Protocol Status: PUBLISHED
Protocol:
Version: 2026.01
Effective Date:
Last Reviewed:
Medical Director Approval:
Clinical Note: This content reflects current GCEMS clinical guidelines as of the dates listed above. If content appears inconsistent with current policy, use the most recent approved guideline and notify leadership for correction.

NITROGLYCERIN

(Nitro-Bid, Nitrostat, Nitro)

 

GCEMS Protocol:

 

  • Acute Coronary Syndrome
  • Hypertensive Crisis
  • CHF/Pulmonary Edema

 

INDICATIONS:

 

  • Chest pain consistent with acute coronary symptoms.
  • Pulmonary edema

 

DOSAGE:

 

ADULT:

 

Spray:

 

  • 0.4 mg/metered dose, Spray 1 or 2 metered doses directly on the oral mucosa under the tongue; may repeat every 5 minutes while symptoms persist

 

Sublingual:

 

  • Tablet 0.3 - 0.4 mg; may be repeated every 5 minutes while symptoms persist.

 

Ointment Paste:

 

  • Apply in ½” to 1” thin layer to patient’s skin by means of the dose measured applicator supplied with the tube

 

PEDIATRIC:

 

  • NOT APPROVED

 

CONTRAINDICATIONS:

 

  • Increased Intracranial Pressure (ICP)
  • Hypotension/Shock
  • Glaucoma
  • Use of some erectile dysfunction medications within the last 36 hours

 

SIDE EFFECTS:

 

  • Headache
  • Dizziness
  • Hypotension