The Basics

What is Nitroglycerin?

Used to treat episodes of angina in people who have coronary artery disease; also used just before activities that may cause episodes of angina.

Brand names for Nitroglycerin

Nitro-Dur

How Nitroglycerin is classified

Cardiovascular Agents, Vasodilator Agents

Nitroglycerin During Pregnancy

Nitroglycerin pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Nitroglycerin while pregnant

Animal teratology studies have not been conducted with nitroglycerin transdermal systems. Teratology studies in rats and rabbits, however, were conducted with topically applied nitroglycerin ointment at doses up to 80 mg/kg/day and 240 mg/kg/day, respectively. No toxic effects on dams or fetuses were seen at any dose tested. There are no adequate and well-controlled studies in pregnant women. Nitroglycerin should be given to a pregnant woman only if clearly needed. Nursing Mothers It is not known whether nitroglycerin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when nitroglycerin is administered to a nursing woman. Pediatric Use Safety and effectiveness in pediatric patients have not been established. Geriatric Use Clinical studies of NITRO-DUR Transdermal Infusion System did not include sufficient information to determine whether subjects 65 years and older respond differently from younger subjects. Additional clinical data from the published literature indicate that the elderly demonstrate increased sensitivity to nitrates, which may result in hypotension and increased risk of falling. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of the decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Taking Nitroglycerin While Breastfeeding

What are recommendations for lactation if you're taking Nitroglycerin?

Topical use of nitroglycerin for anal fissures by nursing mothers appears to have no adverse effects on their breastfed infants. Topical use on the nipples has been used for alleviation of Raynaud phenomenon of the nipples, but only after cessation of breastfeeding.[1] Nitroglycerin should not be used topically on the nipples during breastfeeding. Sublingual and intravenous nitroglycerin have not been studied during breastfeeding. Observe infants for flushing and discomfort after breastfeeding.

Maternal / infant drug levels

Topical use of nitroglycerin for anal fissures by nursing mothers appears to have no adverse effects on their breastfed infants. Topical use on the nipples has been used for alleviation of Raynaud phenomenon of the nipples, but only after cessation of breastfeeding.[1] Nitroglycerin should not be used topically on the nipples during breastfeeding. Sublingual and intravenous nitroglycerin have not been studied during breastfeeding. Observe infants for flushing and discomfort after breastfeeding.

Possible effects of Nitroglycerin on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Nitroglycerin

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. O’Sullivan S, Keith MP. Raynaud phenomenon of the nipple: a rare finding in rheumatology clinic. J Clin Rheumatol. 2011;17:371-2. PMID: 21946463
2. Taylor T, Kennedy D. Safety of topical glyceryl trinitrate in the treatment of anal fissure in breastfeeding women. Birth Defects Research Part a-Clinical and Molecular Teratology. 2008;82:411. Abstract. DOI: doi:10.1002/bdra.20478

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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