Key facts
- Active ingredient
- Nitroglycerin
- Drug class
- Nitrate Vasodilator
- Form
- Injectable, Topical, Spray/Inhaler, Tablet
- Strength
- Nitroglycerin 2%
- Type
- Prescription (Rx)
- Brand or generic
- Generic
- May treat
- angina pectoris, eclampsia, fissure in ano
- Manufacturer
- Encube
- What the pharmacy pays
- ~$4.23 for 30 — not your price
- FDA application
- ANDA218235
What is Nitroglycerin?
From the FDA label:Nitroglycerin is 1,2,3-propanetriol trinitrate, an organic nitrate whose structural formula is: and whose molecular weight is 227.09. The organic nitrates are vasodilators, active on both arteries and veins. Nitroglycerin ointment USP, 2% for topical use contains lactose and 2% nitroglycerin in a base of lanolin, white petrolatum and purified water. Each inch (2.5 cm), as squeezed from the tube, contains approximately 15 mg of nitroglycerin. str
How to use
Nitroglycerin is sold in more than one form (Injectable, Topical, Spray/Inhaler and Tablet), and each is dosed differently. The instructions below come from the FDA label for application ANDA218235 — follow the label that came with the product you were actually prescribed.
As noted above ( CLINICAL PHARMACOLOGY ), controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Doses used in clinical trials have ranged from 1/2 inch (1.3 cm; 7.5 mg) to 2 inches (5.1 cm; 30 mg), typically applied to 36 square inches (232 square centimeters) of truncal skin. It is reasonable to believe that the rate and extent of nitroglycerin absorption from ointment may vary with the site and square measure of the skin over which a given dose of ointment is spread, but these relationships have not been adequately studied. Controlled trials with other formulations of nitroglycerin have demonstrated that if plasma levels are maintained continuously, all anti-anginal efficacy is lost within 24 hours. This tolerance cannot be overcome by increasing the dose of nitroglycerin. As a result, any regimen of nitroglycerin ointment administration should include a daily nitrate-free interval. The minimum necessary length of such an interval has not been defined, but studies with other nitroglycerin formulations have shown that 10 to 12 hours is sufficient. Thus, one appropriate dosing schedule for nitroglycerin ointment would begin with two daily 1/2- inch (7.5 mg) doses, one applied on rising in the morning and one applied six hours later. The dose could be doubled, and even doubled…
Side effects
Adverse reactions to nitroglycerin are generally dose-related, and almost all of these reactions are the result of nitroglycerin's activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose, especially at higher doses. Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur. Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy. Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon. Allergic reactions to nitroglycerin are also uncommon, and the great majority of those reported have been cases of contact dermatitis or fixed drug eruptions in patients receiving nitroglycerin in ointments or patches. There have been a few reports of genuine anaphylactoid reactions, and these reactions can probably occur in patients receiving nitroglycerin by any route. Extremely rarely, ordinary doses of organic nitrates have caused methemoglobinemia in normal-seeming patients; for further discussion of its diagnosis and treatment see OVERDOSAGE . Data are not available to allow estimation of the frequency of adverse reactions during treatment with nitroglycerin ointment.
Warnings
Important safety information
Amplification of the vasodilatory effects of nitroglycerin by sildenafil can result in severe hypotension. The time course and dose dependence of this interaction have not been studied. Appropriate supportive care has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion. The benefits of transdermal nitroglycerin in patients with acute myocardial infarction or congestive heart failure have not been established. If one elects to use nitroglycerin in these conditions, careful clinical or hemodynamic monitoring must be used to avoid the hazards of hypotension and tachycardia.
Who should not take Nitroglycerin
Allergic reactions to organic nitrates are extremely rare, but they do occur. Nitroglycerin is contraindicated in patients who are allergic to it.
Overdose — what happens if you take too much
Hemodynamic Effects: The ill effects of nitroglycerin overdose are generally the results of nitroglycerin's capacity to induce vasodilation, venous pooling, reduced cardiac output, and hypotension. These hemodynamic changes may have protean manifestations, including increased intracranial pressure, with any or all of persistent throbbing headache, confusion, and moderate fever; vertigo; palpitations; visual disturbances; nausea and vomiting (possibly with colic and even bloody diarrhea); syncope (especially in the upright posture); air hunger and dyspnea, later followed by reduced ventilatory effort; diaphoresis, with the skin either flushed or cold and clammy; heart block and bradycardia; paralysis; coma; seizures; and death. Laboratory determinations of serum levels of nitroglycerin and its metabolites are not widely available, and such determinations have, in any event, no established role in the management of nitroglycerin overdose. No data are available to suggest physiological maneuvers (e.g., maneuvers to change the pH of the urine) that might accelerate elimination of nitroglycerin and its active metabolites. Similarly, it is not known which—if any—of these substances can usefully be removed from the body by hemodialysis. No specific antagonist to the vasodilator effects of nitroglycerin is known, and no intervention has been subject to controlled study as a therapy of…
U.S. Poison Control: call or text 1-800-222-1222 (free, 24/7). In an emergency call 911. From the FDA label; not medical advice.
