Daily headaches sometimes accompany treatment with nitroglycerin. In patients who get these headaches, the headaches may be a marker of the activity of the drug. Patients should resist the temptation to avoid headaches by altering the schedule of their treatment with nitroglycerin, since loss of headache may be associated with simultaneous loss of antianginal efficacy.
Treatment with nitroglycerin may be associated with lightheadedness on standing, especially just after rising from a recumbent or seated position. This effect may be more frequent in patients who have also consumed alcohol.
After normal use, there is enough residual nitroglycerin in discarded patches that they are a potential hazard to children and pets.
A patient leaflet is supplied with the systems.
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.
Use of Transderm-Nitro (nitroglycerin) transdermal system is contraindicated in patients
using Viagra (sildenafil) because sildenafil may amplify the vasodilatory effects of
Transderm-Nitro resulting in severe hypotension.
Allergic reactions to organic nitrates are extremely rare, but they do occur. Nitroglycerin
is contraindicated in patients who are allergic to it. Allergy to the adhesives used in
nitroglycerin patches has also been reported, and it similarly constitutes a contraindication
to the use of this product.