GTN spray is used to relieve angina. Angina is chest pain which may spread to your throat, jaw, neck, shoulders or arms. Angina happens when the blood supply to the muscles of your heart is restricted, due to the narrowing of the blood vessels supplying the heart.
2. WHAT YOU NEED TO KNOW BEFORE YOU USE GLYCERYL
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 anemia.
• 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 hemorrhage (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 (failure of blood circulation).
• If you have toxic pulmonary edema (lung swelling/ fluid)
• If you have a 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
Glyceryl Trinitrate Spray
400 micrograms per metered dose, Sublingual spray
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.
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.
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
Before using GTN spray for the fi first time, check that the spray is
working by pressing the spray 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.
If you use more GTN Spray than you should:
Special treatment is not normally required.
Overdose symptoms are usually the same as the stated side effects.
Some people may experience a reaction similar to shock, with nausea,
weakness, and sweating. If you feel faint sit down and raise your legs.
Contact your doctor if your symptoms do not improve.
Rarely a bluish color to lips/fingers may occur (cyanosis or methemoglobinemia). If this happens contact your doctor immediately.
4. POSSIBLE SIDE EFFECTS
Like all medicines, this medicine can cause side effects, although not
everyone gets them.
If you experience one of the following rare serious side effects
(may affect up to 1 in 1,000 people unless specified), stop taking
GTN Spray immediately and consult your doctor:
• An allergic skin reaction (with or without rashTongue 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 hypoxemia (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) Headache
(may affect up to 1 in 10 people)
Vertigo (spinning sensation), dizziness,
nausea, facial flushing, weakness
(may affect up to 1 in 100 people) Burning sensation, stinging sensation
(may affect up to 1 in 1,000 people)
Severe fall in blood pressure, heart
(may affect up to 1 in 10,000 people) 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 label and carton 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 pressurized 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
tetrafl urethane (the propellant).