Overview
Nitroglycerin is a nitrate and antianginal medication. Common forms may include sublingual tablet, sublingual spray, transdermal patch, ointment, or another ordered form. Common brand names may include Nitrostat for sublingual tablets and Nitro-Dur for patch products when listed on medication profile or pharmacy label.
DailyMed lists Nitrostat as a nitrate vasodilator indicated for relief of an attack or prophylaxis of angina pectoris due to coronary artery disease. DailyMed also states nitroglycerin sublingual tablets are indicated for acute relief or acute prophylaxis of angina due to coronary artery disease.
For home health nurses, Nitroglycerin indication and home health teaching often focuses on medication form identification, provider-specific chest pain instructions, medication safety, dizziness and low Blood Pressure symptom awareness, fall prevention, medication interaction review, refill and expiration concerns, safe storage, and clear PCP/cardiology versus 911 escalation.
Nitroglycerin should not be used with PDE-5 inhibitors such as sildenafil, tadalafil, vardenafil, or avanafil, or with soluble guanylate cyclase stimulators such as riociguat, because serious low Blood Pressure can occur. [1] Patient-specific chest pain plan, Blood Pressure monitoring, medication form instructions, and emergency escalation must follow PCP/provider, cardiology instructions, pharmacy label, medication profile, plan of care, agency policy, emergency protocol, and skilled nursing judgment.
Medication Quick Information
| Item | Information |
|---|---|
| Generic name | Nitroglycerin |
| Common brand name(s) | Nitrostat, Nitro-Dur, and other form-specific brands if listed |
| Drug classification | Nitrate / antianginal medication |
| Common home health teaching focus | Angina/chest pain support when ordered, medication form review, provider-specific chest pain instructions, dizziness and low Blood Pressure symptom awareness, fall prevention, interaction warnings, refill/expiration concerns, safe storage, and when to notify PCP/cardiology or call 911 |
Common Indications for Nitroglycerin
Common indications may include:
- Angina symptom support, when ordered
- Chest pain support, when ordered
- Coronary artery disease symptom support
- Provider-ordered nitrate therapy
- Antianginal medication therapy
- Cardiac symptom medication support
- Chest pain plan teaching
- Nitroglycerin medication safety
- Medication safety support for Nitroglycerin therapy
Nitroglycerin patches are used to help prevent angina attacks but do not cure coronary artery disease, according to MedlinePlus. MedlinePlus also advises patients to call doctor if angina attacks become more frequent, last longer, or become more severe during patch treatment. [1]
Drug classification is not the same as patient-specific indication. For example, Nitroglycerin may be classified as a nitrate or antianginal medication, but patient-specific indication may be angina symptom support, chest pain support, coronary artery disease symptom support, provider-ordered nitrate therapy, or another cardiology-directed reason.
Short EMR Indication Options
Verify patient-specific reason before use. Examples below are possible short indication options. Select only indication that matches patient diagnosis, provider order, medication profile, discharge instructions, pharmacy label, cardiology instructions, or clarified PCP/provider instruction.
| Patient diagnosis / reason | Short EMR indication option |
|---|---|
| Angina | Angina symptom support |
| Chest pain, when ordered | Chest pain support |
| Coronary artery disease | CAD symptom support |
| Provider-ordered nitrate therapy | Nitrate therapy |
| Antianginal medication therapy | Antianginal therapy |
| Cardiac symptom medication support | Cardiac symptom support |
| Chest pain plan teaching | Chest pain plan teaching |
| Nitroglycerin medication safety | Nitroglycerin safety |
| Medication compliance support | Nitroglycerin compliance |
Home Health Teaching Focus
For home health nursing, Nitroglycerin teaching often focuses on identifying the ordered medication form, following patient-specific chest pain instructions from PCP/cardiology/pharmacy label, knowing when to call 911, avoiding unsafe medication combinations, and reporting dizziness, fainting, weakness, worsening chest pain, or medication not working as expected.
