Glyceryl Trinitrate
Description
Glyceryl Trinitrate is used to relieve the symptoms of angina (chest pain). Angina is chest pain or discomfort caused when your heart muscle does not get enough oxygen-rich blood. This medicine relieves angina by relaxing the blood vessels. It also facilitates more blood and oxygen to reach your heart.
Glyceryl Trinitrate shows some common side effects like headache, blurred vision, decreased blood pressure, dizziness, flushing (sense of warmth in the face, ears, neck, and trunk), increased heart rate, and lightheadedness. Avoid consuming alcohol with this medicine as it can worsen the side effects.
Glyceryl Trinitrate can be taken with or without food as directed by your doctor. Take this medicine at the same time every day to maintain constant levels of the medicine in the blood. Inform your doctor about any other health conditions you have, or if you are undergoing any medical treatment. Consult your doctor if you are pregnant or are breastfeeding, before taking this medicine. Using Glyceryl Trinitrate for long periods may increase your tolerance (when you no longer respond to the medicine in the way you did at the start of the treatment) to this medicine.
Glyceryl Trinitrate is available in various forms like tablets, sublingual tablets, patches, sprays, injections, and ointment. While all these forms are used to relieve symptoms of angina, Glyceryl Trinitrate ointment is used to treat anal fissure (a small tear or cut in the lining of your anus). It works by relaxing the blood vessels in and around the anus and increasing blood flow to the fissure, allowing it to heal faster.
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Side effects
Major & minor side effects for Glyceryl Trinitrate
- Difficulty in breathing
- Dizziness and fainting
- Swelling of the eyes, ears, and inside of nose
- Nausea and Vomiting
- Headache
- Coma
- Seizures
- Change in heart rate
- Excessive sweating
- Flushing or redness of skin
- Severe chest pain
- Blurred vision
- Pale and clammy skin
- Temporary loss of consciousness
- Prolonged bleeding time
- Fall in blood platelet levels
Uses of Glyceryl Trinitrate
What is it prescribed for?
- Angina pectoris
- Hypertension during surgeries
- Chronic anal fissures
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Concerns
Commonly asked questions
- Onset of actionThe effect of Glyceryl Trinitrate is very quick and can be observed within an hour of oral administration. However, this time may differ depending on the type of dosage form. The onset of action for each preparation is as follows: Extended-release capsules and tablets: 20 to 45 minutes Sublingual tablets (tablet to be placed below the tongue): 1 to 3 minutes Buccal extended-release tablets (tablet to be placed between the gums and cheeks): 2 to 3 minutes Injection: immediate Ointment: 20 to 60 minutes Transdermal patch (patch to be attached to the skin): 40 to 60 minutes
- Duration of effectDuration of action of Glyceryl Trinitrate differs as per the form in which it is administered. Follow are the duration of action as per the dosage form: Extended-release capsules and tablets: 8 to 12 hours Sublingual Tablets (tablet to be placed below the tongue): 30 minutes Buccal extended-release (tablet to be placed between the gums and cheeks): 5 hours Injection: 3 to 4 mins Ointment: 4 to 8 hours Transdermal patch (patch to be attached to the skin): 18 to 24 hours
- Safe with alcohol?Do not consume alcohol during treatment with Glyceryl Trinitrate due to the increased risk of serious side effects like dizziness, drowsiness, difficulty concentrating, breathing difficulties, etc.
- Is it habit forming?No habit forming tendencies were reported for Glyceryl Trinitrate.
- Usage in pregnancy?Do not take Glyceryl Trinitrate during pregnancy since it is not known if it passes the placental barrier (the lining that protects your baby and supplies nutrition). If you are pregnant, consult your doctor before using this medicine.
- Usage while breast-feeding?Do not take Glyceryl Trinitrate as it is not known if the medicine passes into breastmilk. You should consult your doctor before using this medicine while breastfeeding.
Allergy
Avoid taking Glyceryl Trinitrate if you are allergic to it. Allergic reactions are rare; however, contact a doctor immediately if you experience symptoms like rashes, itching/swelling (particularly of the face/tongue/throat), severe dizziness, and breathing difficulty, etc.
Anaemia
Anaemia is a condition in which your blood does not have enough healthy red blood cells. Do not take Glyceryl Trinitrate if you are anaemic or have low levels of haemoglobin in your blood, as large doses of glyceryl trinitrate could worsen your condition.
Glaucoma
Glaucoma is a group of eye conditions that damage the optic nerve (a nerve responsible for good vision), caused by abnormally high pressure in your eye. This can lead to blindness. Glyceryl Trinitrate is not recommended for use if you have glaucoma as this medicine may also increase pressure inside your eyes.
