Nitroglycerin + AvanafilContraindicated
PDE-5 inhibitor that potentiates hypotensive effects of nitroglycerin. Contraindicated with nitroglycerin.
Source: NLP:nitroglycerin
Nitroglycerin Interactions
Brand names: Nitroglycerin
Nitrate Vasodilator
Route: Oral
FDA Black Box Warning
You must consult your doctor for important information before using this drug.
Contraindications
4 CONTRAINDICATIONS Use of phosphodiesterase type 5 (PDE-5) Inhibitors, such as avanafil, sildenafil, tadalafil, or vardenafil, or soluble guanylate cyclase (sGC) stimulator (riociguat). ( 4.1 , 7.1 ) Severe anemia. ( 4.2 ) Increased intracranial pressure. ( 4.3 ) Hypersensitivity to Nitroglycerin Lingual Spray or to other nitrates or nitrites or any excipient. ( 4.4 ) 4.1 P DE-5 - I nhibitors and sGC- S timulators Do not use Nitroglycerin Lingual Spray in patients who are taking PDE-5-Inhibitors, such as avanafil, sildenafil, tadalafil, or vardenafil. Concomitant use can cause severe hypotension, syncope, or myocardial ischemia [see Drug Interactions (7.1) ]. Do not use Nitroglycerin Lingual Spray in patients who are taking soluble guanylate cyclase (sGC) stimulators, such as riociguat. Concomitant use can cause hypotension. 4.2 Severe Anemia Nitroglycerin Lingual Spray is contraindicated in patients with severe anemia (large doses of nitroglycerin may cause oxidation of hemoglobin to methemoglobin and could exacerbate anemia). 4.3 Increased I ntracranial P ressure Nitroglycerin Lingual Spray may precipitate or aggravate increased intracranial pressure and thus should not be used in patients with possible increased intracranial pressure (e. g. cerebral hemorrhage or traumatic brain injury). 4.4 Hypersensitivity Nitroglycerin Lingual Spray is contraindicated in patients who are allergic to nitroglycerin, other nitrates or nitrites or any excipient. 4. 5 Circulatory F ailure and S hock Nitroglycerin Lingual Spray is contraindicated in patients with acute circulatory failure or shock.
Pregnancy & Breastfeeding
8.1 Pregnancy Risk summary Limited published data on the use of nitroglycerin are insufficient to determine a drug associated risk of major birth defects or miscarriage. In animal reproduction studies, there were no adverse developmental effects when nitroglycerin was administered intravenously to rabbits or intraperitoneally to rats during organogenesis at doses greater than 64-times the human dose [see Data]. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 – 4% and 15 – 20%, respectively. Data Animal Data No embryotoxic or postnatal development effects were observed with transdermal application in pregnant rabbits and rats at doses up to 240 mg/kg/day for 13 days, at intraperitoneal doses in pregnant rats up to 20 mg/kg/day for 11 days, and at intravenous doses in pregnant rabbits up to 4 mg/kg/day for 13 days.
55 interactions on record
Nitroglycerin + ErgotamineContraindicated
Nitroglycerin markedly decreases first-pass metabolism of ergotamine, increasing bioavailability. Ergotamine can precipitate angina pectoris. Avoid concomitant use.
Source: NLP:nitroglycerin
Nitroglycerin + Mao InhibitorsContraindicated
Concomitant use of nitroglycerin with phosphodiesterase inhibitors in any form is contraindicated.
Source: NLP:nitroglycerin
Nitroglycerin + RiociguatContraindicated
Concomitant use of nitroglycerin with riociguat, a soluble guanylate cyclase stimulator, is contraindicated.
Source: NLP:nitroglycerin
Nitroglycerin + SildenafilContraindicated
PDE-5 inhibitor that potentiates hypotensive effects of nitroglycerin. Contraindicated with nitroglycerin.
Source: NLP:nitroglycerin
Nitroglycerin + Sildenafil CitrateContraindicated
Concomitant use is contraindicated; PDE-5 inhibitors potentiate hypotensive effects of organic nitrates.
