro-Dur) patch and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Avanafil
- Riociguat
- Sildenafil
- Tadalafil
- Vardenafil
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Alteplase, Recombinant
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acetylcysteine
- Apomorphine
- Aspirin
- Dihydroergotamine
- Pancuronium
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Nitroglycerin (Nitro-Dur) patch contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Nitroglycerin (Nitro-Dur) patch will not be safe for you to take.
- Taking PDE-5 inhibitors like sildenafil (Viagra, Revatio)
- Taking sGC stimulators like Adempas (riociguat)
- Allergy to other nitrates, such as isosorbide mononitrate (Monoket) or isosorbide dinitrate (Isordil)
- Allergy to adhesives
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