Do you sometimes feel a pain in your chest that feels like it is being squeezed, squeezed, or a heavy weight? In medical terms, this is called angina. This is a condition that occurs when the heart does not get enough blood. So, one of the medicines that doctors often recommend to prevent this type of chest pain related to heart disease is Nitroglycerin ointment. This is something that is only available with a prescription. So today, let's talk about how to use this ointment exactly and what we need to be especially careful about.
What is Nitroglycerin ointment?
Simply put, this is a medicine that helps your body's blood vessels widen and relax. This type of medicine is called nitrates. Think about it, when a water pipe is blocked, it's hard for water to flow, right? In the same way, when the blood vessels that carry blood to the heart become narrow, the heart has to work harder to pump blood. That's when that chest pain comes.
Nitroglycerin ointment works by widening those blood vessels and making blood flow easier. This reduces the workload on the heart. This prevents the pain of angina.
Important: This ointment is used to prevent angina pain, not to treat sudden chest pain. Your doctor may have given you another tablet (GTN tablet) to keep under your tongue for sudden pain.
Things to tell your doctor before using this medicine
Before your doctor prescribes this medicine, he or she will need to know your complete medical history. Therefore, be sure to tell your doctor if you have any of the following conditions:
- Anemia , which means if there is a lack of blood.
- If you have recently had a head injury , a stroke , or a brain hemorrhage.
- If you have any liver disease .
- If you have had a heart attack before.
- If you have an allergy to nitroglycerin, any other medicine, food, or dye.
- If you are pregnant or hoping to become pregnant .
- If you are a breastfeeding mother .
Based on this information, the doctor will decide whether this medication is suitable for you or not.
How exactly do you use this ointment?
It is very important to use this correctly. Even a small mistake can affect the effectiveness of the medicine.
1. First of all, remember, this is just a topical ointment . Do not take it orally or ingest it in any other way.
2. You will receive a special piece of paper with a measuring tape with a measurement on it. Always use this paper to measure the correct dose. Apply the ointment to the measurement your doctor tells you (e.g. 1 inch) on the paper.
3. Next, apply this ointment to a clean, dry area of skin with little hair, such as the chest, stomach, or upper arms .
4. Do not apply to cuts, scrapes, scars, wounds, or irritated skin .
5. Most importantly: Don't rub the ointment into your skin . Don't do that. Spread it on the skin surface in a thin layer, just like a paper towel.
6. Then, place the paper over the coating and secure it with surgical tape to prevent it from moving. This will prevent it from getting on your clothes. You can also cover it with plastic wrap if necessary.
7. After applying the medicine, wash your hands thoroughly with soap as it may get on your fingers.
8. Before applying the next dose, remove the paper from the old medication area and clean the area thoroughly .
9. Applying medicine to the same area of skin every day can damage the skin. Therefore, rotate the sites where you apply the medicine every day . If you applied it to the right side of your chest today, apply it to the left side tomorrow.
Do not stop using this medicine suddenly without your doctor's advice. Doing so may cause your chest pain to return.
Drug interactions and other risks
Nitroglycerin is a drug that can react strongly with other medications, so you need to be very careful with this.
| Possible drug interactions with nitroglycerin | |
|---|---|
| Never take this medicine with any other medicine (extremely dangerous) | |
| Medication for Erectile Dysfunction (ED) | Medications like Sildenafil (Viagra), Tadalafil (Cialis), and Vardenafil. Taking these together can cause dangerously low blood pressure and even be life-threatening. |
| Some medications for migraines | Medications such as Ergotamine and Dihydroergotamine (DHE). |
| Riociguat | This is a special medicine for pulmonary hypertension. |
| Interactions may occur with this medication (tell your doctor ) | |
| Other medications | Aspirin, Heparin (blood thinner), high blood pressure medication, depression medication, other angina medications. |
Other things to consider
- Dizziness and drowsiness: This medication may make you dizzy and drowsy. Therefore, avoid activities that require alertness, such as driving or operating machinery, until you know how this medication affects you.
- Be careful when getting up: Standing up suddenly or getting up from a sitting position can cause dizziness and fainting. Be especially careful if you are elderly. Always get up slowly.
- Avoid alcohol: Alcohol can make dizziness and drowsiness worse.
- If you overdose: If you think you have overdosed, immediately contact the National Poisons Information Centre at the Colombo National Hospital . Or go to the Emergency Department (ETU) of the nearest hospital.
What are the possible side effects?
Like all medications, this one can have side effects. Some are serious, some are common.
| Side effect | What to do |
|---|---|
| If you experience these symptoms, tell your doctor immediately or go to the ETU. | |
| Allergic reactions (Skin rash , itching, swelling of the face/lips/tongue) | Seek medical advice immediately. |
| Symptoms of Methemoglobinemia (severe headache, unusual tiredness, difficulty breathing, vomiting, rapid heartbeat, blue skin or lips ) | This is an emergency condition that affects the oxygen carrying capacity of the blood and requires immediate hospitalization. |
| Increased pressure around the brain (Very severe headache, blurred vision, vomiting) | Seek medical advice immediately. |
| Low blood pressure (Dizziness, fainting, blue eyes) | Tell your doctor. If you feel faint, sit or lie down. |
| Increased chest pain (angina) (If pain or stiffness in the chest, neck, back, or arms increases) | Seek medical advice immediately. |
| Symptoms that are usually not serious, but should be reported to the doctor if they persist | |
| Headache | This is very common in the early stages. It usually subsides within a few days. If it persists, tell your doctor . |
| Dizziness, flushing | These are also common. If they persist, talk to your doctor. |
Take-Home Message
- Nitroglycerin ointment is not used to treat sudden chest pain, but to prevent it.
- The medicine should be applied using the special paper that comes with it, without rubbing it into the skin.
- It is extremely dangerous to use this with erectile dysfunction medications like Viagra (sildenafil). Tell your doctor about all the medications you are taking.
- Be careful when driving or working with machinery, as dizziness and fainting may occur.
- If you experience any unusual side effects (especially blue lips, severe headache), seek medical advice immediately .
- Keep this medicine out of the reach of children , at room temperature. Throw away expired medicine.
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