Patients may need reinforcement if they have angina, coronary artery disease, chest pain history, recent Hospital stay, new Nitroglycerin order, sublingual tablet use, patch use, ointment use, dizziness, fall risk, low Blood Pressure concern, memory issues, medication confusion, poor teach-back, vision issues, expired medication concern, refill problems, or PCG involvement.
MedlinePlus notes that nitroglycerin can cause dizziness, lightheadedness, and fainting, especially with position changes or alcohol use, and advises extra fall precautions. [1] DailyMed also warns that severe hypotension can occur and may be accompanied by nausea, vomiting, weakness, pallor, perspiration, collapse, or syncope. [2]
Patient Teaching Points for Nitroglycerin
Basic teaching may include:
- Use Nitroglycerin exactly as ordered by PCP/provider, cardiology instructions, and pharmacy label.
- Do not start, stop, hold, take extra, restart, or change Nitroglycerin unless instructed by PCP/provider, cardiology, or pharmacist. Follow pharmacy label or provider instructions for missed doses, and ask PCP/cardiology/pharmacist if unsure.
- Know which form is ordered, such as sublingual tablet, sublingual spray, transdermal patch, ointment, or another form.
- Follow patient-specific chest pain instructions from PCP/cardiology/pharmacy label and do not delay 911 for severe, new, unusual, or unrelieved chest pain.
- Sit or rest safely when symptoms occur if instructed by provider or agency policy.
- Check Blood Pressure only if ordered or instructed, and follow provider-specific reporting instructions.
- Report dizziness, lightheadedness, fainting, weakness, fall, severe headache, flushing, palpitations, medication not working as expected, or confusion about instructions.
- Ask PCP/cardiology/pharmacist before using PDE-5 inhibitors, erectile dysfunction medications, pulmonary hypertension medications, riociguat, alcohol, Blood Pressure medications, supplements, herbal products, or new prescriptions.
- Store Nitroglycerin safely and follow pharmacy instructions for original container, expiration, refill, and potency concerns.
- Keep updated medication list available for PCP, cardiology, pharmacy, home health agency, and Hospital visits.
Possible Side Effects or Concerns to Report
Possible side effects or concerns may include:
- headache
- dizziness
- lightheadedness
- weakness
- flushing
- nausea
- low Blood Pressure symptoms
- fainting or near fainting
- falls or near falls
- fast heartbeat or palpitations
- worsening chest pain
- chest pain not relieved according to provider-specific instructions
- shortness of breath
- severe weakness
- confusion
- blurred vision
- rash or skin irritation if patch or topical form is used
- medication not working as expected
- possible medication interaction concern
- accidental use with PDE-5 inhibitor or sGC stimulator
- medication confusion or expired/old medication concern
DailyMed lists headache, dizziness, paresthesia, flushing, drug rash, and manifestations of postural hypotension such as vertigo, dizziness, weakness, palpitations, nausea, vomiting, weakness, sweating, pallor, collapse, and syncope as reported concerns. MedlinePlus lists blurred vision, dry mouth, rash, hives, itching, difficulty breathing or swallowing, nausea, vomiting, weakness, sweating, and pale skin as symptoms requiring doctor contact for sublingual nitroglycerin. [1]
When to Notify PCP
Call PCP/cardiology or follow agency/provider instructions if patient has:
- chest pain episodes occurring more often, lasting longer, or changing from usual pattern
- chest discomfort that occurs with less activity than usual
- dizziness, lightheadedness, weakness, low Blood Pressure symptoms, fainting, fall, or near fall
- severe or bothersome headache
- nausea, flushing, palpitations, or bothersome side effects
- medication does not seem to work as expected
- rash, skin irritation, or patch/topical application concern if applicable
- missed doses, possible medication error, refill problems, expired medication concern, or confusion about instructions
- new or current PDE-5 inhibitor use, such as sildenafil, tadalafil, vardenafil, or avanafil
- riociguat or other pulmonary hypertension medication concern
- new alcohol use concern, Blood Pressure medication change, cardiac medication change, OTC medication, supplement, herbal product, or new prescription
- uncertainty about chest pain plan or when to call 911
- symptoms that worsen or do not improve as expected
