Experiences of nitroglycerin spray - British Heart Fou...

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Experiences of nitroglycerin spray

Heather1957 profile image

I started suffering with angina in 2016 which led to a bypass in 2017, the angina pain stopped after the bypass. Although I had been prescribed with nitroglycerin (GTN) spray I never used it mainly because so many people said it gave them horrendous headaches.

In October last year I started having Angina pain again which, after a week, resulted in 2 stents being fitted. I was given a spray by the hospital but again the pain has stopped.

I seem to have a real fear of using the pump because of the headache stories.

I carry the pump with me everywhere now and wondered what experience people had with using nitroglycerin and if they would hesitate to use it?

I know that the angina could return at any time and I know I may have to use the spray rather than suffer the pain so wondered what to expect.

49 Replies

Hi Heather, I also carry my spray everywhere, haven't had to use it since getting my stents , but like you, I know I could need it at anytime. Its always worked for me pre stents. I hear all the time about the headaches but I have never experienced any side effects using it

Hope this is of some help to you though obviously everyone's different

Heather1957 profile image
Heather1957 in reply to ScottL

Thanks for this, I like to know what to expect! When I was admitted this time one of the doctors asked if I had used my spray as it would help pin down the pain to angina pain (I knew it was once had never forgotten) I explained I hadn't needed one since the bypass but I could understand what he was getting at so it may be useful.

I am leaning towards just having a spray just to see what it tastes like and if it does cause a headache, I don't think it is harmful.

Hi Heather, it is an absolutely amazing product, although its a long time since I've had the need to use it I always have it in my pocket and I always have a spare in the car in case I loose mine.I was first given it eight years ago when I was diagnosed with angina and I needed to use it quite regularly, the first few times I used it, when out walking, I had to make sure I could lean on something, say a tree when I used it....the "whoosh" blood flowing to your brain made me feel light headed for a few seconds and a slight headache for 15/30 seconds, importantly any chest pain and arm ache quickly dissapeared. After a few weeks this experience all but dissapeared.

I learned to use it proactively, using it before I knew I would be exerting myself.....before tackling a hill when out walking, before doing some digging in the garden, before attempting a fast dance......therby avoiding the chest pain in the first place.

My change in lifestyle, loosing weight and improvng my fitness level over a couple of years I'm pleased to say reduced my dependence on it.

I guess if I used it now I would feel the "whoosh" as it hit my system, I would however have no hesitation in using it......I'd rather have the few uncomfortable seconds than putting a strain on my heart.

Heather1957 profile image
Heather1957 in reply to JohnH100

Thanks John that is a very positive review. For some reason the doctors have not put it on repeat and I am (hopefully) going to Vegas in March (a cancelled trip from 2020) so I will need it on a prescription repeat in case I am stopped.Thanks again.

It's not a P Med (prescription only) Heather, it is available to buy over the counter in a pharmacy.....mine is still shown on my repeat.I had a HA and angioplasty 7 months ago and the need to carry it at all times and how to use it was discussed at my discharge and at my "online" rehab course.

I have a "healthy heart" check once a year at my GP's and it's use is always covered....it's a vital tool in our armoury of things to keep us safe

Heather1957 profile image
Heather1957 in reply to JohnH100

Someone posted you can buy it over the counter from the Pharmacy and I am happy to do that I just don't want there to be any difficulty at Customs in the USA who can be quite picky!! I need to make enquiries as to whether it can be bought over the counter in the USA.

Knowing my luck if I didn't have it I would need it!

Hi Heather. A bit of background: I've had angina since my heart attack in November last year. I take Isosorbide Mononitrate 30mg which is a slow release tablet version of Nitrate spray. I also have spray handy for when I experience angina pain. In the early days of my treatment I found that I had to use the GTN quite a bit although it didn't always work and after a 3 sprays over 15 mins dose ended up having to call an ambulance on quite a few occasions! My meds are now really working quite well controlling my angina pain and I find that I only have to use GTN every now and then.

So, as far as headaches are concerned I found that early on I did get quite strong headaches from using the spray and took paracetamol to combat the pain and they didn't (for me anyway) last very long. Over time I have found that the headaches have diminished and honestly the effect of GTN reducing chest pain is very welcome and worth having to deal with short term headaches.

Of course this is my own unique experience with GTN and it may be very different for other folk including yourself. I guess that as you aren't suffering angina at the moment your GP has got you on GTN to be used as needed and not long term mononitrate meds. I think that a spray to combat chest pain and perhaps paracetamol would be the way to go but I will always advise getting further advice from your GP just to be sure. Take care and good luck with your treatment and future health.

Thanks for the very helpful reply, it sounds that it is worth the short term headaches for the long term angina relief.I'll think of it as magic spray!!

Hi Heather, I get angina as soon as I exercise due to microvascular dysfunction. I use my GTN a few times a day. I use it as a preventative before I go walking or running. I'll also use it during running the moment I feel the pain building up. I've never had headaches with it. I do get a bit of a rush to the head if I use it when I'm sitting still, which only lasts a few moments, but this disappears as soon as I start moving about. Without it, I wouldn't be able to walk far so it has helped me enormously to get my fitness back.

