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Nitro-Dur patch

Generic Name: nitroglycerin (NYE-troe-GLIS-er-in)
Brand Name: Examples include Minitran and Nitro-Dur

Nitro-Dur patch is used for:

Preventing chronic chest pain caused by heart disease. It also may be used for other conditions as determined by your doctor.

Nitro-Dur patch is a nitrate. It works by relaxing (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Relaxing blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart.

Do NOT use Nitro-Dur patch if:

  • you are allergic to any ingredient in Nitro-Dur patch
  • you are allergic to the adhesive that makes the patch stick to your skin
  • you have increased pressure in or severe injury to the head
  • you have severe anemia
  • you are taking avanafil, riociguat, sildenafil, tadalafil, or vardenafil

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

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Before using Nitro-Dur patch:

Some medical conditions may interact with Nitro-Dur patch. 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 drink alcoholic beverages
  • if you have a history of other heart problems (eg, heart failure, enlarged heart, heart attack), overactive thyroid, stroke or other bleeding in the brain, or recent head injury
  • if you have anemia, low blood pressure, dehydration, or low blood volume
  • if you will be having a certain heart procedure (cardioversion)

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

  • Avanafil, beta-blockers (eg, propranolol), calcium channel blockers (eg, diltiazem), diuretics (eg, furosemide, hydrochlorothiazide), medicines for high blood pressure, phenothiazines (eg, thioridazine), riociguat, sildenafil, tadalafil, or vardenafil because the risk of low blood pressure and dizziness on standing may be increased
  • Salicylates (eg, aspirin) because they may increase the risk of Nitro-Dur patch's side effects
  • Alteplase because the effectiveness of Nitro-Dur patch may be decreased

This may not be a complete list of all interactions that may occur. Ask your health care provider if Nitro-Dur patch 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-Dur patch:

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

  • An extra patient leaflet is available with Nitro-Dur patch. Talk to your pharmacist if you have questions about this information.
  • Nitro-Dur patch is for external use only.
  • Apply the patch at the same time every day.
  • Wash your hands thoroughly before and after applying the patch.
  • Apply the patch to a non-hairy area of the chest, inner side of the upper arm, back, or shoulder.
  • Clean and completely dry the skin before applying the patch. If necessary, hair should be removed by clipping or lightly shaving.
  • Remove the patch from the package. Apply with a firm pressure to the skin. To avoid skin irritation, change the treatment site daily. Do not apply to irritated or damaged skin.
  • If the patch becomes loose, remove it and apply a new patch at a different site.
  • After removing the used patch, fold it in half with the sticky sides together. Discard the patch out of the reach of children and away from pets.
  • This patch should only be worn for up to 12 to 14 hours a day, or as directed by your doctor, so that you will have a 10 to 12 hour "nitrate-free" period each day. Do not use more of Nitro-Dur patch than prescribed. It is important to have a "nitrate-free" period of time each day for Nitro-Dur patch to continue to work well and to decrease the risk of physical dependence.
  • If you miss a dose of Nitro-Dur patch, 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-Dur patch.

Important safety information:

  • Nitro-Dur patch may cause dizziness, light-headedness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use Nitro-Dur patch with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Check with your doctor before you drink alcohol while you are taking Nitro-Dur patch. Drinking alcohol may increase the risk of low blood pressure with Nitro-Dur patch.
  • Nitro-Dur patch may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Contact your doctor right away if you develop slow heartbeat or new or worsening chest pain after you take Nitro-Dur patch.
  • Tell your doctor or dentist that you take Nitro-Dur patch before you receive any medical or dental care, emergency care, or surgery.
  • Nitro-Dur patch may give you daily headaches. This should become less noticeable with time. Do not change how you use Nitro-Dur patch to avoid these headaches. Talk with your doctor for ways to lessen this side effect.
  • Other dosage forms of Nitro-Dur patch (eg, sublingual, or under the tongue, tablets) may not work as well while you are taking Nitro-Dur patch.
  • Nitro-Dur patch takes about 1 to 2 hours to start working and should not be used for a sudden chest pain attack.
  • You may need to check your blood pressure often while using Nitro-Dur patch. Talk with your doctor.
  • Use Nitro-Dur patch with caution in the ELDERLY; they may be more sensitive to its effects.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Nitro-Dur patch while you are pregnant. It is not known if Nitro-Dur patch is found in breast milk. If you are or will be breast-feeding while you are using Nitro-Dur patch, check with your doctor. Discuss any possible risks to your baby.

When used for long periods of time without a break, Nitro-Dur patch may not work as well. This is known as TOLERANCE. Increasing the dose is not effective in managing tolerance to Nitro-Dur patch. Tolerance to other nitrates or nitrites may also occur. Be sure to have a "nitrate-free" period of time each day to help prevent this tolerance. Talk with your doctor if Nitro-Dur patch stops working well. Do not take more than prescribed.

Some people who use Nitro-Dur patch for a long time without a break may develop a physical need to continue taking it. This is known as physical DEPENDENCE. If you use Nitro-Dur patch without a break and then suddenly stop using it, you may get WITHDRAWAL symptoms. These may include chest pain, heart attack, or possibly sudden death. Be sure to have a "nitrate-free" period of time each day; this may help prevent dependence and withdrawal problems.

Possible side effects of Nitro-Dur patch:

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:

Dizziness or light-headedness; headache; irritation at site of patch.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; dry mouth; fainting; fast or irregular heartbeat; flushing; heavy sweating; pale skin; restlessness; severe or persistent dizziness or headache; severe or persistent nausea or vomiting; severe skin irritation; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Nitro-Dur patch:

Store Nitro-Dur patch at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nitro-Dur patch out of the reach of children and away from pets.

General information:

  • If you have any questions about Nitro-Dur patch, please talk with your doctor, pharmacist, or other health care provider.
  • Nitro-Dur patch 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.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Nitro-Dur patch or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Nitro-Dur patch. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Nitro-Dur patch. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Nitro-Dur patch.

Issue Date: December 3, 2014
Database Edition 14.4.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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