Nitrolingual (Glyceryl Trinitrate)
Complete patient guide for uses, dosage, side effects, and safety information
Prescription RequiredQuick Facts
What Is Nitrolingual Used For?
Nitrolingual Pumpspray contains glyceryl trinitrate and belongs to a group of medicines called nitrates. It works by widening blood vessels, allowing more blood and oxygen to reach the heart.
Primary Uses
Nitrolingual is used to treat acute angina attacks – chest pain or discomfort that may spread to the arms, neck, shoulders, or back. It can also be used to prevent angina when taken 5-10 minutes before activities that might trigger an attack.
How It Works
The medication works by widening blood vessels, which lets more blood and oxygen reach the heart. This helps relieve the pain caused by too little blood and oxygen getting to the heart during an angina attack.
Good to know: There is no evidence to suggest that Nitrolingual Pumpspray is addictive.
How to Take Nitrolingual
Nitrolingual is not taken regularly – it’s used when you need relief from acute angina pain or to prevent an attack before certain activities.
Dosage Instructions
At the first sign of an angina attack, spray one metered dose (400 micrograms) under your tongue. If pain continues after 5 minutes, take a second dose. Sit down and rest before taking. Hold the bottle upright, aim under your tongue, and press the nozzle firmly. Don’t inhale the spray or swallow immediately after taking. For prevention, use 5-10 minutes before activities that may trigger angina.
First-Time Use
When using for the first time, prime the spray by pressing the nozzle 5 times into the air. If not used for 1 week, prime with 1 spray. If not used for more than 4 months, prime with 5 sprays.
Important: DO NOT TAKE MORE THAN TWO DOSES DURING AN ANGINA ATTACK. If pain continues after two doses, call an ambulance or go to the nearest hospital immediately.
Available Tablet Strengths
Side Effects
Like all medications, this medicine can cause side effects. Most are mild and temporary, but some require medical attention.
Common Side Effects
These side effects occur relatively frequently and usually don’t require emergency care:
- Headache
- Dizziness
- Weakness
- Feeling faint or lightheaded, especially when standing up suddenly
Seek immediate medical attention if you experience:
- Severe headache
- Severe dizziness or fainting
- Weak or unusually fast or slow heartbeat
- Skin rash
- Nausea and vomiting
- Flushing of face or neck
- Bluish color of lips, nails, or palms
- Sudden allergic reactions (rash, itching, hives, swelling of face/lips/tongue, shortness of breath)
- Swelling causing difficulty swallowing or breathing
Important Warnings
Several important conditions and situations require special caution or prevent the use of Nitrolingual.
Who Should Not Take Nitrolingual
Do not use if you are allergic to glyceryl trinitrate, nitrates, or nitrites. Do not use with phosphodiesterase inhibitors (Viagra®, Cialis®, Levitra®) or soluble guanylate cyclase stimulators (Adempas®). Do not use after the expiry date or if packaging is damaged.
Medical Conditions to Discuss
Tell your doctor if you have: severe anemia, low blood pressure, recent heart attack or serious heart disease, recent head injury or stroke, abnormal hemoglobin, high blood pressure in pulmonary arteries. Elderly patients may be more sensitive to effects and side effects.
Pregnancy and Breastfeeding
Do not use during pregnancy or breastfeeding unless you and your doctor have discussed the risks and benefits. Tell your doctor immediately if you become pregnant while using this medication.
Emergency Situation: If you take phosphodiesterase inhibitors and experience an acute angina attack, immediately go to the emergency department at your nearest hospital.
Drug Interactions
Several medications can interfere with Nitrolingual and affect how it works. Always tell your doctor about all medications you’re taking.
Dosage Changes: If transferring from glyceryl trinitrate tablets to Nitrolingual spray, you may receive a larger dose and experience more side effects because the spray doesn’t break down as quickly.
- Blood vessel expanding drugs
- Blood pressure lowering medications
- Diuretics (water pills)
- Erectile dysfunction treatments (Viagra®, Cialis®, Levitra®)
- Pulmonary hypertension medications
- Mental health medications
- Depression treatments
- Migraine medications
- Heparin (blood thinner)
- Adempas® (pulmonary hypertension treatment)
Alcohol & Driving
Nitrolingual can affect your ability to drive and may interact dangerously with alcohol.
Alcohol
Be careful when drinking alcohol while using Nitrolingual. Alcohol can cause your blood pressure to drop further, making you feel dizzy or faint. Tell your doctor if you drink alcohol.
Driving and Operating Machinery
Be careful before driving or using machines until you know how Nitrolingual affects you. The medication may cause dizziness and fainting, especially when you first start using it. Make sure you know how you react before driving or operating dangerous equipment.
Storage
Store Nitrolingual below 25°C in a cool, dry place away from moisture, heat, and sunlight. Don’t store in the bathroom, near sinks, in cars, or on window sills. Keep out of reach of children. Don’t spray into flames, onto hot surfaces, or incinerate. Take expired or unwanted medication to any pharmacy for safe disposal.
Overdose Information
If you use too much Nitrolingual, you may experience severe headaches, flushed or clammy skin, vision problems, nausea, dizziness, lightheadedness, fainting, or unusual heart rate. If you think you’ve used too much, immediately call the Poisons Information Centre (13 11 26), contact your doctor, or go to the nearest hospital emergency department, even if you feel fine.
Frequently Asked Questions
Nitrolingual should provide relief from angina pain within minutes of taking one or two doses. If you don’t get relief after two doses, seek emergency medical help immediately.
No, there is no evidence to suggest that Nitrolingual Pumpspray is addictive.
Don’t suddenly stop using Nitrolingual if you’ve been using large amounts regularly, as your angina attacks may become worse. Ask your doctor how to stop gradually over a few weeks.
Be careful when drinking alcohol while using Nitrolingual. Alcohol can cause your blood pressure to drop further, making you feel dizzy or faint.
Elderly patients may be more sensitive to the effects and side effects of Nitrolingual and should watch carefully for signs of side effects.
Store below 25°C in a cool, dry place away from moisture, heat, and sunlight. Keep out of reach of children and don’t store in bathrooms or cars.
If you don’t get relief after taking two doses and the pain continues, call an ambulance or go to the nearest hospital immediately. Never take more than two doses during an angina attack.
Important Disclaimer
This information is intended for general educational purposes only and should not be considered medical advice. Always consult your healthcare provider or pharmacist before starting, stopping, or changing any medication.
If you think you may have a medical emergency, call your doctor or emergency services immediately.