Source: NLP:nitroglycerin
Nitroglycerin + Soluble Guanylate Cyclase (Sgc) StimulatorsContraindicated
sGC stimulators are contraindicated with nitroglycerin. Concomitant use can cause severe hypotension.
Source: NLP:nitroglycerin
Nitroglycerin + TadalafilContraindicated
PDE-5 inhibitor that potentiates hypotensive effects of nitroglycerin. Contraindicated with nitroglycerin.
Source: NLP:nitroglycerin
Nitroglycerin + VardenafilContraindicated
PDE-5 inhibitor that potentiates hypotensive effects of nitroglycerin. Contraindicated with nitroglycerin.
Source: NLP:nitroglycerin
Nitroglycerin + Vardenafil HydrochlorideContraindicated
Concomitant use of vardenafil hydrochloride and nitroglycerin is contraindicated. Vardenafil potentiates the blood pressure lowering effects.
Source: NLP:vardenafil hydrochloride
Concomitant use may cause hypotension.
Source: NLP:nitroglycerin
Intravenous nitroglycerin decreases the thrombolytic effect of alteplase; caution advised with sublingual nitroglycerin during alteplase therapy.
Source: NLP:nitroglycerin
Concomitant use causes greater decreases in blood pressure compared to apomorphine alone, with risk of hypotension, myocardial infarction, falls, and injuries.
Source: NLP:apomorphine hydrochloride
Increased risk of methemoglobinemia when concurrently exposed to articaine.
Source: NLP:articaine hydrochloride and epinephrine
Increased risk of developing methemoglobinemia when concurrently exposed to this nitrate.
Source: NLP:articaine hydrochloride, epinephrine bitartrate
Increased risk of methemoglobinemia when concurrently exposed to this nitrate oxidizing agent with local anesthetics.
Source: NLP:benzocaine, butamben, and tetracaine hydrochloride
Increased risk of methemoglobinemia when concurrently exposed with bupivacaine.
Source: NLP:bupivacaine hydrochloride
Marked symptomatic orthostatic hypotension reported when combined with organic nitrates. Dose adjustments of either class may be necessary.
Source: NLP:nitroglycerin
Induces methemoglobinemia; concomitant use may increase risk for developing methemoglobinemia.
Source: NLP:dapsone
Oral nitroglycerin markedly decreases first-pass metabolism and increases bioavailability of dihydroergotamine; monitor for ergotism symptoms.
Source: NLP:nitroglycerin
Intravenous nitroglycerin interferes with the anticoagulant effect of heparin in some patients. Concomitant heparin therapy should be guided by frequent measurement of activated partial thromboplastin time.
Source: NLP:nitroglycerin
Increased risk of methemoglobinemia when used concurrently with lidocaine.
Source: NLP:lidocaine
Nitrate that may cause methemoglobinemia when used concomitantly with lidocaine patch 5%.
Source: NLP:lidocaine 5%
Nitrate drug that increases risk of methemoglobinemia when used concurrently with lidocaine and capsaicin patch.
Source: NLP:lidocaine and capsaicin
Nitrate/nitrite; increased risk of methemoglobinemia when concurrently exposed.
Source: NLP:lidocaine and prilocaine
Increased risk of methemoglobinemia when used concurrently with lidocaine hydrochloride.
Source: NLP:lidocaine hydrochloride
Associated with methemoglobinemia risk when concurrent exposure occurs with local anesthetics.
Source: NLP:lidocaine hydrochloride and epinephrine bitartrate
Increased risk of methemoglobinemia when local anesthetic is concurrently exposed to nitrates/nitrites.
Source: NLP:lidocaine hydrochloride and hydrocortisone acetate
Increased risk of methemoglobinemia when lidocaine is concurrently exposed to nitrates.
Source: NLP:lidocaine and menthol
Increased risk of methemoglobinemia when local anesthetics are concurrently exposed to nitrates.
Source: NLP:lidothol patch
Increased risk of methemoglobinemia when concurrently exposed to nitrates/nitrites.
Source: NLP:marcaine, lidocaine, povidone iodine
Concurrent exposure increases risk of methemoglobinemia in patients administered mepivacaine.
