How does it work?

This medicine contains the active ingredient glyceryl trinitrate, which is a type of medicine used to enable the heart to work more easily. Glyceryl trinitrate works by releasing a chemical called nitric oxide. This chemical is also made naturally by the body and has the effect of making the veins and arteries relax and widen (dilate). This increases the space within the blood vessels and therefore reduces the resistance within the blood vessels, which makes it easier for the heart to pump blood around the body. Widening the veins also decreases the volume of blood that returns to the heart in the veins with each heartbeat, and this makes it easier for the heart to pump that blood out again. As a result of both these actions, the heart requires less energy to pump the blood around the body and therefore does not need as much oxygen. The medicine also widens the arteries within the heart, and this increases the blood and oxygen supply to the heart muscle. The pain of angina is caused by too little oxygen reaching the heart when its workload increases, such as during exercise. Glyceryl trinitrate makes it easier for the heart to pump blood and so decreases the amount of oxygen that the heart needs, as well as improving the oxygen supply to the heart. It can therefore be used to relieve the pain of an angina attack. Glyceryl trinitrate is taken as a tablet that is dissolved under the tongue, or as a spray that is sprayed under the tongue. This area of the mouth has a large supply of blood vessels that allows the medicine to be rapidly absorbed. Glyceryl trinitrate taken in this way is used to give rapid relief from an angina attack, and can also be used to prevent an anticipated attack, for example before exercise. Glyceryl trinitrate is also available as long acting tablets, skin patches and ointment that are used regularly each day to help prevent angina attacks.

What is it used for?

Prevention and relief of angina attacks

Warning!

Short-acting glyceryl trinitrate tablets should be kept in the container they are dispensed in and discarded after eight weeks. The tablets may lose their effectiveness if the container has been open for longer than eight weeks or if they are transferred to a different container.

This medicine may cause dizziness and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.

This medicine is not recommended for use in children.

Follow the instructions you receive with this medicine. Glyceryl trinitrate sublingual tablets should be allowed to dissolve under the tongue - they should not be swallowed like normal tablets. Glyceryl trinitrate spray should be sprayed under the tongue, and the mouth closed after each dose. Do not inhale the spray.

Drinking alcohol may enhance some of the side effects of this medicine, such as feeling faint or dizzy.

Use with caution in

Dangerously low body temperature (hypothermia)

Hypothyroidism

Malnutrition

People who have recently had a heart attack

Severe kidney disease

Severe liver disease

Not to be used in

Allergy to nitrates

Bleeding in the brain (cerebral haemorrhage)

Blood in the sac surrounding the heart which prevents the heart beating properly (cardiac tamponade)

Closed angle glaucoma

Head injury

Heart disease in which the muscle of the heart grows abnormally (hypertrophic obstructive cardiomyopathy)

Inflammation of the sac surrounding the heart which stops the heart from beating properly (constrictive pericarditis)

Low blood pressure (hypotension)

Low volume of circulating blood (hypovolaemia)

Narrowing of one of the valves in the heart

Narrowing of the main artery coming from the heart (aortic stenosis)

Severe anaemia

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy unless considered essential by your doctor. Seek medical advice from your doctor.

It is not known if this medicine passes into breast milk. It is not recommended for use during breastfeeding unless considered essential by your doctor. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Weakness

Dizziness

Nausea and vomiting

Flushing

A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)

Increased heart rate (tachycardia)

Headache

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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