Nitrolingual Special Precautions

Exercise caution before using Nitrolingual Spray in case of constrictive pericarditis (inflammation of the sac surrounding the heart) or pericardial tamponade.
Exercise caution before using Nitrolingual Spray in case of low filling pressure, e.g. in acute heart attack, impaired function of the heart's left chamber (left-sided heart failure). A reduction in systolic blood pressure below 90 mmHg should be avoided.
Exercise caution before using Nitrolingual Spray in case of narrowing of the heart valves in the heart's left chamber (aortic and/or severe mitral valve stenosis).
Exercise caution before using Nitrolingual Spray in patients who are prone to orthostatic hypotension (a drop in blood pressure upon standing).
Exercise caution before using Nitrolingual Spray in case of a disorder affecting blood flow through the brain, as its symptoms can be brought on by low blood pressure (hypotension).
Exercise caution before using Nitrolingual Spray in case of early stages of glaucoma (increased inner eye pressure).
Exercise caution before using Nitrolingual Spray in case of enlarged left heart chamber (left ventricular hypertrophy) combined with narrowing of the aortic valve (aortic valve stenosis). In such cases, the use of Nitrolingual Spray can compromise blood supply to the heart due to a rapid pulse (tachycardia) and reduced diastolic aortic pressure.
Nitrolingual Spray contains small amounts (less than 10 mg per dose) of alcohol (ethanol).
Driving and using machines: This medicine may, even when used as directed, alter responsiveness to such an extent that the ability to drive, use machines or work without a secure foothold is impaired. Patients should wait for at least 5 minutes after using Nitrolingual Spray before driving or using machines. If patients feel weak, dizzy or unwell, they should wait until they feel better. Patients should be particularly careful at the start of treatment, whenever there is a dose increase or change in medication and in combination with alcohol.