Nitroglycerin Dosages for Adults: Your GoodRx Guide

Chest pain is a very common reason for why adults go to the emergency room (ER). But there are also ways to address certain types of chest pain at home.

One of those ways is with a medication called nitroglycerin (Nitrostat). It’s a sublingual tablet that’s prescribed to prevent and relieve chest pain caused by angina due to coronary artery disease. This is when the heart isn’t getting enough oxygen. Nitroglycerin works for this type of chest pain by opening up (widening) blood vessels so blood can more easily flow to the heart.

There are other types of nitroglycerin, including capsules, patches, and oral sprays. But the sublingual tablets will be the focus of this dosing guide. We’ve provided general recommendations about the sublingual tablet dosages below. You should always speak with your healthcare provider about the dose that’s right for you.

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What’s the typical sublingual nitroglycerin dosage for adults?

Nitroglycerin sublingual tablets are available in three doses: 0.3 mg, 0.4 mg, and 0.6 mg.

A healthcare provider may prescribe the 0.3 mg or 0.4 mg tablets for adults with angina-related chest pain to use at home. The higher 0.6 mg dose is usually given to adults with recurring chest pain who may be in the ER.

Nitroglycerin should be taken right when you feel chest pain. Place a 0.3 mg or 0.4 mg tablet under your tongue and let it completely dissolve. It enters your bloodstream quickly and can relieve chest pain within 30 seconds to 5 minutes. You should not chew, crush, or swallow it. It’s recommended to sit down before and after taking a tablet since it can cause low blood pressure.

If your chest pain hasn’t resolved in 5 minutes, take another tablet. If you still feel chest pain after another 5 minutes, you can repeat this process one more time. It’s not recommended to take more than 3 tablets in a 15-minute period. At this point, call 911 or go to the nearest ER. It’s important to be checked out for something more serious, such as a potential heart attack or arrhythmia.

While nitroglycerin is usually used to relieve existing chest pain, it can also be taken to prevent it before physical activity. For chest pain prevention, place a 0.3 mg or 0.4 mg tablet under your tongue 5 to 10 minutes before starting the physical activity.

Are there any dosage adjustments for medical conditions?

No. Nitroglycerin dosages are not typically adjusted based on other medical conditions, such as kidney or liver issues. But it should be avoided altogether with certain medical conditions or interacting medications.

Nitroglycerin should not be used in combination with riociguat (Adempas) or erectile dysfunction medications, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil. Taking nitroglycerin with any of these can cause dangerously low blood pressure (hypotension).

You should also avoid taking nitroglycerin if you had a recent heart attack, have severe anemia, or there’s high pressure in your skull.

What happens if you miss a dose of nitroglycerin?

This shouldn't be an issue. You likely won’t be prescribed nitroglycerin sublingual tablets on a schedule. They should only be used as needed if you feel chest pain or want to prevent chest pain before exerting yourself.

But, it’s important to be prepared in the event of an attack. Always keep your bottle of nitroglycerin close to you so you have quick access to it. You should also keep a close eye on your product’s expiration date, since nitroglycerin can become less effective once expired. If you feel sudden chest pain and you don’t have nitroglycerin close by (or it's expired), call 911 or go to the nearest ER.

Your healthcare provider may also suggest taking nitroglycerin before you perform physical activity. If you realize that you missed a dose before exercise, be cautious of continuing the activity. You may have a higher risk of feeling discomfort or angina-related pain, since it’s more likely to be triggered when you exert yourself.

What should you do if you take too much nitroglycerin?

If you take too much nitroglycerin, you may need medical care right away to prevent an overdose. Some potentially dangerous side effects from taking too much nitroglycerin are:

• Very low blood pressure or lightheadedness

• Ongoing throbbing headache

• Vertigo

• Nausea and vomiting

• Flushing or sweating

• Vision changes

If you or someone you know took too much nitroglycerin, contact your healthcare provider or call Poison Control at 1-800-222-1222. But if you’re experiencing symptoms that feel worrisome or severe, go to the nearest ER right away.

How to save on sublingual nitroglycerin

There are many ways to save on nitroglycerin, which is available as both a brand-name and generic medication.

• Save with GoodRx. GoodRx can help you save over 75% off the average retail price of the generic version. Generic nitroglycerin’s price at certain pharmacies is as low as $9.00 with a free GoodRx discount.

• Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for certain nitroglycerin products’ patient assistance programs, which offer the medication free of cost.

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Written by:

Hindu Rao, PharmD, APh, BCACP

Hindu Rao, PharmD, APh, BCACP is a clinical assistant professor of pharmacy practice at Chapman University School of Pharmacy and a clinical pharmacist at Providence Medical Foundation. She specializes in chronic disease management and has her board certification in ambulatory care.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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