Glyceryl trinitrate is used to prevent angina (chest pain which occurs when the heart does not receive enough blood supply).
Apply Glyceryl trinitrate patch on your skin exactly as directed by your doctor or according to the instructions on the label. Do not apply more or less than instructed by your doctor.
Do not apply the patch on broken skin. Do not cut the patch. The release pattern of the medicine will be affected if you cut the patch. Do not use it for a longer period of time than instructed by your doctor.
To apply the patch, follow these steps:
- Remove the patch from the protective foil pouch and peel away half of the liner. Do not touch the sticky side with your fingers.
- Apply the patch to a clean, dry and hairless area. Apply the patch on your chest, upper stomach area, upper arm, shoulder or thigh. Make sure that the area of skin is not oily, cut, blistered or irritated. The skin should be free of any powder, creams or lotions. If the area of skin is hairy, you should shave the area at least 3 days before applying the patch. Do not put the patch near the waistline or where your belt or clothes may rub against it.
- Peel away the other half of the liner. Press firmly on the skin for a few seconds to ensure that the patch stays in place.
- Apply the patch at around the same time every day.
- Replace the patch according to your doctor's instructions. Change the site of application every day to avoid skin irritation. For example, if you put the patch on your right thigh on the first day, put it on your left thigh on the second day, and so on. Do not apply the patch to the same area of skin more than once in 3-4 days.
- If the patch falls off, apply a new patch to a new area of skin and change the patch at the usual scheduled time. If the sides of the patch lift up, use a plaster or bandage to secure it to your skin.
- Throw away the used patch by folding the sticky sides together, put it back in the empty pouch, and place it in a rubbish bin. Do not throw it into the toilet bowl. Wash your hands after throwing the used patch.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of treatment depending on the severity of your condition and your response to the medication.
Glyceryl trinitrate must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it suddenly as this may worsen your condition.
Apply the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose to make up for a missed dose.
If you often forget to apply your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- hypertrophic obstructive cardiomyopathy (abnormally thick heart muscle that results in blockage of blood flow)
- narrowing of the heart valves
- constrictive pericarditis (inflammation of the sac-like membrane surrounding the heart)
- pericardial tamponade (a condition where fluid builds up in the sac around the heart that prevents it from pumping enough blood)
- severe low blood pressure
- low volume of circulating fluids in the body which have not been treated
- increased pressure in the brain e.g. head trauma or injury, bleeding in the brain
- severe anaemia (low red blood cell count in the body)
- acute circulatory failure (a serious sudden condition when the heart and blood vessels cannot supply enough oxygen-rich blood to the organs and tissues)
as Glyceryl trinitrate may not be suitable for you.
Do not use Glyceryl trinitrate with medicines used to treat impotence and certain medicine used to treat high blood pressure in the lungs. Please see the section "Can I use this with other medicines?" below for more information.
Inform your doctor if you have the following conditions:
- hypothyroidism (underactive thyroid gland)
- disease of the blood vessels supplying the brain
- lung problem
- recent history of heart attack
- nutrient imbalance due to insufficient or excessive dietary intake
- low body temperature
- low levels of oxygen in the blood
- severe liver disease
- severe kidney disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Glyceryl trinitrate to the elderly. Elderly people may be more sensitive to the side effects.
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
Glyceryl trinitrate may cause dizziness. If affected, do not drive or take part in any activity in which you need to be alert.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
Other side effects include any of the following: headache, dizziness with sensations of spinning, generalised weakness or lack of energy, drowsiness, nausea, vomiting, flushing, and itching, burning sensation, and irritation at the application site.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- severe dizziness, passing out
- worsening of chest pain, fast heartbeat
- bluish skin, shortness of breath, tiredness
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not use Glyceryl trinitrate with the following medicines:
- medicines used to treat impotence e.g. sildenafil, vardenafil, tadalafil
- riociguat (medicine used to treat high blood pressure in the blood vessels leading to the lungs)
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for high blood pressure e.g. amlodipine, captopril
- medicines to treat depression e.g. amitriptyline
- medicines for migraine (severe throbbing pain or pulsating sensation usually affecting one side of the head that is often accompanied by nausea, vomiting, and sensitivity to light and sound) e.g. ergotamine
This list does not include all medicines that may interact with Glyceryl trinitrate.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol. Alcohol intake may worsen the side effects caused by Glyceryl trinitrate.
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.
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