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Nitroglycerin sublingual is a medication prescribed to patients with coronary artery disease who also suffer from angina, or chest pain, which occurs when blood flow to the heart is decreased. This medicine is a nitrate that works by relaxing blood vessels to allow for greater blood flow. The doctor may instruct the patient to use the drug to prevent angina or to relieve chest pain that is already occurring. Sublingual tablets are dissolved in the mouth and are fast-acting.
Patients should follow all dosing instructions carefully. Sublingual tablets may be used as soon as the patient experiences chest pain to stop the angina attack, or they may be taken before exercise, sexual activity, or other physical activities for prevention purposes. To relieve an attack, patients should first sit down before placing a nitroglycerin sublingual tablet on the tongue. It must not be chewed or swallowed. Patients should allow it to dissolve fully and avoid consuming food, drinks, or using tobacco during this process.
Sublingual tablets typically provide relief within one to five minutes. If the patient still experiences chest pain, he may use a second tablet. Some patients may be instructed to use a third tablet, if needed, no sooner than five minutes after the second. Those who still have chest pain after three tablets should immediately go to the emergency room.
Some side effects may occur from the use of nitroglycerin sublingual, which should be reported to the prescribing physician if they become severe. Immediately after using the tablet, patients may feel faint, dizzy, or lightheaded. Sitting down before taking the medicine can help prevent this from occurring. These reactions may be relieved by taking deep breaths and gently leaning forward until the head is between the knees. Some patients may also experience flushing, nausea, and headaches.
More serious side effects from nitroglycerin sublingual require immediate medical help. Rarely, patients may faint or experience a rapid or irregular heartbeat. They may also notice unusual or rapid weight gain, shortness of breath, and wheezing. Unusual fatigue, dark urine, and a bluish tint to the fingernails, palms, or lips have also been reported.
Before using nitroglycerin sublingual tablets to treat chest pain, patients must disclose their other medical conditions, medications, and supplements. As of 2011, it is unknown whether this drug may pass into breast milk. Women who are pregnant are discouraged from using it whenever possible. Nitroglycerin sublingual may be contraindicated for use by those who have a recent head injury, low blood pressure, or anemia. This drug may interact with other medicines, including drugs for blood pressure, migraine medicines, or those that treat erectile dysfunction.