That is good to know, so glad you don't have any headaches and it still works its magic!!

Yes you have headache but the spray is doing it's job and if it doesn't then you know you have to go to a&e. I'm also on 60mg isosobide mononitrate so don't need spray so much now but it's always with me.

Heather1957 profile image
Heather1957 in reply to benjijen

I think I am going to have to try just to see what it's like, I take so many pills it is silly to get so hung up on this!

When I had my stent they gave me some. Never needed to use it but being me I tried it a couple of times just to see what happened and all that happened what’s a flushed face. No headache. The effect wore off pretty quickly too.

Heather1957 profile image
Heather1957 in reply to Mentdent

I think I am going to have to do the same just to get over the fear!

Always worked for me and never had a headache. What I don’t understand is if you have the choice between the pain of an angina attack and possible heart attack, and a possible headache. Why wouldn’t you use it?

I have always been lucky in that in the past the angina pain stops when I stopped doing what caused it so that is why I made that choice.

I look upon my GTN spray as my get out of jail magic spray that I use whenever one of the many angina attacks happens when I am out walking my dogs.

As for the GTN spray, initially I didn't get on with them and then I was given as part of my next prescription a GTN spray carrying the Aspire brand which is, for me so very much better as it isn't a pump action. It tastes nice whereas some of the others had a nasty flavour and for me, it works very fast indeed.

Because of my preference I got my GP to write it down correctly on the prescription, very cleared with the instruction "Aspire branded spray only". Now when I collect my prescriptions every month I get the pharmacy to open the bag it comes in along with all my other meds and if they have happened to use another brand, I refer them back to the instruction clearly marked on the prescription and refuse to accept the alternative.

Hi and thanks for the reply, I am starting to get the message it is a 'magic spray'. I think on prescription there is a limited choice but I'll see what the Pharmacy has to offer.Thanks again.

If you speak to your pharmacist I very much doubt they will be of any help as they will simply order a GTN spray without being specific. In my case, I have found that the only way I could guarantee getting the brand I have found is best for my tastes was by getting my GP to actually specify it by name. Then on collecting my 'scrip', I always get the pharmacy to open my bag of goodies and if by chance it is the wrong brand I refuse to accept it and they have to replace it.

Hi Heather,

I have my GTN spray with me all the time, unfortunately I have to use mine regularly 🥴.

I used to get the short sharp headaches at first but after a few months of using it these stopped. Fortunately the headaches were very brief but do appreciate that as short as they were they were never pleasant! So totally understand your apprehension ❤

I hope you continue to stay as pain free as possible xx

Heather1957 profile image
Heather1957 in reply to Ninjanoo

Thanks for your reply, the fact the headaches eventually go is very good to hear, I hope to remain pain free too but the way things are going who knows.

Hi Heather,

The only time I've had the spray is when it was administered by the paramedics when I was having my heart attack. It was prescribed after I had stents, but I never had to use it. Then when I had a triple bypass a year later I was told that it was "contra-indicated" and the prescription stopped.

Although you had your bypass first and stents afterwards (which to me seems to be the wrong way around), I guess the difference between being prescribed GTN or not may be that you have angina and I don't. If I needed it, I would certainly use it, but evidently I don't.... being able to climb mountains proves that! 😀

Kindest regards,


Heather1957 profile image
Heather1957 in reply to GWP1952

Hi Gerald, I had my bypass in 2017 and when the angina returned in 2021 they gave me another angiogram which showed a blockage in the RCA (they had to drill it) The bypass was of the LAD. So the right way around. They were surprised that the blockage was so bad after just 4 years which is why I am now on 80 mg of statins. The bypass is still clear (thank goodness)

GWP1952 profile image
GWP1952 in reply to Heather1957

Hi Heather,

I'm just surprised that they didn't see that there was a blockage brewing in your RCA before they carried out the bypass. My HA was caused by a clot blocking my narrowed RCA and so I had stents inserted. My later bypass corrected the remaining narrowing on the left side and my RCA was also bypassed for good measure.


Heather1957 profile image
Heather1957 in reply to GWP1952

Which is why I said above they were surprised by the blockage especially as it needed drilling. That is why they have put me on a very high dose of statins to bring down my cholesterol. The cardio nurse told me that in normal circumstances my cholesterol is at an acceptable level but they want it even lower.

I found that if i sprayed just once i was ok but if pain was bad i sprayed GTN twice then had a headache but it wasn't so bad i couldnt cope. Dont be afraid to use it as its there to help. X

Thank you, I think that is the attitude I need, a headache isn't the worse thing.

I don't think the GTN spray works for me at all, unfortunately. I've tried it a few times and never noticed an effect.

For those that use paracetamol as well for the headache, surly paracetamol takes about 20 minutes to take effect, by which time wouldn't the headache have died down anyway? Just a thought.....

