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1 May 2026Oral drugsSource update: August 2021

Glyceryl trinitrate = Nitroglycerin = Trinitrin oral

Sublingual nitroglycerin guidance for short-term angina prophylaxis, acute angina treatment, and adjunctive therapy in acute heart failure.

Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.

Therapeutic action

Vasodilator, antianginal.

Indications

  • Short-term prophylaxis and treatment of acute angina.
  • Adjunctive therapy in acute heart failure (acute pulmonary oedema).

Forms and strengths

  • 0.5 mg sublingual tablet.

Dose

Do not exceed 3 mg daily.

Short-term prophylaxis of acute angina

  • Adult: 0.5 to 1 mg sublingually taken 5 to 10 minutes before a precipitating event such as physical exertion or stress.

Treatment of acute angina

  • Adult: 0.5 to 1 mg sublingually, to be repeated 1 to 3 times at 3 to 4 minute intervals.

Adjunctive therapy in acute heart failure (acute pulmonary oedema)

  • Adult: 0.5 mg sublingually, to be repeated 1 to 2 times at 5 minute intervals if necessary.
  • The objective is to lower systolic pressure to 120 to 150 mmHg and diastolic pressure to under 110 mmHg.

Duration

According to clinical response.

Contra-indications, adverse effects, precautions

  • Do not administer to patients with obstructive cardiomyopathy, hypotension, shock, severe anaemia, intracranial hypertension, or neurologic injury.
  • May cause orthostatic hypotension, headache, nausea, flushing, haemolytic anaemia in patients with G6PD deficiency, and severe hypotension in overdose.
  • Avoid combination or use the lowest effective dose in patients taking another nitrate derivative, a vasodilator, a diuretic, or an antihypertensive drug, and in older patients.
  • Do not combine with sildenafil or other drugs used for erectile dysfunction because of the risk of severe hypotension, syncope, and acute coronary syndrome.
  • Pregnancy: not recommended.
  • Breast-feeding: not recommended.

Source

MSF Essential drugs practical guidelines (January 2026)

This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.

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