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Nitroglycerin overdose

Nitroglycerin is a medicine that helps relax the blood vessels leading to the heart. It is used to prevent and treat chest pain (angina), as well as extremely high blood pressure and other conditions. Nitroglycerin overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

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Poisonous Ingredient

Nitroglycerin

Where Found

Brand names of nitroglycerin tablets include:

• Minitran
• NitroBid
• Nitrodisc
• Nitro-Dur
• Nitrogard
• Nitroglyn
• Nitrolingual pump spray
• Nitromist
• Rectiv

Medicines with other names may also contain nitroglycerin.

Symptoms

Below are symptoms of a nitroglycerin overdose in different parts of the body.

AIRWAYS AND LUNGS

• Shortness of breath
• Slow breathing

EYES, EARS, NOSE, AND THROAT

• Blurred vision
• Double vision
• Involuntary eye movements

HEART AND BLOOD VESSELS

• Being able to feel heartbeat (palpitations)
• Low blood pressure
• Rapid heartbeat or slow heartbeat

NERVOUS SYSTEM

• Convulsions (seizures)
• Coma (lack of responsiveness)
• Confusion
• Dizziness
• Fainting
• Headache
• Weakness

SKIN

• Bluish color to lips and fingernails
• Cold skin
• Flushing

STOMACH AND INTESTINES

• Diarrhea
• Cramping
• Loss of appetite
• Nausea and vomiting

Home Care

Seek medical help right away. Do NOT make a person throw up unless poison control or a health care provider tells you to.

Before Calling Emergency

Determine the following information:

• Person's age, weight, and condition
• The name of the medicine and strength, if known
• Time it was swallowed
• The amount swallowed
• If the medicine was prescribed for the person

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container with you to the hospital, if possible.

The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated. The person may receive:

• Activated charcoal
• Blood and urine tests
• Breathing support, including oxygen and a tube through the mouth into the lungs and breathing machine (ventilator)
• Chest x-ray
• ECG (electrocardiogram, or heart tracing
• Intravenous fluids (IV, or through a vein)
• Laxative
• Medicines to treat symptoms

Outlook (Prognosis)

Deaths from nitroglycerin overdose have occurred, but they are rare.

Very low blood pressure may result from taking nitroglycerin with other medicines whose action also lowers blood pressure, such as drugs used to treat erectile dysfunction.

An overnight hospital stay may be needed if a long-acting nitroglycerine drug preparation caused the overdose.

References

Aronson JK. Nitrates, organic. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:192-202.

Cole JB. Cardiovascular drugs. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 142.

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Review Date: 7/1/2023  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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