Nitro Dur (Nitroglycerin) belongs to the class of medications called antianginals. Nitro Dur (Nitroglycerin) patches are used alone or in combination with other medications to prevent Angina attacks (chest pain). Nitro Dur (Nitroglycerin) reduces the number of angina attacks by relaxing blood vessels and increasing the oxygen and blood supply to the heart. The Nitro Dur (Nitroglycerin) patch is not intended for immediate relief of angina.

Nitro Dur (Nitroglycerin) may be available under multiple brand names and/or in several different forms. Any specific brand name of Nitro Dur (Nitroglycerin) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Nitro Dur (Nitroglycerin) may not be used for all of the conditions discussed here.

Your doctor may have suggested Nitro Dur (Nitroglycerin) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given Nitro Dur (Nitroglycerin), speak to your doctor. Do not stop using Nitro Dur (Nitroglycerin) without consulting your doctor.

Do not give Nitro Dur (Nitroglycerin) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use Nitro Dur (Nitroglycerin) if their doctor has not prescribed it.

The usual dose of Nitro Dur (Nitroglycerin) patches varies according to need. The patch is usually applied in the morning and taken off 12 to 14 hours later (leaving 10 to 12 hours overnight without the patch).

The patch may be applied to any convenient skin area – recommended sites include the upper arm, back, shoulders, or chest. Use a different application site each time. A suitable area may be shaved if necessary. Do not apply the patch to the ends of the arms or legs. Wash your hands thoroughly after application. Following use, discard the patch in a manner that prevents accidental application or ingestion by curious pets or children.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

It is important to use Nitro Dur (Nitroglycerin) exactly as prescribed by your doctor. If you miss a dose, apply a patch as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Nitro Dur (Nitroglycerin) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Nitro Dur (Nitroglycerin). If you are concerned about side effects, discuss the risks and benefits of Nitro Dur (Nitroglycerin) with your doctor.

The following side effects have been reported by at least 1% of people taking Nitro Dur (Nitroglycerin). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• dizziness or lightheadedness, especially when getting up from a sitting or lying down position
• flushing of the face and neck
• headache
• nausea
• reddened skin, rash, or itching where the patch was applied
• vomiting

Although most of these side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• fast, slow, or irregular heartbeat
• headache (severe or prolonged)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a Heart Attack (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)
• signs of methemoglobinemia (e.g., shortness of breath; blue to purplish lips, fingers or toes; severe headache; fatigue; dizziness or loss of consciousness)

Contact a doctor at once if any of the following signs of overdose occur:

• bluish-coloured lips, fingernails, or palms of the hands
• convulsions (seizures)
• dizziness (extreme) or fainting
• feeling of extreme pressure in the head
• Fever
• shortness of breath
• unusual tiredness or weakness
• weak and fast heartbeat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Nitro Dur (Nitroglycerin).

Nitro-Dur 0.2
Each 10 cm2 patch contains 40 mg of Nitro Dur (Nitroglycerin) released at 0.2 mg per hour.

Nitro-Dur 0.4
Each 20 cm2 patch contains 80 mg of Nitro Dur (Nitroglycerin) released at 0.4 mg per hour.

Nitro-Dur 0.6
Each 30 cm2 patch contains 120 mg of Nitro Dur (Nitroglycerin) released at0.6 mg per hour.

Nitro-Dur 0.8
Each 40 cm2 patch contains 160 mg of Nitro Dur (Nitroglycerin) released at 0.8 mg per hour.

Do not use Nitro Dur (Nitroglycerin) if you:

• are allergic to Nitro Dur (Nitroglycerin) or any ingredients of the medication
• are allergic to the adhesive used in Nitro Dur (Nitroglycerin) patches
• are allergic to other nitrates or nitrites
• have acute circulatory failure associated with severe lowering of blood pressure (states of collapse or shock)
• have extremely Low Blood Pressure
• have increased eye pressure (Glaucoma)
• have increased pressure within the head (e.g., after an accident)
• have reduced heart function due to obstruction (e.g., narrowing of the heart valves)
• have severe Anemia
• have severe dizziness when getting up from a sitting or lying down position
• are using the Erectile Dysfunction medications called PDE-5 inhibitors (e.g., Sildenafil, Tadalafil, or Vardenafil)
• are taking the medication Riociguat

There may be an interaction between Nitro Dur (Nitroglycerin) and any of the following:

• alcohol
• Aldesleukin
• Aliskiren
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• second generation anti-psychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• Bromocriptine
• Cabergoline
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• clonidine
• conivaptan
• Dapsone
• diazoxide
• Dipyridamole
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Duloxetine
• Eplerenone
• ergot alkaloids (e.g., Dihydroergotamine, ergonovine, ergotamine, methylergonovine)
• Heparin
• Hydralazine
• Guanfacine
• levodopa
• Minoxidil
• other nitrates (e.g., Nitro Dur (Nitroglycerin), isosorbide dinitrate, isosorbide mononitrate)
• Obinutuzumab
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., sildenafil, tadalafil, vardenafil)
• prilocaine
• riociguat
• Ropinirole
• Rosiglitazone
• Selegiline
• sodium nitrite
• tetracaine
• Tizanidine
• tolcapone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Nitro Dur (Nitroglycerin). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Nitro Dur (Nitroglycerin).

Acute angina attacks: Nitro Dur (Nitroglycerin) patches are not intended for immediate relief of acute attacks of angina. Sublingual (under the tongue) Nitro Dur (Nitroglycerin) preparations (spray or tablets) should be used for this purpose.

Dizziness/reduced alertness: People using Nitro Dur (Nitroglycerin) may experience faintness or dizziness and reduced reaction time when driving or operating machinery, especially at the start of treatment. Avoid these and other hazardous tasks until you have determined how Nitro Dur (Nitroglycerin) affects you.

Heart disease: The benefits and safety of using the Nitro Dur (Nitroglycerin) patch have not been established for people who have had an acute heart attack or have Congestive Heart Failure.

Low blood pressure: Headaches or symptoms of low blood pressure such as weakness or dizziness, particularly when getting up suddenly from a sitting or lying down position, may result from taking too much Nitro Dur (Nitroglycerin). If these symptoms occur, your doctor may reduce the dose or have you stop using the Nitro Dur (Nitroglycerin) patch. People who might be negatively affected by low blood pressure should use Nitro Dur (Nitroglycerin) with caution. If you take diuretics or have preexisting low blood pressure, you may be at an increased risk of experiencing this effect.

Symptom changes: If your symptoms of angina increase at any time (including during the period of the day that you aren't taking the medication), be sure to tell your doctor.

Tolerance: People who use Nitro Dur (Nitroglycerin) may develop tolerance to the medication, resulting in it not working as well. Tolerance to other nitrates or nitrites can also happen, especially if a medication-free period is not observed each day. As tolerance to Nitro Dur (Nitroglycerin) patches develops, the effect of fast-acting sublingual (under the tongue) Nitro Dur (Nitroglycerin) is also somewhat reduced.

Pregnancy: Nitro Dur (Nitroglycerin) has not been studied for use by pregnant women and should not be used during pregnancy unless the benefits outweigh the risks. Be sure to tell your doctor if you are pregnant or planning to become pregnant. If you become pregnant while using Nitro Dur (Nitroglycerin), inform your doctor as soon as possible.

Breast-feeding: It is not known if Nitro Dur (Nitroglycerin) passes into breast milk. If you are a breast-feeding mother and are taking Nitro Dur (Nitroglycerin), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of Nitro Dur (Nitroglycerin) for children have not been established.