Interactions
The vasodilating effects of nitroglycerin may be additive with those of other vasodilators. Alcohol, in particular, has been found to exhibit additive effects of this variety. Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. Dose adjustments of either class of agents may be necessary.
Storing Nitroglycerin, and how long it keeps
Quoted from this product’s own FDA label. Storage belongs to the product and its device, not to the drug in general — a pen and a tablet of the same medicine are kept completely differently.
- “Use within 8 weeks of first opening.”
- “Store nitroglycerin sublingual tablets at room temperature (between 68° and 77°F).”
Drug class
How this class works, per Nitrates - StatPearls - NCBI Bookshelf.
May treat (source: NIH RxClass)
- angina pectoris
- eclampsia
- fissure in ano
- heart failure
- pulmonary hypertension
- intraoperative complications
See how Nitroglycerin ranks — best-rated nitrate vasodilator for:
Dosage forms
Injectable, Topical, Spray/Inhaler and Tablet
The forms currently marketed in the U.S., per the FDA National Drug Code Directory.
Ways to save
Ask for the generic
Same active ingredient, far cheaper. Is there a generic? →
Request a 90-day supply
Bulk fills usually lower the per-dose price vs monthly refills.
Use copay cards
Manufacturer copay cards & patient-assistance programs — especially for brand drugs.
Compare alternatives
A same-class option may cost less. See alternatives →
Frequently asked questions
- What does Nitroglycerin treat?
- Nitroglycerin (Nitroglycerin) may be used to treat angina pectoris, eclampsia, fissure in ano, heart failure, pulmonary hypertension, intraoperative complications, based on NIH RxClass drug-classification data (conditions a drug may treat — not a verbatim copy of the FDA-approved label). This is general reference, not medical advice.
- How does Nitroglycerin work?
- Nitroglycerin is a nitrate vasodilator. Nitrate vasodilators are converted in the body into nitric oxide, which relaxes the smooth muscle in blood vessel walls and widens them. This mainly opens up the veins, reducing how hard the heart must work and relieving chest pain.
- How much does Nitroglycerin cost?
- Nobody can tell you what you will pay — your price is set by your insurer's formulary, your deductible and the pharmacy's markup, and none of those are published. What IS published is what the pharmacy paid to acquire it: about $4.23 for 30, per the CMS NADAC survey. Treat that as the floor, not the quote — ask the pharmacist for the cash price as well as your copay, because for cheap generics the cash price often wins.
- Is there a coupon or discount for Nitroglycerin?
- pharmaranks is an independent ratings site, not a pharmacy — we don't issue coupons or sell Nitroglycerin. To pay less, Nitroglycerin is already a generic — usually the lowest-cost version — so the main levers are comparing cash prices between pharmacies and using a pharmacy discount-card service. Prices vary by pharmacy, insurance, and location, so always confirm at the counter. This is general reference, not medical or financial advice.
- Who makes Nitroglycerin?
- Nitroglycerin is marketed by Encube. You can see Encube's full profile, rating, and other products on pharmaranks.
- Is Nitroglycerin a brand-name or generic drug?
- Nitroglycerin is a generic medication; its active ingredient is Nitroglycerin. Generics contain the same active ingredient as the brand-name original and are usually lower cost.
- Is Nitroglycerin available over the counter?
- No. Nitroglycerin is a prescription (Rx) medication in the US — you need a prescription from a licensed clinician (in person or via telehealth); it isn't sold over the counter. For some conditions there are OTC alternatives — ask your pharmacist.
- What forms does Nitroglycerin come in?
- Nitroglycerin is currently marketed as injectable, topical, spray/inhaler and tablet, per the FDA's National Drug Code Directory.
- What class of drug is Nitroglycerin?
- Nitroglycerin is classified as nitrate vasodilator, per the FDA's Established Pharmacologic Class.
- Is Nitroglycerin FDA-registered?
- Nitroglycerin is on record with the U.S. FDA under application number ANDA218235. You can verify this on its official FDA label.
- Is Nitroglycerin safe?
- There's no single safe-or-not verdict, and we don't yet have a composite recall-safety score for Nitroglycerin. Review its FDA-label side effects and warnings below, and always consult a licensed professional.
- What are the side effects of Nitroglycerin?
- Nitroglycerin's side effects are taken directly from its FDA label. From the label: Adverse reactions to nitroglycerin are generally dose-related, and almost all of these reactions are the result of nitroglycerin's activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose,… Both common and serious reactions are documented in full on this page. This is general reference from the FDA, not medical advice — always consult a professional.
Clinical content sourced from the FDA label via openFDA (U.S. FDA). View the FDA label on DailyMed → Provided for general reference only — not medical advice. Always consult a licensed professional and the current prescribing information.
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