NitroMist

NitroMist is a prescription medication used to treat or prevent episodes of angina (sudden chest pain). NitroMist belongs to a group of drugs called nitrates which work by relaxing (widening) blood vessels making it easier for the heart to pump blood.

This medication comes in a spray and is administered on or under the tongue at the first sign of chest pain. The dose may be repeated every 5 minutes as needed. Seek emergency medical attention if the pain persists after 3 doses.

Common side effects of NitroMist include headache, flushing, and low blood pressure. 

NitroMist is a prescription medicine used to treat and prevent angina associated with coronary artery disease (CAD).

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Akrimax Pharmaceuticals, LLC

• Novadel Pharma Inc.

NitroMist may cause the following side effects:

• headache
• flushing (warm or red condition of your skin)
• low blood pressure
• lightheadedness on standing, especially just after rising from a laying or seated position. 
• dizziness
• weakness
• nausea and vomiting
• sweating
• paleness
• fainting

Tell your doctor if you are concerned about any side effects you experience. These are not all the possible side effects of NitroMist. For a complete list, ask your doctor or pharmacist.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• any medicines that are used to treat angina, heart failure, or an irregular heartbeat.
• any medicines that reduce blood pressure.
• any diuretics (water pills).
• medications to treat depression or psychiatric illness.
• ergotamine or similar drugs for migraine headaches.
• aspirin.
• the blood thinner medicine heparin.
• any medicines for erectile dysfunction.

Do not consume alcohol while taking NitroMist, as this can lower your blood pressure.

This is not a complete list of NitroMist drug interactions. Ask your doctor or pharmacist for more information.

Do not use NitroMist if you are allergic to organic nitrates.

You should not use NitroMist if you have the following conditions:

• very recent heart attack
• severe anemia
• increased pressure in the head

Do not use NitroMist with drugs for erectile dysfunction, like Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil), as this may lead to extreme lowering of your blood pressure.

• Do not breastfeed. It is not known if NitroMist will pass through your milk.
• Do not consume alcohol while using NitroMist, as this can lower your blood pressure.
• Do not start any new prescription or non-prescription medicines or supplements, unless you check with your doctor first.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of NitroMist, there are no specific foods that you must exclude from your diet when receiving this medication.

Before using NitroMist, tell your doctor if you are taking:

• any medicines that are used to treat angina, heart failure, or an irregular heartbeat.
• any medicines that reduce blood pressure.
• any diuretics (water pills).
• medications to treat depression or psychiatric illness.
• ergotamine or similar drugs for migraine headaches.
• aspirin.
• the blood thinner medicine heparin.
• any medicines for erectile dysfunction.

Tell your doctor if you are pregnant or plan to become pregnant or if you are breastfeeding.

Tell your doctor if you are pregnant. 

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

NitroMist falls into category C. There are no adequate and well controlled studies in pregnant women. NitroMist should be given to a pregnant woman only if clearly needed.

Tell your doctor if you are breastfeeding. It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when NitroMist is administered to a nursing woman.

Use NitroMist exactly as prescribed.

NitroMist comes in a spray and is administered on or under the tongue at the first sign of chest pain. 

Patients must prime the pump before using NitroMist for the first time.

To Prime NitroMist spray, follow the steps below:

• Do not shake the container.
• Remove the plastic cap from the container
• While holding the container away from yourself and others, press the actuator button 10 times
• Your NitroMist spray is now primed. You are ready to give your first dose.
• If you do not use your NitroMist spray for more than 6 weeks, you will need to prime again by pressing the nozzle button 2 times.

Giving a Dose:

• Hold your NitroMist spray upright with your index finger on top of the actuator button.
• Open your mouth and bring the NitroMist spray as close as possible to your mouth.
• Press the actuator button firmly to release the NitroMist spray(s) onto or under your tongue at the beginning of angina or to prevent an angina attack. 
• Release the actuator button and close your mouth. Do not spit out NitroMist or rinse your mouth for 5 to 10 minutes after using NitroMist.
• If a second dose is needed, repeat steps 1-4.
• Replace the plastic cap

Treatment with nitroglycerin products such as NitroMist may be associated with lightheadedness on standing, especially just after rising from a laying or seated position. To help avoid feeling lightheadedness on standing, patients should be seated when taking NitroMist. This reduces the likelihood of falling due to lightheadedness or dizziness.

Use NitroMist as directed by your doctor. 

At the onset of an attack, administer one metered spray or two metered sprays on or under the tongue. A spray may be repeated approximately every 5 minutes as needed.

Maximum of 3 metered sprays are recommended within a 15-minute period. If chest pain persists after a total of 3 sprays, call for medical attention.

To prevent an attack, NitroMist may be used prophylactically 5 minutes to 10 minutes before engaging in activities that might precipitate an acute attack.

If you use too much NitroMist, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store NitroMist upright at room temperature 59°F to 85°F (15°C to 30°C).
• NitroMist is flammable. Do not burn the NitroMist container after use, and do not spray directly toward flames.
• Do not forcefully open a NitroMist container.
• Keep NitroMist and all medicines out of the reach of children