Therapeutic Index

Each film-coated tablet contains:

USES:
This medication is used to control high blood pressure, congestive heart failure, lung congestion and chest pain especially in heart attack patients. It decreases the workload on the heart by enlarging (dilating) blood vessels.

HOW TO USE:
This drug is given by vein (IV), diluted in a sugar or saline IV solution. The dosage is based on facts such as your blood pressure, symptoms, degree of heart failure or chest pain, age and overall medical condition. Your body may get used to the drug (tolerance), may not work as well and may require an increase in dosage. This drug is absorbed by plastics, so the dosage varies depending on the type of IV you have. All usage instructions must be followed carefully.

SIDE EFFECTS:
Headache, dizziness, unusual weakness, nausea, vomiting and sweating may occur. If these persist or worsen, notify your doctor promptly. Unlikely but report promptly: fainting, loss of bowel or bladder control, unusually slow or fast heartbeat, vision problems. Very unlikely but report promptly: increase in chest pain (this may result from a large decrease in blood pressure). Headache may be relieved by use of acetaminophen as directed. Headache can be a sign the medication is working properly. In the unlikely event you have a serious allergic reaction to this drug, seek medical attention immediately. Symptoms of a serious allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS:
Before using this drug, tell your doctor your medical history, including: allergies (especially drug allergies), head injury/internal bleeding (increased intracranial pressure), anemia, heart disease, low blood pressure. Avoid alcohol while receiving this medication since it may aggravate side effects. To avoid dizziness and lightheadedness when rising from a seated or lying position, get up slowly. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. It is not known if this drug is excreted into breast milk. Consult your doctor before breast-feeding. Caution is advised if this drug is used in children. A blood disorder (methemoglobinemia) may occur rarely in small children. Caution is advised when this drug is used in the elderly.

DRUG INTERACTIONS:
This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: drugs to treat impotence (e.g., sildenafil, vardenafil, tadalafil). If you are currently using any of these medications, tell your doctor or pharmacist before starting nitroglycerin. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: heparin, drugs for high blood pressure (e.g., ACE inhibitors such as fosinopril or lisinopril, alpha blockers such as prazosin or doxazosin, beta-blockers such as propranolol), antipsychotics for mental conditions (e.g., chlorpromazine, haloperidol), other nitrate drugs such as isosorbide, "dopamine-like" drugs such as bromocriptine or cabergoline. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE:
 If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US national poison hotline at 1-800-222-1222. Canadian residents should call their local poison control center directly. Symptoms of overdose may include a persistent, throbbing headache; dizziness; confusion; weakness; sweating; changes in heart rate; changes in vision; flushing; nausea; and vomiting.
           

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