Nitro-Dur (Nitroglycerin) for Heart Disease

What Members SayTop TipsSide EffectsFAQs

Nitro-Dur (nitroglycerin) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to prevent chest pain called angina in people with coronary artery disease.

What Members Say

MHT logo These insights are based on 121 comments about Nitro-Dur from MyHeartDiseaseTeam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Long-acting nitroglycerin can reduce chest pain frequency.
Severity of chest pain can also lessen with long-acting nitroglycerin.
A patch can feel convenient because it lasts longer than a pill.

Considerations:

Headaches are common and can be severe, especially early on.
Nitro-Dur requires a daily patch-on and patch-off schedule to help prevent tolerance.
Nitro-Dur does not work for an acute angina attack.

How Nitro-Dur Works and How It’s Taken

Nitro-Dur is a nitrate medicine. It relaxes blood vessels, especially veins. This reduces the amount of blood returning to the heart. It also lowers the heart’s workload and need for oxygen. These effects help prevent chest pain called angina.

Doctors prescribe Nitro-Dur to help prevent angina caused by coronary artery disease.

Nitro-Dur is a skin patch. An appropriate schedule is to wear the patch for 12 to 14 hours each day, followed by 10 to 12 hours without a patch. This patch-free time helps prevent the body from becoming less responsive to the medicine.

You may shower while wearing Nitro-Dur. Apply it to skin that is clean, dry, and reasonably free of hair.

After removing the patch, the skin may feel warm or look red or discolored. This is usually normal and should go away soon. A soothing lotion may be used if the skin feels dry. Tell your doctor if skin discoloration or a rash does not go away.

Typical Dosing for Angina

The recommended starting dose for Nitro-Dur is 0.2 milligrams per hour to 0.4 milligrams per hour.

Doses from 0.4 milligrams per hour to 0.8 milligrams per hour have shown continued benefit for 10 to 12 hours each day. The daily schedule may include wearing the patch for 12 to 14 hours, followed by 10 to 12 hours without a patch.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Top Advice From Members on Nitro-Dur

MHT logo These insights are based on 121 comments about Nitro-Dur from MyHeartDiseaseTeam members.

Members who use Nitro-Dur often say it helps to set realistic expectations, pay attention to side effects, and keep their cardiologist updated on symptoms. Several members also describe asking about long-acting nitroglycerin options and using Nitro-Dur differently from fast-acting nitroglycerin used for sudden symptoms.

1

Be patient if relief is not immediate.
“Give the patch time to work. It took about three to four days for it to start working.”
2

Keep track of headaches and lightheadedness.
“The patch does work. The side effects are headaches, which is true cuz I’m getting them, so hopefully as time goes by it will get better.”
3

Take care of your skin and rotate patch sites.
“After you remove Nitro-Dur, your skin may feel warm and appear red. This is normal. The redness will disappear in a short time.”

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Nitro-Dur Side Effects

In clinical studies of Nitro-Dur, the most common side effects occurred in about 2 percent to 63 percent of people. These include:

Headache
Lightheadedness
Low blood pressure and/or fainting
Increased angina (more chest pain)

Serious Side Effects and Warnings

Nitro-Dur can cause serious side effects that may require immediate medical attention. These include:

Severe low blood pressure — Blood pressure can drop a lot, especially when standing up.
Fainting — Loss of consciousness can occur.
Increased angina — Chest pain may worsen.
Rebound high blood pressure — Blood pressure may rise after stopping nitrates.
Methemoglobinemia — This rare blood condition can reduce oxygen delivery in the body.
Severe allergic reaction — Allergic reactions, including anaphylactoid reactions (a serious allergy that can cause trouble breathing, swelling, or widespread rash), can occur.
Allergic skin reactions — Contact dermatitis or a fixed drug eruption (a recurring rash in the same spot) can occur.

Get medical help right away if you think you are having a serious reaction.

What To Know Before Taking Nitro-Dur

Do not use Nitro-Dur if you are allergic to nitroglycerin or to the adhesive in the patch.

Before using Nitro-Dur, tell your doctor if you:

Have low blood pressure
May be low on body fluids
Have hypertrophic cardiomyopathy, a condition that affects the heart muscle
Are pregnant or plan to become pregnant
Are breastfeeding
Are age 65 or older

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not use Nitro-Dur with:

PDE-5 inhibitors, such as avanafil, sildenafil, tadalafil, or vardenafil
Soluble guanylate cyclase stimulator, such as riociguat

These combinations can cause dangerously low blood pressure, fainting, or reduced blood flow to the heart.

It is important not to miss a day of Nitro-Dur treatment. Do not change your schedule unless your doctor gives you special instructions.

Nitro-Dur should be used during pregnancy only if clearly needed. Caution is advised during breastfeeding.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Nitro-Dur for angina?

In studies, patches that delivered at least 0.4 milligrams per hour worked better than placebo. The benefit started about two hours after the patch was applied and lasted until about 10 to 12 hours after application.

Lower-dose patches were not studied as much. In one large study, a 0.2 milligrams per hour patch showed less antianginal activity than placebo.

Nitro-Dur helps prevent angina. It does not work fast enough to stop an angina attack that has already started.

How long does Nitro-Dur take to work for angina?

In clinical studies, Nitro-Dur began showing antianginal activity about two hours after application. Its effect continued until about 10 to 12 hours after the patch was applied.

Nitro-Dur is not fast enough to treat an acute angina attack.

Can Nitro-Dur be used with other medicines for angina?

Some combinations should be avoided. Do not use Nitro-Dur with phosphodiesterase inhibitors such as sildenafil, tadalafil, or vardenafil. Do not use it with riociguat. These combinations can cause a severe drop in blood pressure.

Other medicines that widen blood vessels may increase Nitro-Dur’s effects. Alcohol can also increase this effect. Tell your doctor about all medicines you take.