Nitroglycerin Pumpspray 0.4mg

Antianginal Agent; Vasodilator

CSA NA – FDA Approved – REMS (N) – Can Ship

Nitroglycerin/Glyceryl Trinitrate (Sublingual), Nitrolingual/Nitrostat forms nitric acid which increases cGMP which dephosphorylates myosin light chains in smooth muscle resulting in their relaxation.  This results in vasodilation of peripheral veins and arteries with more effect on the veins. Reduces oxygen demand of heart by decreasing the preload and modestly reducing afterload of left ventricle.  It also increased blood flow to ischemic areas of heart via action of coronary arteries.  If used rectally for fissures it decreases sphincter tone and intra-anal pressure.

Nitroglycerin/Glyceryl Trinitrate (Sublingual), Nitrolingual/Nitrostat is officially indicated for coronary artery disease/angina, or chronic anal fissures.  It is also prescribed off-label for acute decompensated heart failure, esophageal spastic disorders, gastroesophageal variceal hemorrhage, and uterine relaxation for inversion. (may be used for conditions not listed)

Before starting Nitroglycerin/Glyceryl Trinitrate (Sublingual), Nitrolingual/Nitrostat make sure your physician is aware of any allergies, medications (medications that can be used for erectile dysfunction especially) you currently take, if you have hypertrophic cardiomyopathy, closed angle glaucoma, if you are pregnant, or breastfeeding.

Use one spray or place one tablet under the tongue as needed for chest pain.  Suggest sitting before dosage due to potential for dizziness from decreased blood pressure.  If no relief within 5 minutes, try another dosage and if no relief after another 5 minutes repeat dosage one more time and call and ambulance.

How to Take: Follow instructions provided by physician/pharmacy label, store at room temperature, make sure to prime bottle of solution if has not been used recently.

You Need to Avoid: Do not chew or swallow sublingual tablets, do not shake spray before use, do not use with erectile dysfunction medications

Headache, hypotension, syncope (fainting), dizziness 

Note this is not a complete list of side effects.

1. What is the issue with using erectile dysfunction medication with this?
   Mixing this medication with PDE-5 inhibitors (sildenafil/Viagra, tadalafil/Cialis etc.) which are generally used for erectile dysfunction can result in extremely dangerous drops in blood pressure which could result in loss of perfusion of organs and result in death.  There is no exact interval that has been established for safe use of both medications concurrently so the combination should be avoided.