What are the instructions for patients wearing nitroglycerin (nitro) patches?

Patient Instructions for Wearing Nitroglycerin Patches

Nitroglycerin patches should be applied for 12-14 hours daily and then removed for 10-12 hours (typically overnight) to avoid developing nitrate tolerance. 1, 2

Application Instructions

• Apply nitroglycerin patches to clean, dry, hairless skin areas, avoiding scars, cuts, or irritated skin 3
• Use patches with a dosage of at least 10 mg for effective treatment of angina symptoms 4, 2
• Apply the patch at the same time each morning and remove it at the same time each evening to maintain consistent blood levels 2, 5
• Rotate application sites daily to prevent skin irritation 3
• Avoid touching the medication surface of the patch during application 3

Timing and Duration

• Apply patches for 12-14 hours during the day and remove for 10-12 hours at night (patch-free interval) 1, 2
• This intermittent schedule helps prevent nitrate tolerance, which occurs with continuous 24-hour application 1, 5
• Research shows that continuous 24-hour application leads to complete loss of effectiveness within 24-48 hours 6, 7
• The patch-free period should be overnight when angina attacks are typically less frequent 1

Important Precautions

• Do not use nitroglycerin patches within 24 hours of taking sildenafil (Viagra), 48 hours of tadalafil (Cialis), or while taking vardenafil (Levitra) as this can cause dangerous drops in blood pressure 3
• Keep sublingual nitroglycerin available for breakthrough angina pain even when using patches 4
• For angina lasting more than 1 minute, use sublingual nitroglycerin; if pain doesn't subside within 3-5 minutes, call emergency services immediately 4
• If you experience persistent headaches, dizziness, or light-headedness, contact your healthcare provider 4

Monitoring Effectiveness

• Be aware that changes in the pattern or severity of angina (more frequent, more severe, occurring with less effort or at rest) require immediate medical attention 4
• Report any skin irritation, persistent headaches, or dizziness to your healthcare provider 4, 3
• Do not stop using patches suddenly; consult your healthcare provider before discontinuing 3

Common Side Effects

• Headache is the most common side effect and usually diminishes with continued use 4
• Dizziness or light-headedness may occur, especially when standing up quickly 4, 3
• Skin redness or irritation at the application site may develop 3