MedlinePlus advises patients to discuss all current or planned medications with doctor and pharmacist before starting, stopping, or changing medications while taking nitroglycerin. It also advises telling doctor or dentist about nitroglycerin use before surgery, including dental surgery. [1]
When to Call 911
Call 911 or get emergency help right away for:
- severe chest pain or chest pressure
- chest pain that is new, unusual, or different from usual pattern
- chest pain with shortness of breath, sweating, nausea, weakness, fainting, or feeling of doom
- chest pain not relieved according to provider-specific Nitroglycerin instructions
- severe shortness of breath
- fainting or loss of consciousness
- severe dizziness or inability to stand safely
- severe weakness with emergency concern
- severe confusion or inability to respond normally
- signs of stroke, such as face drooping, arm weakness, trouble speaking, sudden confusion, sudden vision change, or one-sided weakness
- blue or gray lips or face
- severe allergic-type reaction
- trouble breathing or trouble swallowing
- symptoms that feel severe or life-threatening
MedlinePlus emergency guidance for nitroglycerin patch overdose says to call emergency services if a person has collapsed, had a seizure, has trouble breathing, or cannot be awakened. [1]
Related Home Health Teaching Resources
You may also find these resources helpful:
- Medication Safety Resource Pack for Home Health Nurses
- Emergency Signs and Escalation Pack for Home Health Nurses
- Fall Prevention Teaching Pack for Home Health Nurses
- Blood Pressure Teaching Resource Pack for Home Health Nurses
- CHF Teaching in Home Health: What Nurses Should Cover Across the Episode
- Aspirin Indication and Home Health Teaching
Premium Library members can access the full resource content, documentation support, and downloadable tools inside each pack.
Important Use Note
This post is for education and home health teaching support only. It does not provide dosing advice, universal chest pain medication instructions, Blood Pressure parameters, patch timing instructions, emergency treatment instructions beyond calling 911 or following agency emergency protocol, medication adjustment instructions, or patient-specific medication profile instructions.
Always verify patient-specific Nitroglycerin use and indication with provider order, cardiology instructions, medication profile, discharge instructions, pharmacy label, chest pain action plan, Oxygen orders if applicable, plan of care, agency policy, emergency protocol, and clinical judgment. This post does not replace provider orders, cardiology instructions, pharmacy guidance, discharge instructions, medication profile, chest pain action plan, Oxygen orders if applicable, plan of care, agency policy, payer requirements, emergency protocols, or skilled nursing judgment.
This content does not tell patients to take Nitroglycerin every 5 minutes or up to a certain number of doses unless that is directly included in provider order or pharmacy label. It also does not tell patients to combine Nitroglycerin with PDE-5 inhibitors, sGC stimulators, alcohol, Blood Pressure medications, erectile dysfunction medications, pulmonary hypertension medications, or other vasodilators. Medication questions and interaction concerns should be reviewed with PCP/provider, cardiology, or pharmacist.
Sources Used for Medication Information
- DailyMed / FDA prescribing label for Nitrostat / Nitroglycerin sublingual tablets, including nitrate vasodilator classification, angina indication, contraindications with PDE-5 inhibitors and sGC stimulators, severe hypotension warning, adverse reactions, and patient counseling information.
- DailyMed / FDA prescribing information for Nitroglycerin transdermal system, including prevention of angina due to coronary artery disease and contraindications with PDE-5 inhibitors and riociguat.
- MedlinePlus medication information for Nitroglycerin sublingual tablets, including medication form instructions, medication interaction reminders, dizziness/fall precautions, side effects, storage reminders, and emergency guidance. [1]
- MedlinePlus medication information for Nitroglycerin transdermal patches, including patch purpose, dizziness/fall precautions, patch-related side effects, stopping precautions, storage/disposal reminders, and emergency guidance. [1]
- Patient-specific use should always be verified with provider order, medication profile, discharge instructions, pharmacy label, cardiology instructions, chest pain action plan, agency policy, emergency protocols, and clinical judgment.
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