Nitroglycerin
Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026
Nitroglycerin is a potent vasodilator used for acute relief and prevention of angina pectoris, as well as management of acute heart failure and hypertensive emergencies. Sublingual nitroglycerin is the classic rapid-acting treatment for angina attacks. Available in multiple formulations including sublingual tablets, spray, transdermal patches, and IV.
Exploratory record, not a reviewed medical publication.
See the editorial and medical-review policies for the publication gate.
This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.
What the research says.
A quick, data-only summary. The full evidence, dosing, and sources are below.
Nitroglycerin is a potent vasodilator used for acute relief and prevention of angina pectoris, as well as management of acute heart failure and hypertensive emergencies. NutriStack rates the supporting evidence as strong. Common adult dosing is Sublingual: 0.3–0.6 mg as needed (up to 3 doses in 15 minutes); Patch: 0.2–0.8 mg/hr (with 10–12 hour nitrate-free interval); IV: 5–200 mcg/min (as prescribed by your physician), though a prescriber sets the actual dose. This profile indexes 10 sources.
- Headache (most common)
- Hypotension and dizziness
- Flushing
- Concurrent PDE-5 inhibitor use (sildenafil, tadalafil, within 24–48 hours), severe hypotension
- Concurrent riociguat
The bottom line
Evidence rating strong. Most-documented uses: rapid relief of acute angina attacks (sublingual), reduces myocardial oxygen demand, reduces preload in acute heart failure. 10 sources indexed (2021–2024), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Converted to nitric oxide (NO) in vascular smooth muscle via mitochondrial aldehyde dehydrogenase. NO activates soluble guanylyl cyclase, increasing cGMP, which causes smooth muscle relaxation. At lower doses, preferentially dilates veins (reduces preload and ventricular wall stress). At higher doses, also dilates coronary and systemic arteries. Reduces myocardial oxygen demand and improves supply.
Dosing & protocol.
Sublingual route bypasses first-pass metabolism for rapid onset; oral forms have significant first-pass metabolism; a 10–12 hour nitrate-free interval is essential to prevent tolerance8
Full safety detail.
Side effects
- Headache (most common)
- Hypotension and dizziness
- Flushing
- Reflex tachycardia
- Lightheadedness and syncope
- Tolerance with continuous use
- Methemoglobinemia (rare, at very high doses)
Contraindications
- Concurrent PDE-5 inhibitor use (sildenafil, tadalafil, within 24–48 hours), severe hypotension
- Concurrent riociguat
- Severe hypotension (SBP <90 mmHg)
- Right ventricular infarction
- Hypertrophic obstructive cardiomyopathy
- Severe anemia
- Increased intracranial pressure
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
5- 1The efficacy of glyceryl trinitrate for acute intracerebral hemorrhage: A systematic review and meta-analysisPMIDTian Q, Song X, Wu L et al. · Advances in clinical and experimental medicine : official organ Wroclaw Medical University · 2024
Tian Q, Song X, Wu L et al.. The efficacy of glyceryl trinitrate for acute intracerebral hemorrhage: A systematic review and meta-analysis. Advances in clinical and experimental medicine : official organ Wroclaw Medical University. 2024
- 2Effectiveness of topical glyceryl trinitrate in treatment of tendinopathy - systematic review and meta-analysisPMIDSaltychev M, Johansson J, Kemppi V et al. · Disability and rehabilitation · 2022
Saltychev M, Johansson J, Kemppi V et al.. Effectiveness of topical glyceryl trinitrate in treatment of tendinopathy - systematic review and meta-analysis. Disability and rehabilitation. 2022
- 3Local nitroglycerin to facilitate peripheral arterial cannulation in children: systematic review and meta-analysisPMIDWagh D, Pawale D, Tan JKG et al. · Archives of disease in childhood · 2022
Wagh D, Pawale D, Tan JKG et al.. Local nitroglycerin to facilitate peripheral arterial cannulation in children: systematic review and meta-analysis. Archives of disease in childhood. 2022
- 4Management of Lateral Epicondylitis Using Transdermal Nitroglycerin: A Systematic ReviewPMIDMcCulloch C, Hunter MM, Lipp C et al. · Cureus · 2022
McCulloch C, Hunter MM, Lipp C et al.. Management of Lateral Epicondylitis Using Transdermal Nitroglycerin: A Systematic Review. Cureus. 2022
- 5Topical nitroglycerin ointment as salvage therapy for peripheral tissue ischemia in newborns: a systematic reviewPMIDSushko K, Litalien C, Ferruccio L et al. · CMAJ open · 2021
Sushko K, Litalien C, Ferruccio L et al.. Topical nitroglycerin ointment as salvage therapy for peripheral tissue ischemia in newborns: a systematic review. CMAJ open. 2021
Reference material
5- 6Abrams J. Nitroglycerin and long-acting nitrates in clinical practice. Am J Med. 1983.Source linkedPMID
- 7Parker JD and Parker JO. Nitrate therapy for stable angina pectoris. N Engl J Med. 1998.Source linkedPMID
- 8Pramudyo M et al. Low-dose versus high-dose intravenous nitroglycerin in the treatment of sympathetic crashing acute pulmonary oedema: a systematic review and meta-analysis focusing on efficacy, safety and outcomes. BMJ Open. 2025.Source linkedPMID
- 9Meunier M, Yammine A, Bettaieb A et al.. Nitroglycerin: a comprehensive review in cancer therapy. Cell death & disease. 2023Source linkedPMID
- 10Sureda-Gibert P, Romero-Reyes M, Akerman S. Nitroglycerin as a model of migraine: Clinical and preclinical review. Neurobiology of pain (Cambridge, Mass.). 2022Source linkedPMID
Common questions.
Quick answers about Nitroglycerin, drawn from the data on this page.
What is Nitroglycerin?
Nitroglycerin is a potent vasodilator used for acute relief and prevention of angina pectoris, as well as management of acute heart failure and hypertensive emergencies. Sublingual nitroglycerin is the classic rapid-acting treatment for angina attacks. Available in multiple formulations including sublingual tablets, spray, transdermal patches, and IV.
What is Nitroglycerin used for?
Commonly cited benefits of Nitroglycerin include: Rapid relief of acute angina attacks (sublingual); Reduces myocardial oxygen demand; Reduces preload in acute heart failure; Coronary vasodilation improves perfusion to ischemic areas. NutriStack rates the overall evidence as strong.
What is a typical dose of Nitroglycerin?
A typical adult dose of Nitroglycerin is Sublingual: 0.3–0.6 mg as needed (up to 3 doses in 15 minutes); Patch: 0.2–0.8 mg/hr (with 10–12 hour nitrate-free interval); IV: 5–200 mcg/min (as prescribed by your physician). The commonly recommended form is Sublingual tablet or spray for acute angina; transdermal patch or oral sustained-release for prophylaxis. These are general ranges, not personalized advice; confirm the right dose with a clinician.
What are the side effects of Nitroglycerin?
Reported side effects include headache (most common), hypotension and dizziness, flushing, reflex tachycardia, lightheadedness and syncope, tolerance with continuous use. This is educational information; check with a healthcare professional before use.
How strong is the evidence for Nitroglycerin?
NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.
Use this with your stack
Nitroglycerin in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.