GTN skin patches or ointment are used every day to help prevent chest pain starting. You use the tablets or spray during an angina attack, or before any activity that's likely to cause an attack. The most common side effects are headaches, feeling dizzy, weak, tired or sick nausea , and flushing.
Tell your doctor or pharmacist if you have: ever had an allergic reaction to GTN or any other medicine in the past any recent brain or head injuries or problems including bleeding in your brain and raised pressure in your head ever had a stroke any heart problems other than angina , including a recent heart attack or heart failure low blood pressure hypotension anaemia glaucoma.
Stopping chest pain during an angina attack GTN tablets and spray are used under your tongue. Immediate action required: Call if:. You have taken 3 doses of GTN and: you're still in pain 5 minutes after your 3rd dose or your pain is getting worse you feel unwell These are signs that you may be having a heart attack.
Preventing chest pain before exercise or physical effort Tablets — put 1 tablet under your tongue before you start your activity. Preventing angina with a daily patch or ointment Patches — usually you put on 1 patch in the morning and take it off before you go to bed at night. How to take GTN tablets Sit down. Put a tablet under your tongue and close your mouth.
Allow the tablet to dissolve slowly — do not suck, chew or swallow it. Close the container — this is important, so your tablets do not lose their strength. Rest for a while, then stand up slowly. How to use GTN spray Before using the spray for the first time, check it's working by pressing the button on the nozzle at the top of the bottle a few times, until a fine mist comes out.
Sit down. If you have not used your spray for over a week, do 1 spray into the air before you use it. Hold the nozzle in front of your mouth, with your finger on the button, and take a deep breath. Open your mouth and lift your tongue up. Spray the GTN under your tongue by pressing once firmly — do not breathe in while you spray. Close your mouth immediately. Breathe through your nose keeping your mouth closed. Rest for a while before you stand up slowly.
How to apply a GTN patch Sit down. Decide where to put your patch — choose an area of skin with no hair, or very little hair, so the patch sticks well. Good places are the side of your chest, upper arm, shoulder or thigh. Put your patches in a different place each day of the week, and wait several days before using the same place again. Wash the area of skin and dry it completely — do not use talcum powder or anything else on your skin.
Open the GTN packet with your fingers — do not use scissors because you might cut the patch. Remove the patch from the packet. Peel the plastic backing off the patch and throw it away — do not touch the sticky surface of the patch with your fingers.
Put the sticky side of the patch on the clean skin — press it down firmly and count to 5. Rub your finger round the edge of the patch to make sure no air or water can get in.
How to apply ointment Sit down. Measure the dose — squeeze the right length of ointment onto the paper measure that comes in the packet. Apply the ointment to your skin by holding the paper and pressing the ointment on to your chest, thigh, or arm until it is spread in a thin layer under the paper. Do not rub the ointment in. You can use surgical tape to stick the paper onto your skin. Will my dose go up or down? What if I forget to take it?
Never use a double dose to make up for a forgotten dose. What if I take too much? Urgent advice: Call now if:. Common side effects These common side effects happen in more than 1 in people, but some are less likely if you're using skin patches. Talk to your doctor or pharmacist if these side effects bother you or last more than a few days: headaches very common feeling dizzy feeling weak, tired or sleepy feeling sick nausea red face flushing Serious side effects Serious side effects after taking GTN are rare and happen in less than 1 in 1, people.
Serious allergic reaction In rare cases, it is possible to have a serious allergic reaction anaphylaxis to GTN. Information: You can report any suspected side effect to the UK safety scheme. What to do about: headaches — make sure you rest and drink plenty of fluids. Ask a pharmacist to recommend a painkiller for headaches. Try to avoid alcohol, as it could make your headaches worse.
Headaches usually go away after a few days if you use GTN regularly. Talk to your doctor if they last longer than a week or are severe. If using GTN ointment, reduce your ointment by 1cm if you are trying to find the right dose. Avoid alcohol, as it could make you feel worse.
