GLYCERYL TRINITRATE SPRAY 400 MICROGRAMS PER METERED DOSE SUBLINGUAL SPRAY
Active substance(s): GLYCERYL TRINITRATE / GLYCERYL TRINITRATE / GLYCERYL TRINITRATE
400 micrograms per metered dose, Sublingual spray
Read all of this leaﬂet carefully before you start using this
medicine because it contains important information for you.
• Keep this leaﬂet. You may need to read it again.
• If you have any further questions, ask your doctor or pharmacist.
• This medicine has been prescribed for you only. Do not pass it on
to others. It may harm them, even if their signs of illness are the
same as yours.
• If you get any side effects, talk to your doctor or pharmacist. This
includes any possible side effects not listed in this leaﬂet. See
What is in this leaﬂet
1. What Glyceryl Trinitrate Spray is & what it is used for
2. What you need to know before you use Glyceryl TrinitUate Spray
3. How to use Glyceryl Trinitrate Spray
4. Possible side effects
5. How to store Glyceryl Trinitrate Spray
6. Contents of the pack and other information
1. WHAT GLYCERYL TRINITRATE SPRAY IS AND WHAT IT IS USED FOR
Your medicine is called Glyceryl Trinitrate Spray. It will be referred to
throughout this leaﬂet as GTN Spray.
It is a sublingual (under the tongue) aerosol spray that contains the
active ingredient glyceryl trinitrate. Glyceryl trinitrate belongs to a
group of medicines called nitrates that relax the muscle walls of the
blood vessels and reduce the workload of the heart.
GTN Spray is used to treat angina at the onset of an attack. It is also
used for the prevention of angina, which can be brought on from
physical effort, emotional stress, and exposure to cold, etc.
2. WHAT YOU NEED TO KNOW BEFORE YOU USEGLYCERYL
Do not use GTN Spray and talk to your doctor:
• If you are allergic to glyceryl trinitrate or any of the other
ingredients of this medicine (listed in section 6).
• If you have severe low blood pressure.
• If you have shock caused by low blood pressure.
• If you have severe anaemia.
• If you have constrictive pericarditis (a heart condition).
• If you have an extremely low heart rate.
• If you have glucose-6-phosphate-dehydrogenase deﬁciency
(an inherited enzyme deﬁciency, mainly affecting men).
• If you have a brain trauma or cerebral haemorrhage (brain or
head injury, including bleeding).
• If you have narrowing of the heart valves or arteries or angina
caused by a disease of the heart muscle.
• If you have circulatory collapse (a failure of blood circulation).
• If you have toxic pulmonary oedema (lung swelling/ ﬂuid)
• If you have cardiogenic shock (a serious heart condition caused
by very low blood pressure, which may result in the following
symptoms: dizziness and lightheadedness, fast pulse rate, white
skin, sweating, restlessness or loss of consciousness).
Do not use if you are taking:
• riociguat to treat pulmonary hypertension
• sildenaﬁl, tildenaﬁl, vardenaﬁl or other similar phosphodiesterase inhibitors used to treat male erectile dysfunction
Warnings and precautions
Talk to your doctor before using GTN Spray if any of the following
apply to you:
• Fluid around the heart (pericardial tamponade).
• Low ﬁlling pressures (e.g. acute myocardial infarction).
• Problems controlling your blood pressure.
• Any disease that increases pressure on the brain.
• Glaucoma (a condition in which the pressure in the eye may
• Liver or kidney problems.
• An underactive thyroid gland.
Please consult your doctor, even if these statements were applicable
to you at any time in the past. You may need to be more closely
supervised during treatment.
Other medicines and GTN Spray
Tell your doctor if you are taking, have recently taken or might
take any other medicines.
Do not use GTN Spray if you are taking:
• Riociguat, used to treat pulmonary hypertension.
• Sildenaﬁl, tildenaﬁl, vardenaﬁl or other similar phospho-diesterase
inhibitors used to treat male erectile dysfunction (impotence).
Talk to your doctor before using GTN Spray if you are taking or
have recently taken any of the following:
• Medicines to treat blood pressure or heart problems, such as
vasodilators, antihypertensives, betablockers and calcium channel
• Tricyclic anti-depressants or neuroleptics, used to treat mental
• Diuretics (water tablets to increase amount of urine produced).
• Dihydroergotamine, used to treat migraine headaches.
• Heparin, a blood thinner used to prevent blood clots. Your doctor
will need to monitor you more closely.
• Organic nitrates (other acute angina treatments).
GTN Spray with alcohol
Be careful about drinking alcohol as GTN Spray may affect you
more than usual. Both alcohol and GTN Spray may lower your blood
pressure and slow down your reactions.
Pregnancy and breast-feeding
If you are, or think you might be pregnant, ask your doctor for advice
before taking this medicine, GTN Spray should not be used if you are
Driving and using machines
Your reactions may slow down. Therefore you should avoid driving and
using machinery whilst using GTN Spray.
GTN Spray contains ethanol
This product contains small amounts of ethanol (alcohol), less than
100mg per spray.
Continuous use warning
Continuous use of GTN Spray and other nitrates may reduce
effectiveness at relieving your symptoms, so high continuous doses
should be avoided.
