Dosage and Directions for Use

Always use Glyceryl Trinitrate Sublingual Spray exactly as instructed by your doctor or pharmacist. Check the patient information leaflet supplied with the medicine before use.

For the Relief of an Angina Attack

1. Sit down before using the spray, as it may make you feel dizzy or faint.
2. Hold the container upright and position it close to your mouth.
3. Hold your breath and spray one or two metered doses under your tongue.
4. Close your mouth immediately after each spray.
5. Do not inhale the spray.
6. If the symptoms do not resolve, the dose may be repeated at five-minute intervals, up to a maximum total of three sprays within 15 minutes.
7. If the symptoms have not resolved after the maximum total of three sprays, seek immediate medical attention.

For the Prevention of Angina

Use one or two sprays under the tongue approximately two to three minutes before an activity that is likely to cause angina, such as physical exertion or exposure to cold.

Do not use more than the prescribed amount. After using the spray, remain seated and stand up slowly to reduce the risk of dizziness or fainting.

Warnings and Precautions

Do not use this medicine if:

• You are allergic to glyceryl trinitrate or any of the other ingredients.
• You have severe low blood pressure, circulatory collapse or shock caused by low blood pressure.
• You have severe anaemia.
• You have certain heart conditions, including constrictive pericarditis, severe narrowing of the heart valves or hypertrophic obstructive cardiomyopathy.
• You have an extremely slow heart rate.
• You have had a recent brain or head injury, bleeding in the brain or increased pressure inside the skull.
• You have toxic pulmonary oedema.
• You are taking riociguat.
• You are taking sildenafil, tadalafil, vardenafil or another phosphodiesterase-5 inhibitor used for erectile dysfunction or pulmonary hypertension. Combining these medicines with glyceryl trinitrate may cause a dangerous fall in blood pressure.

Speak to your doctor or pharmacist before use if you have glaucoma, low blood pressure, liver or kidney problems, an underactive thyroid, recently had a heart attack, have heart failure or have any other serious heart or circulatory condition.

Tell your doctor or pharmacist about all other medicines you take, particularly blood-pressure medicines, heart medicines, diuretics, tricyclic antidepressants, antipsychotic medicines, heparin, dihydroergotamine or other nitrate medicines.

Alcohol may increase the blood-pressure-lowering effect of this medicine and make dizziness or fainting more likely. Avoid or limit alcohol as directed by your healthcare professional.

Glyceryl trinitrate may cause headache, dizziness, weakness, flushing, nausea or fainting. Do not drive, operate machinery or perform hazardous tasks if you are affected.

Consult your doctor before use if you are pregnant, planning a pregnancy or breastfeeding. This medicine should not be used by children or adolescents under 18 years of age unless specifically directed by a specialist.

The spray is pressurised and flammable. Do not use it near cigarettes, naked flames, sparks or incandescent materials. Do not pierce or burn the container, even when empty.

Continuous or excessive use of nitrate medicines can reduce their effectiveness. Use only as prescribed.

Emergency Warning

Angina-like chest pain that is severe, worsening, different from usual or not relieved by the prescribed doses may be a medical emergency. Seek emergency medical assistance immediately.

Ingredients

Active ingredient: Each metered spray contains 400 micrograms of glyceryl trinitrate.

Other ingredients: Peppermint oil, ethanol and 1,1,1,2-tetrafluoroethane, which is used as the propellant.

Each spray contains approximately 7.5mg of ethanol. Ingredients may vary between manufacturers, so always check the packaging and patient information leaflet supplied with the specific product.

Storage Information

• Keep out of the sight and reach of children.
• Do not store above 25°C.
• Do not refrigerate or freeze.
• Protect the pressurised container from temperatures above 50°C.
• Do not use after the expiry date printed on the packaging.
• Ask a pharmacist how to dispose of unwanted or expired medicine safely.