Increased intracranial pressure
Intracranial pressure is the pressure within the skull that is exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. This pressure change usually happens because of any kind of trauma to the skull and brain tissue. Glyceryl Trinitrate is not recommended if you have any condition in which the intracranial pressure is elevated, as this medicine can worsen your condition.
Medicine for erectile dysfunction
Erectile dysfunction occurs when a man can not get or keep an erection firm enough for sexual intercourse. Glyceryl Trinitrate is not recommended for use if you are taking medicines for the treatment of erectile dysfunction.
Heparin
Heparin has anticoagulant properties (properties that prevent the formation of blood clots). Glyceryl Trinitrate is not recommended for use if you are being given Heparin as both medicines have a similar effect. This can lead to extremely low blood pressure that can be fatal.
Warnings for special population
Pregnancy
Do not take Glyceryl Trinitrate during pregnancy since it is not known if it passes the placental barrier (the lining that protects your baby and supplies nutrition). If you are pregnant, consult your doctor before using this medicine.
Breast-feeding
Do not take Glyceryl Trinitrate as it is not known if the medicine passes into breastmilk. You should consult your doctor before using this medicine while breastfeeding.
General warnings
Other diseaes
If you have any problems with the heart, lung, thyroid, kidney, liver etc., inform your doctor before taking Glyceryl Trinitrate as this medicine can interact with the existing disease worsen your condition.
Drowsiness
The use of Glyceryl Trinitrate can cause drowsiness and affect your ability to drive or operate heavy machines. Avoid such activities as long as you are taking this medicine.
Withdrawal symptoms
Glyceryl Trinitrate should not be discontinued abruptly without consulting your doctor, as you can face withdrawal symptoms like anxiety, fatigue, sweating, vomiting, depression, seizures and hallucinations.
Chest pain due to other reasons
Do not use Glyceryl Trinitrate to treat chest pain associated with other causes like hypertrophic cardiomyopathy (enlarged heart muscles) as it may worsen your condition.
Nitrate tolerance
If you take Glyceryl Trinitrate regularly will increase your tolerance (when you no longer respond to the medicine in the way you did at the start of the treatment) levels to this medicine. You should maintain a gap of at least 12 hours between your doses.
Methemoglobinemia
Methemoglobinemia (MetHb) is a blood disorder in which an abnormal amount of methemoglobin is produced. Methemoglobin is a form of haemoglobin. Extended use of Glyceryl Trinitrate can lead to Methemoglobinaemia leading to symptoms like blue-coloured skin, headache, fatigue, lack of energy etc. Consult your doctor if you experience these signs and symptoms.
Form and route of administration
Glyceryl Trinitrate is available in many forms which can be administered via different routes. Your doctor will advise you on which route will suit you better based on your clinical condition. It is recommended that you do not change the form and route of administration without consulting your doctor first.
Missed Dose
Tablet, Capsules: If you forget a dose of this medicine at the given time, take it as soon as you remember. If it is almost the time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.
Capsule SR, Capsule TR, Capsule XL, Tablet SR, Tablet CR: If you forget a dose of this medicine at a given time, then take it as soon as you remember. If it is almost the time for your next dose, skip the missed dose. Do not double your dose to make up for the missed dose.
Injection: Since injections are usually administered by healthcare professionals, the chances of missing a dose is very unlikely.
Ointment: If you have missed a dose of Glyceryl trinitrate rectal ointment, then use it as soon as you can. If it is almost the time for the second dose, then skip the missed dose.
Patch: If you have missed putting on a Glyceryl trinitrate transdermal patch then put on the missed patch as soon as you remember. If it is close to the time for your next patch, skip the missed one and follow your normal schedule Do not put on more than 1 patch at a time.
Spray: Glyceryl trinitrate spray is taken when required, so the chance of missing a dose is not applicable. Consult your doctor for further information regarding this.
Overdose
Tablet, Capsules: If you have intentionally or accidentally consumed more than the prescribed amount of Glyceryl trinitrate, then you might experience headache, confusion, fever, change in the heartbeat, nausea, vomiting etc. Seek immediate medical attention in such cases.
Capsule SR, Capsule TR, Capsule XL, Tablet SR, Tablet CR: If you have intentionally or accidentally consumed more than the prescribed amount of Glyceryl trinitrate, then you might experience headaches, confusion, fever, change in the heartbeat, nausea, vomiting etc. Seek immediate medical attention in such cases.
Injection: As Glyceryl trinitrate injection is administered by a healthcare professional, it is very unlikely to have an overdose.
