When This Medicine Should Not Be Used:
You should not use this medicine if you have had an allergic reaction to nitroglycerin or similar medicines (such as Isordil®, Sorbitrate®, or Monoket®). You should not use this medicine if you are also using Viagra®, Cialis®, or Levitra®.

How to Use This Medicine:
Tablet, Long Acting Capsule, Long Acting Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Most people use this medicine for only part of the day or as needed.
• It is best to take the extended-release capsule or extended-release tablet on an empty stomach with a full glass of water.
• Swallow the extended-release capsule or extended-release tablet whole. Do not crush, chew, or break.
• Place the buccal tablet between your gum and upper cheek or upper lip. Let the tablet dissolve slowly in your mouth over several hours. Do not chew, crush, or swallow the tablet or put it under your tongue. Avoid drinking anything hot while the tablet is in your mouth and do not touch the tablet with your tongue.
• Do not go to sleep with a buccal tablet in your mouth.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using aspirin, alteplase (Activase®), heparin, diuretics or "water pills" (such as furosemide, hydrochlorothiazide, Hyzaar®), heart or blood pressure medicine (such as atenolol, metoprolol, verapamil, Adalat®, Cardizem®, Lotrel®, Plendil®, Procardia®, Tiazac®, Toprol®), phenothiazines (such as Compazine®, Phenergan®, Serentil®, Thorazine®), ergot medicines (such as Cafergot® or Wigraine®), or other nitrates (such as isosorbide).
• If you are using the buccal tablet, tell your doctor if you are also using any medicine that makes your mouth dry, such as some medicines that treat depression (such as amitriptyline, imipramine, Norpramin®, Vivactil®).
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have low blood pressure, congestive heart failure (CHF), enlarged heart, digestion problems, or kidney disease.
• Medicines that treat chest pain sometimes cause headaches. These headaches are a sign that the medicine is working. Do not stop using the medicine or change the time you use it in order to avoid the headaches. If the pain is severe, talk to your doctor.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• This medicine may make you dizzy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert. You may feel lightheaded when standing, so stand up slowly.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in face or hands, swelling or tingling in the mouth or throat, tightness in chest, trouble breathing
• Blue lips or fingernails, trouble breathing
• Blurred vision, dry mouth
• Severe or ongoing dizziness, lightheadedness, or fainting
• Slow heartbeat, increased chest pain
• Throbbing, severe, or ongoing headache, confusion, low fever, or trouble seeing

If you notice these less serious side effects, talk with your doctor:

• Facial flushing, nausea, vomiting, weakness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088