3. HOW TO USE GLYCERYL TRINITRATE SPRAY
1. GTN Spray is not recommended for children.
2. Always use this medicine exactly as your doctor or pharmacist has
told you. Check with your doctor or pharmacist if you are not sure.
3. Learn how to use GTN Spray before the onset of an angina attack,
as you may need to use it in a hurry, or in the dark. Familiarise
yourself with the spray button, which has a ﬁnger rest to help you
direct the spray.
4. Keep a spare handy at all times as it can be difﬁcult to tell how
many doses are left in the canister.
5. Do not use GTN Spray if you are near a naked ﬂame, e.g. a
An allergic skin reaction (with or without rash).
Tongue blistering (may affect up to 1 in 100 people).
A severe fall in blood pressure on standing up.
Worsening of the original angina symptoms.
Failure of the blood circulation.
Transient hypoxaemia (deprived oxygen supply).
Patients with coronary heart disease may experience a restriction
in blood supply.
Continuous use may result in a tolerance to GTN Spray, reducing its
effectiveness. If symptoms are not relieved, medical advice should
be sought immediately.
Other known side effects are:
(may affect more than 1 in 10 people)
(may affect up to 1 in 10 people)
(may affect up to 1 in 100 people)
(may affect up to 1 in 1,000 people)
(may affect up to 1 in 10,000 people)
6. Before using GTN spray for the ﬁrst time, check that the spray is
working by pressing the pump button a few times until it produces
a ﬁne mist of liquid. Practice aiming the spray onto a tissue or
similar item so that you will be able to aim it correctly under the
tongue when you need to use it. If you do not need to use GTN
spray very often, remember to check the spray regularly to see
that it still works properly.
7. At the onset of an attack, or to prevent an imminent attack:
• Sit down.
• Hold the canister upright and near your mouth.
• Hold your breath.
• Aim the spray under your tongue.
• Press down the button ﬁrmly, once only.
• Close your mouth immediately.
• Do not inhale the spray.
8. The usual dose is one or two sprays. No more than three doses
are recommended at any one time.
9. After using GTN Spray, rest for a while. When you stand up, rise
slowly, as you may feel faint.
Vertigo (spinning sensation), dizziness,
nausea, facial ﬂushing, weakness
Burning sensation, stinging sensation
Severe fall in blood pressure, heart
Flaking or peeling skin
Reporting of side effects
If you get any side effects, talk to your doctor. This includes any possible
side effects not listed in this leaﬂet. You can also report side effects
directly via the national reporting system listed in Yellow Card Scheme
Website: www.mhra.gov.uk/yellowcard. By reporting side effects you
can help provide more information on the safety of this medicine.
5. HOW TO STORE GLYCERYL TRINITRATE SPRAY
• Keep this medicine out of the sight and reach of children.
• Do not use this medicine after the expiry date which is stated on
the carton and the canister base after EXP. The expiry date refers to
the last day of that month.
• Do not store above 25°C. Do not refrigerate or freeze.
• GTN Spray is an aerosol spray and contains a pressurised liquid.
Do not expose to temperatures higher than 50°C, and do not
pierce the canister, even when empty.
• Do not throw away any medicines via wastewater or household
waste. Ask your pharmacist how to throw away medicines you no
longer use. These measures will help protect the environment.
6. CONTENTS OF THE PACK AND OTHER INFORMATION
What GTN Spray contains
• The active ingredient is glyceryl trinitrate. Each spray of product
contains 400 micrograms of glyceryl trinitrate.
• The other ingredients are peppermint oil, ethanol and 1,1,1,2
tetraﬂuoroethane (the propellant).
If you use more GTN Spray than you should:
Special treatment is not normally required.
What GTN Spray looks like and contents of the pack
Overdose symptoms are usually the same as the stated side effects.
Some people may experience a reaction similar to shock, with nausea, • GTN Spray is a colourless spray presented in a printed aluminium
canister, with a metered dose spray nozzle, and a cap.
weakness and sweating. If you feel faint sit down and raise your legs.
• Each canister contains enough product for 180 or 200 sprays.
Contact your doctor if your symptoms do not improve.
Rarely a bluish colour to lips/ﬁngers may occur (cyanosis or
Marketing Authorisation Holder and Manufacturer
methaemoglobinaemia). If this happens contact your doctor
Marketing Authorisation Holder: Ayrton Saunders Ltd., 9 Arkwright
4. POSSIBLE SIDE EFFECTS
Road, Astmoor Industrial Estate, Runcorn, Cheshire, WA7 1NU, UK.
Like all medicines, this medicine can cause side effects, although not Manufacturer: Pharmasol Limited, North Way, Andover, SP10 5AZ, UK.
everyone gets them.
For information in large print, audio CD or braille please contact the
Marketing Authorisation Holder.
If you experience one of the following rare serious side effects
(may affect up to 1 in 1,000 people unless speciﬁed), stop taking This leaﬂet was last revised in April 2017.
GTN Spray immediately and consult your doctor:
® Registered Trademark Ayrton Saunders Ltd.
Source: Medicines and Healthcare Products Regulatory Agency
Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.