Discharge Instructions: Taking Fast-Acting Nitroglycerin

Your healthcare provider prescribed nitroglycerin for you. This medicine relieves chest pain caused by a lack of blood flow to the heart (angina) by getting more oxygen-rich blood to your heart. Fast-acting nitroglycerin can stop an angina attack. Follow the steps below for taking fast-acting nitroglycerin. Note: Your healthcare provider may give you slightly different instructions. If so, follow them carefully.

The name of my fast-acting nitroglycerin medicine is ________________________________.

To stop an angina attack 

Sit down before you take your nitroglycerin. The medicine may make you feel dizzy because it lowers blood pressure rapidly.

Using fast-acting tablets

  • Place 1 tablet under your tongue. You can also place it between your lip and gum, or between your cheek and gum.

  • Let the tablet dissolve completely. Don’t swallow or chew the tablet.

  • As the tablet is dissolving, do not eat or drink anything, or smoke or chew tobacco.

Using fast-acting spray

  • Open your mouth and hold the sprayer just in front of your mouth.

  • Press the button on the top. Spray once on or under your tongue. Do not inhale.

  • Close your mouth. Then wait a few seconds before you swallow.

After taking 1 tablet or spraying once

  • Continue sitting for 5 minutes.

  • If the angina goes away completely, rest for a while and continue your normal routine.

Call 911 if your angina lasts longer than 5 minutes and 1 tablet or 1 spray has not relieved it. Don't delay. You may be having a heart attack (acute myocardial infarction, or AMI)!

After you call 911, take a second tablet. Or, spray a second time. Wait another 5 minutes. If the angina still does not go away, take a third tablet, or spray a third time. Don't take more than 3 tablets, or spray more than 3 times, within 15 minutes. Stay on the phone with 911 for further instructions. 


  • Limit the amount of alcohol you drink. Too much alcohol can cause dizziness or fainting.

  • Don't take phosphodiesterase inhibitors, such as sildenafil. These are medicines used to treat sexual dysfunction in men—at any time if you are on nitroglycerin treatment. The combination of nitroglycerin with these medicines can cause a severe drop in blood pressure. This can lead to dizziness, fainting, heart attack, or stroke.

  • Check the expiration date. Nitroglycerin can lose its effectiveness over time.

  • Tell your healthcare provider if your angina attacks last longer, occur more often, or are more severe. 

Possible side effects of nitroglycerin

If you have any of these side effects, tell your healthcare provider right away. But don’t stop taking the medicine until your doctor tells you to. Mild side effects include:

  • More gas (flatulence) than normal

  • Bloating

  • Nausea

  • Hair loss

  • Decreased appetite

  • Weight loss

  • Headache

  • Dizziness

  • Flushing (redness of the face, neck, or chest)

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

  • Severe headache

  • Severe dizziness, or fainting

  • Nausea or vomiting

  • Fast heartbeat (higher than 100 beats per minute)

  • Swollen ankles

  • Weakness

  • Angina attacks that last longer, occur more often, or are more severe than in the past or occur at rest