Side Effects Headache may occur, but usually lasts a short time after each dose. With continued use of this medication , some people may not be bothered as much by the headaches. Your doctor may recommend treating headaches with a nonprescription pain reliever such as acetaminophen. Nitroglycerin can also cause a drop in your blood pressure , which can lead to dizziness and lightheadedness.
To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects.
Many people using this medication do not have serious side effects. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction , including: This is not a complete list of possible side effects. Before using this medication, tell your doctor or pharmacist your medical history, especially of: This drug may make you dizzy. Alcohol or marijuana can make you more dizzy.
Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages because they can also cause a drop in your blood pressure. Talk to your doctor if you are using marijuana. Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products.
Older adults may be more sensitive to the side effects of this medication, especially dizziness and lightheadedness. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
It is unknown if this medication passes into breast milk. Pediatric TOP Appropriate studies have not been performed on the relationship of age to the effects of nitroglycerin in the pediatric population.
Safety and efficacy have not been established. Geriatric TOP Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of nitroglycerin in the elderly. However, elderly patients are more likely to have unwanted effects such as lightheadedness, dizziness, or fainting, which may require caution and an adjustment in the dose for patients receiving nitroglycerin.
Breast Feeding TOP There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Drug Interactions TOP 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. Cover your finger with plastic-wrap, a disposable surgical glove or a finger cot.
Lay the covered finger alongside the 1 inch dosing line marked on the side of the medicine box see figure below so that the tip of your finger is at one end of the dosing line.
Starting at the tip of the finger, squeeze the ointment onto your finger for the same length marked on the box. Refer to carton for accurate dosage guide. Gently insert the finger with the ointment into the anal canal, up to the first finger joint. Carefully smear the ointment around the inner sides of the anal canal. This action may be additive with other agents that can cause hypotension such as diuretics.
Moderate The manufacturer of alfuzosin warns that concurrent use with nitrates has the potential to cause hypotension, orthostatic hypotension, or syncope. Caution is advisable when coadministering alfuzosin and a nitrate to patients with symptomatic hypotension or those who have had a previous hypotensive response to either agent.
Moderate Concomitant use of nitrates with other antihypertensive agents can cause additive hypotensive effects.
Dosage adjustments may be necessary. This action may be additive with other agents that can cause hypotension such as benzodiazepines. Patients should be monitored more closely for hypotension if nitroglycerin is used concurrently with benzodiazepines.
Major Two separate studies have shown that concomitant administration of IV nitroglycerin can compromise the therapeutic efficacy of alteplase. In another controlled study, patients who did not receive concomitant IV nitroglycerin reperfused faster, more often, and had fewer reocclusions. It appears that when combined in vitro, nitroglycerin enhances the degradation of alteplase. Nitroglycerin may enhance the hepatic clearance of alteplase since alteplase plasma concentrations are lower in patients receiving concomitant nitroglycerin.
This action may be additive with other agents that can cause hypotension such as antidepressants. Patients should be monitored more closely for hypotension if nitroglycerin is used concurrently with antidepressants. Angiotensin II receptor antagonists: Extreme caution should be exercised if apomorphine is used concurrently with antihypertensive agents, or vasodilators such as nitrates. Belladonna Alkaloids; Ergotamine; Phenobarbital: Severe Ergot alkaloids are contraindicated in patients with hypertension, angina, or coronary artery disease; which are the primary patient populations for which nitroglycerin is utilized.
Because of the potential to cause coronary vasospasm, ergot alkaloids can oppose the vasodilatory actions of nitroglycerin and, in doing so, may precipitate angina. In addition, oral administration of nitroglycerin decreases the first-pass metabolism of dihydroergotamine, thereby increasing its oral bioavailability. Moderate Rare and sometimes fatal cases of methemoglobinemia have been reported with the use of topical or oromucosal benzocaine products.
Gently insert the finger with the ointment into the anal canal, up to the first finger joint. Carefully smear the ointment around the inner sides of the anal canal.
If this cannot be achieved due to pain, application of the ointment should be made directly to the outside of the anus. What do I do after I have applied the ointment? Throw away the finger covering in the garbage, out of the reach of children and pets.
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