Glycerol Trinitrate headaches

Hi All. My GP has given me a glycerol Trinitrate spray for angina pain which works really well but gives me a hammering headache and makes me dizzy. I understand these side effects are normal and usually go away when you get used to the spray, can anyone who uses this spray advise how long it took them to get used to it? Thanks!

[MichaelJH Heart Star]

Whilst I was awaiting my bypass the second cardiolgist put me on an anti-anginal, Diltiazem. This was very effective but I had a few side effects so was changed to Isosorbide Mononitrate which was slightly less effective. It might be worth running these past your GP/cardiologist.

Have you a timescale for your bypass?

[Hidden in reply to MichaelJH]

Thanks for the advice Michael. Waiting for a date for my bypass but have been put on urgent waiting list and advised by the cardiac surgeon it will be before Xmas.

[Stumpy47]

I was recently prescribed gtn spray & isosorbide after my PM was fitted, the gtn spray works quickly enough & yes those headaches are a nuisance ( not sure if they ever stop frankly). I had real problems with the isosorbide peeing freely was almost impossible I also had pain in the lower gut & bowel motions were loose!! I persevered for 2 weeks & then asked my Dr if I could come off them & just rely on gtn spray which I did, have felt much better after it was out of my system. I find the spray works well despite those banging headaches, but might have to have an alternative to isosorbide!

[Arty56]

Hi, I have to use gtn for angina regularly without it who knows, first time I hadn't been prescribed yet, it was bad. Anyway glad you have one keep it close by best to have 3 or so, so you can get to it quickly before, it takes hold properly.

Yes the headaches do get better, the nausea gets better and the opening up of arteries/vessels in the brain is not so intense. You will not feel quite so tired as well, although you will need to sit or lie down peacefully after which helps. The more you use it, the more confident you feel that it will stop the pain, but, of course you are never quite, sure, iv had only one episode where it didn't work although I did the usual second spray and waited, stayed in hospital overnight, but OK. Got some new meds. Over time you will get used to it more, if your having a bad time of it and having more attacks advise who your with and give them the nod if you need an ambulance, but hopefully gtn works anyway it usually does good luck with everything x

[Gjkas]

Hi ,to be honest, i don't think that the headaches ever stop. Ive been using the Spray for about 10 years BUT, only when absolutely necessary. Because it gives me such a banging headache. I am also on Isosorbide Monotrate, it does the same job as the Spray. But its a slow release tablet that i take every morning I am also on Amlodopine ,Bisoporol, and Aspirin. .

Hope you don't have to wait too long for your Bypass Operation.

Good Luck 👍 and wish you a

Speedy Recovery.x.

[Hidden]

Thanks all for the comments and best wishes to you all. Yeah, bit of a double edged sword isn't it? Angina pain or banging headache from gtn, although I will take the headache over the angina pain anytime.

Am on lisinopril for my blood pressure, a statin and aspirin as well. God, don't we all end up rattling with the amounts of meds we have to take!

[Jro77]

My Dr advised that the GTN opens up the vessels and the rush of blood gives the headaches & dizziness.

Depends which make they give, one of them really stings under my tongue. But, still better than the angina pain.

[Parminter]

The headache is a sign that the spray is working. Try to welcome it as a lovely big fat discomfort.

If it stops your med may be out of date or no longer working and you don't want that.

There is absolutely no way the drug can hit your coronary arteries but not your head, nor should it.

If you get dangerously dizzy perhaps the dose is too high - run it past your doctor.

[Oviston]

Drink lots of water, it helps

[Grayjay]

Hi Judge,

I find that it's the certain make that gives me a head ache and you may find if you get another type it wont affect you so much. Presently I'm using Nitrolingual which doesn't affect me at all but Nitromin will. Ask your chemist for an alternative if not go elsewhere. 🤯

[Sunnie2day in reply to Grayjay]

Agree about the NitroLingual - after the first five or six uses, no side effects at all, just near immediate relief from the angina pain.

[bee2]

I had Chronic Migraine for years and took daily migraine meds which eventually caused my first heart attack. I was then told no migraine meds ever again so learned to try to avoid the triggers and give in to the pain if I got one. I got the usual meds given after a heart attack including Nitro spray which I hated with a vengeance as it was a choice of chest pain or head pain and I had spent years avoiding migraine triggers only to be handed one in a bottle. Since then I had a few more heart attacks. But because of other conditions and not tolerating a lot of the meds for the last 3 months all I have to control chest pain is nitro. My neurologist told me that Nitro was being trialled as a Migraine medication, I have issues with my bile duct and the medication advised for it are CCB's and Nitro. So my little orange bottle is a cure all. So for the last 2mths I have gave in and used it for chest pain several times daily, which at first triggered migraine, but strangely after years the pain is not lasting its usual length of time, only half an hour not days. But its been replaced with hours of ocular disturbance but I can cope with that better than pain. So yes I think for some depending how often it's used you can get over headache side effect.

[Qualipop]

Two excellent paramedics suggested that I use a nitro tablet instead of the spray. It dissolves under your tongue. WIth the tablet you can remove it once the pain subsides and before you start to feel dizzy, rather than having a full dose that you may not need.

[Elvee2]

Perhaps you are using too much to start with? Person prescribing mine said 2 puffs, wait, then another 2, but pharmacist said start with one - which I do now, vert first one gave me a headache, but subsequent ones haven’t - gave myself an accidental “overdose “ last week - 2 puffs - and came over all dizzy and peculiar- but got back to normal in a few minutes. My cardiologist suggested to use the spray before undertaking anything that might cause an “attack” so you’re more able to cope with whatever you’re going to do, and avoid the pain/discomfort. Good luck, it seems we all have to find our own way!

[Hidden]

Great advice from you all and very much appreciated. Certainly gives me some viable options I will look into.