Do not drive, ride a bike or use tools or machinery until you feel better. This will also stop you getting dehydrated. Avoid rich, greasy or spicy foods, as these could make you feel worse. Stick to small, simple snacks or meals if you are hungry. It might help to keep the room cool and use a fan. You could also spray your face with cool water or sip cold or iced drinks.
The flushing should go away after a couple of hours if you have used GTN only once, or after a few days if you use GTN every day. Non-urgent advice: Talk to your doctor or pharmacist if you're:. Some medicines can interfere with the way GTN works. Check with a pharmacist or your doctor if you're taking: medicines for erection problems such as alprostadil, avanafil, sildenafil Viagra , tadalafil Cialis , vardenafil anticoagulant medicine such as heparin medicines for depression or other mental health conditions medicines for high blood pressure or heart problems medicines for migraine that contain ergot alkaloids or ergotamine such as Migril medicine for Parkinson's disease such as apomorphine If you take GTN tablets, tell a doctor or pharmacist if you take any medicines that make your mouth dry including some antidepressants, cold medicines or medicines for urinary incontinence.
Important: Medicine safety Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. How does it work? How long will I take or use it for?
Do GTN tablets go out of date? To make sure your tablets do not lose their strength before 8 weeks you need to: keep them in the bottle they came in close the lid tightly after you have taken each tablet out do not put anything else inside your tablet bottle Make sure you have a new supply of GTN to use after each pack expires. Can I take it for a long time?
What will happen if I stop taking it? Talk to your doctor if you want to stop taking GTN. Are there other medicines for angina? There are other medicines that can be taken regularly to prevent angina attacks, including: long-acting nitrates, such as isosorbide mononitrate beta-blockers such as atenolol calcium channel blockers, such as verapamil or diltiazem medicines such as ranolazine, nicorandil or ivabradine Your doctor will decide which is the best medicine for you.
Will I need to stop taking it before surgery or before tests? You must tell the doctor or nurse if you are wearing a GTN patch if you are going to have certain types of tests and treatments including: an MRI scan diathermy treatment treatment using hot wires electrical treatment on your heart.
Can I drink alcohol with it? Is there any food or drink I need to avoid? You can help reduce your risk of problems like these by: eating a balanced diet cutting down on alcohol losing weight if you are overweight. Will it affect my contraception? GTN will not stop your contraception working. Will it affect my fertility? Will it affect my sex life? If you are worried about having an angina attack during sex: keep your GTN nearby, so you can use it quickly if you need to think about taking a tablet or using your spray before you have sex, to reduce the risk of an attack You cannot take medicines for erection problems if you are using GTN.
These include: avanafil sildenafil tadalafil vardenafil If you have used one of these medicines, do not use or take GTN for at least 24 hours after sildenafil or vardenafil, and at least 48 hours after tadalafil. Our famous Scottish-themed cards, face coverings, gifts and a collection of designer clothing Shop Now.
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Treatment approaches, which are explained more fully in the treatments section, can include:. If you have frequent angina attacks it is likely that you will need to take a combination of drugs to help:. There are several groups of drugs which are useful in preventing angina. Your doctor will try and find the most effective combination for you. GTN spray may interact with a few medications and herbal supplements so check with your doctor or pharmacist before starting GTN spray and before starting any new medicines.
It is particularly important that you tell your doctor or pharmacist if you are using any medicines to help treat erectile dysfunction. Using erectile dysfunction medicine with GTN spray can cause a sudden decrease in blood pressure, which can be life threatening.
Looking for Where to get medical help A health professional or service Patient portals Newsletters View all. Belongs to a group of medicines called nitrates Used to treat chest pain angina. This is quite common when you use GTN spray and should settle after a few days. Tell your doctor if it is ongoing. Dizziness Feeling lightheaded Feeling faint when you stand up. This is quite common when you use GTN spray and usually goes away with time.
Sit down when using the spray.
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