What is the immediate at-home treatment for angina?

Immediate At-Home Treatment for Angina

For immediate at-home treatment of angina, take one sublingual nitroglycerin tablet (0.3-0.4 mg) under the tongue at the first sign of chest pain, which may be repeated every 5 minutes for a maximum of 3 doses, and call 911 if pain persists after 3 tablets or 15 minutes. 1, 2

Initial Response to Angina Attack

When experiencing angina symptoms:

1. Stop all physical activity and rest immediately, preferably in a sitting position
2. Take one sublingual nitroglycerin (NTG) tablet and let it dissolve under the tongue or in the buccal pouch
3. Wait 5 minutes to assess if symptoms improve
4. If symptoms persist, take a second NTG tablet
5. If needed, take a third NTG tablet after another 5 minutes
6. Call 911 immediately if:
   • Pain is not relieved after 3 tablets in 15 minutes
   • Pain is more severe than usual
   • Pain feels different than typical angina episodes 1

Proper Nitroglycerin Use

• Keep nitroglycerin in its original glass container with the cap tightly closed 2
• Do not chew, crush, or swallow the tablets 2
• Sit down when taking nitroglycerin to prevent falls from potential lightheadedness 2
• You may feel a burning or tingling sensation under your tongue - this is normal 2
• Nitroglycerin can be used prophylactically 5-10 minutes before activities that might trigger angina 2

When to Seek Emergency Medical Attention

Immediate medical attention is required if:

• Chest pain/discomfort is unimproved or worsening 5 minutes after the first NTG dose 1
• Symptoms persist after taking 3 NTG tablets within 15 minutes 1
• Pain is more intense, lasts longer, or feels different than usual angina 1
• Symptoms include shortness of breath, nausea, lightheadedness, or sweating 3
• Angina occurs at rest (without physical exertion) 1

Important Cautions

• Do not take nitroglycerin if you have recently taken medications for erectile dysfunction (e.g., sildenafil, tadalafil, vardenafil) as this can cause dangerous drops in blood pressure 2
• Do not take nitroglycerin if you have severe hypotension (low blood pressure), recent head injury, or severe anemia 2
• Avoid alcohol when taking nitroglycerin as it may worsen hypotension 2
• If you experience severe headache, excessive lightheadedness, or fainting after taking nitroglycerin, inform your healthcare provider 2

For Patients with Known Chronic Stable Angina

• Ensure you have an adequate supply of sublingual nitroglycerin tablets 1
• Replace nitroglycerin tablets every 6 months or sooner if they no longer cause a tingling sensation 2
• If your pattern of angina changes (becomes more frequent, severe, or occurs with less exertion), contact your physician promptly 1
• Continue taking all prescribed medications for angina management, including daily aspirin (75-100 mg), beta-blockers, and/or calcium channel blockers 1, 3

Remember that sublingual nitroglycerin provides temporary relief but does not treat the underlying cause of angina. Regular medical follow-up is essential for proper management of coronary artery disease.