When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to nitroglycerin or skin patch adhesive.

How to Use This Medicine:
Patch

• Your doctor will tell you how many patches to use, where to apply them, and how often to apply them. Do not use more patches or apply them more often than your doctor tells you to.
• The skin patch is usually worn for 12 to 14 hours each day, followed by a patch-free period of 10 to 12 hours. Carefully follow your doctor's instructions about how long to wear the patch.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
• Wash your hands with soap and water before and after applying a patch.
• Leave the patch in its sealed wrapper until you are ready to put it on. Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors. Do not use any patch that has been cut by accident.
• The patient instructions will show the body areas where you can wear the patch. When putting on each new patch, choose a different place within these areas. Do not put the new patch on the same place you wore the last one. Be sure to remove the old patch before applying a new one.
• Do not put the patch over burns, cuts, or irritated skin.
• Put on a new patch if the old one has fallen off and cannot be reapplied.
• Missed dose: If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.
• Store the patches at room temperature in a closed container, away from heat, moisture, and direct light.

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

• Do not use this medicine if you are also using riociguat, sildenafil, tadalafil, or vardenafil.
• Some medicines and foods can affect how nitroglycerin works. Tell your doctor if you are using blood pressure medicine or if you drink alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding. Also tell him if you had a heart attack or you have low blood pressure, heart failure, an enlarged heart, or other heart problems.
• This medicine may cause the following problems:
  
  • Severe low blood pressure
  • Worsening of chest pain caused by an enlarged heart
• 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 take it in order to avoid the headaches. Ask your doctor if you can take aspirin or acetaminophen to treat the headache.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine may make you dizzy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. You may feel lightheaded when standing, so stand up slowly. Drinking alcohol may make these symptoms worse.
• Tell any doctor who treats you that you are using this medicine. You may need to remove the patch before certain medical tests.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Fold the used patch in half with the sticky sides together. Throw any used patch away so that children or pets cannot get to it. You will also need to throw away old patches after the expiration date has passed.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

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 your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Increased chest pain, fast or slow heartbeat
• Severe headache
• Severe or ongoing dizziness, lightheadedness, or fainting

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

• Mild headache
• Rash or itching where the patch is worn
• Sweating, warmth or redness in your face, neck, arms, or upper chest

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