The most common side effects of the Nitroglycerin Transdermal patch are headache and a feeling of light-headedness or dizziness. These occur because nitroglycerin works by widening your blood vessels, which lowers blood pressure and can affect blood flow.
The central challenge is distinguishing between the very common, often manageable side effects like headaches and the rare but serious symptoms that require immediate medical attention. Understanding this distinction is key to using the medication safely and effectively.

Differentiating Common vs. Serious Reactions
It's essential to recognize what is a typical response to the medication versus what could signal a significant health issue. Most side effects are related to the drug's primary function of vasodilation (widening blood vessels).
Frequent and Typically Mild Side Effects
Headache is the most frequently reported side effect. These headaches can be severe but often diminish in intensity as your body adjusts to the medication over several days or weeks.
Dizziness and light-headedness are also very common. This is a direct result of the medication lowering your blood pressure. You should be cautious when standing up from a sitting or lying position.
Skin irritation at the patch site is another expected effect. You may notice redness, itching, or a mild rash where the patch is applied.
Signs That Require Immediate Medical Attention
While less common, some side effects are signs of a serious problem. Contact your doctor or seek emergency care immediately if you experience any of the following.
Symptoms of a severe allergic reaction include hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.
Worsening cardiovascular symptoms are a critical warning. This includes a worsening of your chest pain (angina), a pounding or fluttering heartbeat, a very slow heart rate, or chest pain that spreads to your jaw or shoulder.
Signs of extremely low blood pressure can include feeling like you might pass out, nausea, and sweating. These symptoms, especially when accompanying chest pain, require an urgent response.
Understanding Critical Contraindications
A side effect profile is incomplete without understanding who should not use the medication at all. These situations, known as contraindications, are critical for avoiding life-threatening adverse events.
Interaction with PDE-5 Inhibitors
You must never use nitroglycerin if you have recently taken a PDE-5 inhibitor. This class of drugs includes medications for erectile dysfunction like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).
Combining these drugs with nitroglycerin can cause a sudden and severe drop in blood pressure, leading to fainting, stroke, or heart attack.
Interaction with Riociguat
Concomitant use with riociguat, a medication used to treat pulmonary hypertension, is also contraindicated. This combination can lead to dangerously low blood pressure (hypotension).
Hypersensitivity Concerns
Do not use this medication if you have a known allergy or hypersensitivity to organic nitrates or to the adhesives used in the transdermal patch.
How to Manage Side Effects and When to Act
Your experience with this medication can be managed safely through awareness and clear communication with your healthcare provider.
- If your primary issue is a recurring headache: Discuss this with your doctor. They may recommend an over-the-counter pain reliever or confirm that this is a temporary adjustment period.
- If you are experiencing mild skin irritation: Ensure you are rotating the application site with each new patch and applying it to a clean, dry, and hairless area to minimize irritation.
- If you experience any serious symptoms (like worsening chest pain or signs of an allergic reaction): This is an emergency. Remove the patch and seek immediate medical help.
Always prioritize open communication with your healthcare provider to manage your treatment safely and effectively.
Summary Table:
| Side Effect Type | Common Examples | Action Required |
|---|---|---|
| Common & Often Mild | Headache, Dizziness, Skin Irritation | Manage with doctor's advice; often temporary. |
| Serious & Requiring Urgent Care | Severe Allergic Reaction, Worsening Chest Pain, Extremely Low Blood Pressure | Remove patch and seek immediate medical help. |
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