That is a shame, maybe you can try the tablets that people have mentioned, it seems to be effective. I thought the same about the paracetamol but those who take the spray in anticipation (exercise etc) they can take the pain killers in advance too!

On the latter point, of course. I hadn't thought of that.

Dear Heather1957

I call it my miracle in a tin for that is what it’s been for me.

My slight headaches were out weighed by the sheer relief that the spray afford me.

Don’t ever suffer Heather, sure some may have worse headaches than others, but on the whole most have mild ones.

My cardiologist told me to use it whenever I thought that I needed it.

Strange if I used it on a walk outside my headaches were a lot milder than using it in the house, but that maybe just the way my body is wired.

Take care

Heather1957 profile image
Heather1957 in reply to Blue1958

I have just tried the spray, tried it with one spray and it did give me a mild headache, then tried it twice and it was no different. It certainly didn't give me the headache I though. I had taken a couple of paracetamols before hand.

Blue1958 profile image
Blue1958 in reply to Heather1957

Excellent, I am so pleased, hopefully it will now give you the confidence to use it whenever you feel you need it.

My main wish would be for you to never have to use it again.

Take care

Heather1957 profile image
Heather1957 in reply to Blue1958

Thank you, mine too but if I do need it I hope it will work its magic like it seems to have for others.

I have gtn spray and although it does give you a headache if you sit down for a couple of minutes when you use it these clear .I use mine daily and as long as you don't over use it you'll be fine .

Heather1957 profile image
Heather1957 in reply to jj62

Thank you, so far I haven't needed it but I have tried it now and it didn't burn my mouth (as has been reported) and the headache was bearable.

Hi Heather. My hubby suffered with angina for years before his bypass. He'd never go to the GP so I got GTN online. Like you, when he stopped doing what he was doing, the pain went but the crunch came when we were visiting my son in the Peak District (very hilly) and he couldn't walk because of the pain and breathlessness.A quick squirt of GTN sorted out the problem quickly and yes, he did have a short term headache because blood vessels were opened up to allow oxygenated blood through!

My son made an appointment with BUPA for my husband and I got told off for ordering GTN.

At the end of the consultation, the consultant said I'd saved his life and put GTN on a prescription for him. A short time after he had a quad bypass.

I still carry around GTN in case but thankfully, he's not needed it.

He still won't see a doctor about anything!!!!!

Take good care of yourself. Jan xxxx

Heather1957 profile image
Heather1957 in reply to Handel

Thanks for your reply Jan thank goodness you are a sensible person and did what was needed, I hope your husband appreciated it. Between bypass and stents I never carried a spray but am doing so now - you just don't know when you'll need it!

Handel profile image
Handel in reply to Heather1957

Love and hugs to you. Take good care. Jan xxx

Heather1957 profile image
Heather1957 in reply to Handel

Right back at you Jan, take care.

I have used one for many years without any significant side effects. Very effective to deliver benefits of pain relief.

Heather1957 profile image
Heather1957 in reply to Ijac49

Very positive to read, I am feeling much more positive now.

Since I had my heart attack back in 2014 which resulted in 7 stents, I have over the years had to use my GTN spray many times. At first I did get a headache but eventually I think I must have got used to it and stopped getting it. I never go anywhere without it even to bed as sometimes I get angina during the night. I was once told by a cardiologist to use it before going out on a very cold day and I find it does help.

I have been lucky so far in that after my bypass and stents the angina stopped. I have heard it can be worse in cold weather. Thank you for your reply it is good to know the spray has worked when you needed it!

Had a HA followed by a stent nearly 10 years ago. I still carry a spray. I would not hesitate to use the spray. The pain may not be angina but a HA. Yes you may get a headache but it's a better alternative to the pain of angina or worse a HA. The headache doesn't last. At times of angina or HA the blood vessels needs to be dilated which is done using the spray. Never hesitate, it could save your life.

My fiancé was very worried about using his GTN spray initially and resisted using it for quite a while when he was first diagnosed with Angina. (He hates any new meds etc.)

Then when he had a CT scan they came in part way through and proceeded to give him several sprays of GTN - he did say it made his head feel a bit funny, but 100% got him over his fear of using it when needed. He was also put on the GTN type tablets (sorry can’t remember the name) and was ok with those too.

Since his bypass he’s not needed it, but has recently had it put back on his repeat prescription as he’s had the odd chest pain.

Thanks for the reply, like your fiancé it is more fear of the unknown, now I have tried it I am not so worried so if I need to use the spray I wouldn't worry. There are a lot of horror stories about the spray which really are just that, stories. I have been so reassured by all these replies, I hope others who feel the same as I did find the replies useful too.

I was given GTN spray, haven't needed to use it much. My experience of headache with it is similar to an ice cream headache, though I would say it's gone quicker than that, and less intense. Really, you hardly have time to say "Ow", and it's gone.

Thank you for your reply, while I think I’d prefer the ice cream, the headache sounds like it’s easily manageable.

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