Nitro-Dur

(Nitroglycerin)

The active ingredient in Nitro-Dur is nitroglycerin. It works by releasing nitric oxide, which relaxes smooth muscle in blood vessel walls. This causes vasodilation, mainly of the veins, reducing venous return to the heart (preload) and lowering the heart’s workload and oxygen demand. As a result, blood flow to the heart muscle improves, helping to prevent angina (chest pain).

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Nitro-Dur. However, the following is a synopsis of the general guidelines for the use of Nitro-Dur:

• Nitro-Dur is applied to the skin as a transdermal patch.
• Apply the patch to a clean, dry, hairless skin area on the upper body or arm.
• Do not apply to irritated or damaged skin.
• Press firmly to ensure the sticky side adheres well.
• Patches are typically worn for part of the day and removed to allow a nitrate-free period.
• Do not stop or change your schedule without medical advice.
• Nitro-Dur is not used to treat acute angina attacks.

Some mild or common side effects of Nitro-Dur include:

• Headache.
• Lightheadedness or dizziness.
• Skin irritation or redness at the application site.
• Blurred vision.
• Flushing or warmth of the skin.
• Low blood pressure.

Some individuals may experience serious side effects while using Nitro-Dur. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Worsening chest pain or angina attacks.
• Fainting or severe hypotension.
• Rapid or irregular heartbeat, including tachycardia.
• Signs of an allergic reaction, such as hives or a skin rash.
• Shortness of breath or symptoms of heart failure.
• Rare cases of methemoglobinemia.
• Severe headaches.

These are not all of the possible side effects of Nitro-Dur. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Nitro-Dur, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• Heart problems or heart failure.
• Coronary artery disease or a history of heart attack.
• Low blood pressure or episodes of fainting.
• Hypertrophic cardiomyopathy.
• Anemia or methemoglobinemia.
• Sensitivity to nitrates or vasodilators.
• Skin conditions that affect patch application.
• Elderly patients and geriatric individuals may be more sensitive to blood pressure changes.

Boxed Warning

Nitro-Dur should not be used with phosphodiesterase-5 inhibitors.

Use of Nitro-Dur with sildenafil, tadalafil, vardenafil, or riociguat is contraindicated because it can cause severe and potentially life-threatening low blood pressure.

Nitro-Dur should not be used in individuals who:

• Have severe hypotension.
• Have known hypersensitivity to nitroglycerin or nitrates.
• Have increased intracranial pressure.
• Are taking certain erectile dysfunction medications like sildenafil.

Nitro-Dur begins releasing medication after application, but it is not designed for immediate relief. It helps reduce the frequency of angina attacks over time with regular use. It does not stop sudden chest pain.

When Nitro-Dur is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• Sildenafil, tadalafil, or vardenafil can cause severe hypotension.
• Riociguat, due to the dangerous blood pressure-lowering effects.
• Ergotamine or dihydroergotamine may reduce effectiveness.
• Alcohol can worsen lightheadedness and low blood pressure.

Nitro-Dur is available as a transdermal system in multiple dosage strengths. Your healthcare provider will select the appropriate dosage form based on your condition.

It should be stored at room temperature, away from the reach of children or pets.

Nitro-Dur is manufactured by the company listed in the FDA-approved labeling. The brand-name drug Nitro-Dur was originally manufactured by Schering Corporation and later by Key Pharmaceuticals, Inc., which became part of Merck.

Yes. Generic nitroglycerin transdermal patches are available.

Do not stop using Nitro-Dur suddenly without medical advice from your healthcare provider. They may gradually adjust your treatment to avoid worsening angina.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.