Ointment: If you have accidentally or intentionally used more than the prescribed dose of Glyceryl trinitrate rectal ointment, then you might experience headache, appearance of a blue tinge on your lips and fingernails, cold or clammy skin, etc. Consult your doctor immediately in such cases.
Patch: If you have accidentally or intentionally used more than the prescribed dose of Glyceryl trinitrate transdermal patch, then you might experience some side effects like headache, the appearance of a blue tinge on your bluish colouring of the lips and fingernails, cold or clammy skin, etc. Consult your doctor immediately in such cases.
Spray: If you have accidentally or intentionally sprayed more than the required amount of Glyceryl trinitrate spray, then you might experience slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, and fainting. Consult your doctor immediately in such cases.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol
Description
The use of alcohol may increase the risk of severe side effects and cause excessive sedation and a fall in blood pressure.
Instructions
Do not consume alcohol during treatment with Glyceryl Trinitrate due to the increased risk of serious side effects like dizziness, drowsiness, difficulty concentrating, breathing difficulties, etc.
Interaction with Medicine
Amitriptyline
Amlodipine
Prilocaine
Sildenafil
Riociguat
Dihydroergotamine
Disease interactions
Acute myocardial infarction
Acute myocardial infarction is also known as a heart attack. Glyceryl Trinitrate should be used with caution if you have a history of heart attack or heart failure. Follow the instructions given by your doctor carefully.
Hypotension
Glyceryl Trinitrate should be used with extreme caution if you have low blood pressure (<90 mm Hg) as this medicine may even reduce your blood pressure even further, thereby worsening your condition.
Food interactions
Information not available.
Lab interactions
Information not available.
tablet or capsules: Take this medicine exactly as advised by your doctor. This medicine can be taken with or without food. Do not take Glyceryl trinitrate in a higher dosage than prescribed. Do not stop taking medicine abruptly as it can cause withdrawal symptoms. Consult your doctor if you experience side effects.
Capsule SR, Capsule TR, Capsule XL, Tablet SR, Tablet CR: This medicine can be taken with or without food, as instructed by your doctor. It is advisable to take plenty of water with it to avoid gastric problems. Do not crush or chew the tablet or capsule as it can reduce its effectiveness. Do not stop this medicine without consulting with a doctor as it can cause withdrawal symptoms. Complete the whole treatment for maximum benefits.
Injection: Injection is normally administered by qualified healthcare professionals in a clinic or hospital. You might feel some pain at the site of injection that usually lasts for a short while. You will be closely monitored for at least 30 minutes after administration of injection for any signs of allergic reactions like redness, swelling, breathing difficulties etc.
Ointment: This medicine can be used as a rectal ointment. Take a small amount of ointment carefully apply the ointment around the inner sides as prescribed by your doctor.
Patch: Wash your hands before and after using a transdermal patch. Put the patch on clean, dry, healthy skin preferably over skin with no hair. Do not put your patch on wet skin. Change the patch at regular intervals. If your patch falls off, stick a new one on the new site.
Spray: Use the spray 5-10 minutes before any activity or as prescribed by your doctor. Always sit down before spraying the medicine. Make sure the pump is working effectively to deliver the required dose. Spray the medicine on or below your tongue and then let it sit for 5-10 minutes. Avoid swallowing and rinsing your mouth during this time as it can wash away the medicine. Your doctor will guide you on how exactly the spray is to be used.
Miscelleneous
How it works
Angina: Glyceryl Trinitrate works by relaxing the blood vessels, lowering blood pressure, and therefore decreasing the workload on your heart. This may reduce chest pain significantly by increasing the blood flow to your heart.
Anal fissures: When used as an ointment, Glyceryl Trinitrate works by relaxing the blood vessels and increasing the blood flow around your anus. This aids in the healing of the fissure.
Legal Status
Classification
Category
Antianginal agents, Vasodilators
Schedule
Schedule H
Medicines.org.uk. 2021. GTN 300mcg / Glyceryl Trinitrate 300 micrograms Tablets - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: < [Accessed 1 July 2021].
Dailymed.nlm.nih.gov. 2021. DailyMed - NITROGLYCERIN tablet. [online] Available at: < [Accessed 1 July 2021].
Pubchem.ncbi.nlm.nih.gov. 2021. Nitroglycerin. [online] Available at: < [Accessed 1 July 2021].
Drugs, H., 2021. Nitroglycerin Topical: MedlinePlus Drug Information. [online] Medlineplus.gov. Available at: < [Accessed 1 July 2021].
Dailymed.nlm.nih.gov. 2021. DailyMed - NITROGLYCERIN tablet. [online] Available at: < [Accessed 28 July 2021].
Information on this page was last updated on 3 Sep 2021
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