Source: NLP:mepivacaine hydrochloride
May increase the risk of developing methemoglobinemia when used with nitric oxide.
Source: NLP:nitric oxide
Increased risk of methemoglobinemia when penicillin is concurrently administered with nitroglycerin (a nitrate).
Source: NLP:penicillin g benzathine and penicillin g procaine
Increased risk of methemoglobinemia when prilocaine is concurrently exposed to nitroglycerin.
Source: NLP:prilocaine hcl and epinephrine
Increased risk of methemoglobinemia when used concurrently with prilocaine.
Source: NLP:prilocaine hydrochloride
Increased risk of developing methemoglobinemia when concurrently exposed to nitroglycerin.
Source: NLP:ropivacaine hydrochloride
Increased risk of methemoglobinemia when concurrently exposed.
Source: NLP:bupivacaine hydrochloride, lidocaine hydrochloride, triamcinolone acetonide, povidine iodine
Increases nitroglycerin maximum concentrations by up to 67% and AUC by 73%, potentially enhancing pharmacological effects. Monitor closely.
Source: NLP:nitroglycerin
Nitroglycerin + AmitriptylineModerate
Tricyclic antidepressant may cause dry mouth and diminished salivary secretions, making sublingual nitroglycerin dissolution difficult.
Source: NLP:nitroglycerin
Nitroglycerin + BupivacaineModerate
May increase risk of methemoglobinemia when concurrently exposed with bupivacaine.
Source: NLP:bupivacaine
Increased risk of methemoglobinemia when concurrently exposed.
Source: NLP:bupivacaine hydrochloride and epinephrine bitartrate
Nitroglycerin + CaptoprilModerate
Data on concomitant use with captopril for heart failure are not available. Should be discontinued before starting captopril if possible; if resumed, administer cautiously at lower dosage.
Source: NLP:captopril
Concomitant use may cause excessive vasodilation. Should be discontinued before starting captopril; if resumed, administer cautiously at lower dosage.
Source: NLP:captopril and hydrochlorothiazide
Nitroglycerin + DesipramineModerate
Tricyclic antidepressant may cause dry mouth and diminished salivary secretions, making sublingual nitroglycerin dissolution difficult.
Source: NLP:nitroglycerin
Nitroglycerin + DoxepinModerate
Tricyclic antidepressant may cause dry mouth and diminished salivary secretions, making sublingual nitroglycerin dissolution difficult.
Source: NLP:nitroglycerin
Nitroglycerin + Heparin SodiumModerate
Intravenous nitroglycerin may decrease partial thromboplastin time with rebound effect upon discontinuation. Careful monitoring and heparin dose adjustment recommended.
Source: NLP:heparin sodium
Nitroglycerin + LabetalolModerate
Labetalol blunts reflex tachycardia from nitroglycerin and may produce additional antihypertensive effects when used concomitantly in angina patients.
Source: NLP:labetalol
Labetalol blunts reflex tachycardia from nitroglycerin without preventing hypotensive effect; additional antihypertensive effects may occur.
Source: NLP:labetalol hydrochloride
Nitrate/nitrite that increases risk of methemoglobinemia when used concomitantly with lidocaine and tetracaine.
Source: NLP:lidocaine and tetracaine
Use of long-acting nitrates may result in a decrease in therapeutic effect of sublingual nitroglycerin.
Source: NLP:nitroglycerin
Increased risk of methemoglobinemia when concurrently exposed to nitrates/nitrites with bupivacaine.
Source: NLP:methylprednisolone acetate, bupivacaine hydrochloride, povidone-iodine
Methylergonovine produces vasoconstriction and can reduce the effect of glyceryl trinitrate and other antianginal drugs.
Source: NLP:methylergonovine maleate
Blunt reflex tachycardia without preventing hypotensive effects. Possible additive hypotensive effects; additional hypotension may occur in angina patients.
Source: NLP:nitroglycerin
Isradipine has been safely coadministered with nitroglycerin with no reported adverse effects.
Source: NLP:isradipine