Nitrolingual Pumpspray (Nitroglycerin) for Angina

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Nitrolingual Pumpspray (nitroglycerin) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to relieve chest pain caused by coronary artery disease. It may also be taken before activities that could trigger an angina attack.

What Members Say

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

Benefits:

Chest pain often eases after a dose.
Using a dose before activity can help prevent angina symptoms.
The spray can be used quickly at the start of symptoms.

Considerations:

Headache is a common side effect, especially when starting treatment.
Dizziness or lightheadedness can happen as blood pressure drops.
Relief is not always complete, and chest pain can continue after a dose.

How Nitrolingual Pumpspray Works and How It’s Taken

Nitrolingual Pumpspray is a nitrate medicine that releases nitric oxide. This relaxes and widens blood vessels, lowers the heart’s workload, and reduces the amount of oxygen the heart needs.

Doctors prescribe Nitrolingual Pumpspray for quick relief during an angina attack. Angina is chest pain caused by coronary artery disease. It may also be taken before an activity that could trigger an attack.

Nitrolingual Pumpspray is sprayed on or under the tongue. It is usually used at the start of chest pain or five to 10 minutes before an activity that may trigger chest pain.

Typical Dosing for Angina

The recommended dose is one or two metered sprays on or under the tongue at the start of an attack. A spray may be repeated about every five minutes as needed. Do not use more than three sprays within 15 minutes.

Nitrolingual Pumpspray may also be used five to 10 minutes before an activity that could trigger an attack. Get emergency medical help right away if chest pain continues after a total of three sprays.

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 Nitrolingual Pumpspray

MHT logo These insights are based on 121 comments about Nitrolingual Pumpspray from MyHeartDiseaseTeam members.

Members who use Nitrolingual Pumpspray often talk about paying close attention to how quickly it helps, what side effects show up, and when symptoms seem to be happening more often. Many also describe checking in with their cardiologist when chest pain changes, when they need nitroglycerin more often, or when longer-acting nitrate treatment may need adjustment.

1

Talk to your doctor if you need Nitrolingual Pumpspray more often.
“Yes. So far, nitroglycerin spray under my tongue has helped. I’m just concerned because it’s happening more often, which is almost every single day.”
2

Be aware of headaches and lightheadedness as possible side effects.
“Yesterday I had to take some nitroglycerin for the first time. It worked, but it gave me a headache.”
3

Keep your cardiologist updated when Nitrolingual Pumpspray does not fully help.
“I took the Nitrolingual Pumpspray today which did not help. I called my cardiologist office about my continuous chest pressure. I had to go into the office to have a stress EKG test, I didn’t pass the test. They gave me nitroglycerin IV, I felt better after.”

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Nitrolingual Pumpspray Side Effects

In clinical studies of Nitrolingual Pumpspray, the most common side effects occurred in more than 2 percent of people. These include:

Headache
Dizziness
Paresthesia (tingling or pins-and-needles feeling)

Serious Side Effects and Warnings

Nitrolingual Pumpspray can cause serious side effects that may require immediate medical attention. These include:

Severe low blood pressure — Hypotension can cause nausea, vomiting, weakness, pale skin, sweating, worsening chest pain, or fainting.
Syncope (fainting) — Passing out has been reported due to nitrate-related blood vessel widening.
Worsening angina in hypertrophic obstructive cardiomyopathy — Nitroglycerin may make chest pain worse with this heart muscle condition.
Allergic reaction — Hypersensitivity reactions can occur.
Increased intracranial pressure — Nitrolingual Pumpspray may trigger or worsen pressure in the head.

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

What To Know Before Taking Nitrolingual Pumpspray

Tell your doctor if you have any allergies to nitroglycerin, other nitrates or nitrites, or any ingredients in Nitrolingual Pumpspray.

Before using Nitrolingual Pumpspray, tell your doctor if you:

Have low blood pressure or may be low on body fluids
Have severe anemia
Have increased pressure in your head, such as from a brain bleed or head injury
Have acute circulatory failure or shock
Have hypertrophic obstructive 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.

Also let your doctor know if you take:

Medicines that lower blood pressure
Beta-blockers
Calcium channel blockers
Nitrates
High-dose aspirin
Ergotamine or related medicines
Tissue-type plasminogen activator, also called t-PA

Do not use Nitrolingual Pumpspray 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.

Do not use Nitrolingual Pumpspray if you have severe anemia, increased pressure in the head, acute circulatory failure or shock, or an allergy to nitroglycerin or related medicines.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Nitrolingual Pumpspray, talk with your doctor about the risks and benefits.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Nitrolingual Pumpspray for angina?

In a study of 51 people with chest pain caused by exercise, Nitrolingual Pumpspray helped people exercise longer. It also delayed the start of chest pain and certain changes on an electrocardiogram (ECG) compared with placebo. Benefits were seen with single doses of 0.2, 0.4, 0.8, and 1.6 milligrams.

How long does Nitrolingual Pumpspray take to work for angina?

The study does not state exactly how long it takes to relieve chest pain. In one study, the average time to reach the highest blood level after a single 0.8 milligram dose was 7.5 minutes.

To help prevent an angina attack, Nitrolingual Pumpspray may be used five to 10 minutes before an activity that could trigger chest pain.

Can Nitrolingual Pumpspray cause headaches or dizziness in people with angina?

Yes. In clinical studies, headache, dizziness, and tingling or a pins-and-needles feeling occurred more often with Nitrolingual Pumpspray than with placebo.

Headaches are related to the dose. They may be severe or last for a while when treatment begins, but they usually lessen with continued use.