Nitro-Bid Ointment

Nitro-Bid Ointment is used for:

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Preventing chest pain due to heart disease. It also may be used for certain conditions as determined by your doctor.

Nitro-Bid Ointment is a nitrate vasodilator. It works by relaxing blood vessels in the body, which allows them to widen (dilate). This allows more blood to flow through the blood vessels easier, which reduces the workload on the heart.

Do NOT use Nitro-Bid Ointment if:

• you are allergic to any ingredient in Nitro-Bid Ointment
• you are currently taking a phosphodiesterase type 5 inhibitor (eg, sildenafil)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Nitro-Bid Ointment:

Some medical conditions may interact with Nitro-Bid Ointment. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have bleeding in the brain or have had a recent head injury
• if you have heart problems, severe anemia, an overactive thyroid, or low blood pressure

Some MEDICINES MAY INTERACT with Nitro-Bid Ointment. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Calcium channel blockers (eg, verapamil) or phosphodiesterase type 5 inhibitors (eg, sildenafil) because side effects, such as low blood pressure, may occur
• Alteplase because the effectiveness of Nitro-Bid Ointment may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Nitro-Bid Ointment may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Nitro-Bid Ointment:

Use Nitro-Bid Ointment as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Nitro-Bid Ointment comes with an additional patient leaflet. Read it carefully and reread it each time you get Nitro-Bid Ointment refilled.
• Nitro-Bid Ointment is for external use only.
• Squeeze the prescribed amount of ointment from the tube onto the applicator. Place the applicator on the skin with the ointment side down. Using the applicator, spread the ointment in a thin, uniform layer. Cover the area with plastic wrap held in place with adhesive tape.
• Remove the plastic wrap from the old dose when you apply a new dose.
• Wash hands before and after applying.
• Nitro-Bid Ointment lasts for about 6 hours. Do not use more of Nitro-Bid Ointment than prescribed. It is important to have a "nitrate-free" period of time each day for Nitro-Bid Ointment to continue to work well and to decrease the risk of physical dependence.
• If you miss a dose of Nitro-Bid Ointment, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Nitro-Bid Ointment.

Important safety information:

• Nitro-Bid Ointment may cause dizziness or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Nitro-Bid Ointment. Using Nitro-Bid Ointment alone, with certain other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks.
• Nitro-Bid Ointment may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit or stand up slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
• Nitro-Bid Ointment may give you daily headaches. This should become less noticeable with time.
• Nitro-Bid Ointment takes about 1 to 2 hours to start working and should not be used for a sudden chest pain attack.
• Nitro-Bid Ointment can stain clothing.
• Use Nitro-Bid Ointment with caution in the ELDERLY because they may be more sensitive to its effects.
• Nitro-Bid Ointment is not recommended for use in CHILDREN; safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Nitro-Bid Ointment during pregnancy. It is unknown if Nitro-Bid Ointment is excreted in breast milk. Do not breast-feed while taking Nitro-Bid Ointment.

When used for long periods of time without a break, Nitro-Bid Ointment may not work as well. This is known as TOLERANCE. Tolerance to other nitrates and nitrites may also occur. Increasing the dose is not effective in managing tolerance to Nitro-Bid Ointment. Talk with your doctor if Nitro-Bid Ointment stops working well. Do not take more than prescribed.

When used for long periods of time without a break, some people develop a physical need to continue taking Nitro-Bid Ointment. This is known as physical DEPENDENCE. Do not suddenly stop taking Nitro-Bid Ointment without your doctor's approval. Stopping Nitro-Bid Ointment suddenly may cause serious, possibly life-threatening, WITHDRAWAL symptoms, including chest pain and heart attack. Having a nitrate-free period each day will help prevent tolerance, dependence, and withdrawal problems.

Possible side effects of Nitro-Bid Ointment:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Daily headache; dizziness, lightheadedness, or fainting when sitting up or standing; fast heartbeat; flushing; nausea or vomiting.

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fainting; pounding in the chest; slow heartbeat.

This is not a complete list of all side effects that may occur. If you have questions or need medical advice about side effects, contact your doctor or health care provider. You may report side effects to the FDA at 1-800-FDA-1088 (1-800-332-1088) or at http://www.fda.gov/medwatch.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org/findyour.htm), or emergency room immediately. Symptoms may include changes in heart rate; changes in vision; confusion; dizziness; flushing; nausea; persistent, throbbing headache; vomiting.

Store Nitro-Bid Ointment at room temperature between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nitro-Bid Ointment out of the reach of children and away from pets.

General information:

• If you have any questions about Nitro-Bid Ointment, please talk with your doctor, pharmacist, or other health care provider.
• Nitro-Bid Ointment is to be used only by the patient for whom it is prescribed. Do not share it with other people.
• If your symptoms do not improve or if they become worse, check with your doctor.

This information is a summary only. It does not contain all information about Nitro-Bid Ointment. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

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