The vasodilation results in a reduction of venous return and an improvement in myocardial perfusion with the result of a reduction in the work performed by the heart and hence reduced oxygen demand.Glyceryl trinitrate is rapidly absorbed through the buccal and sublingual mucosa, and in man peak concentrations in plasma are observed within four minutes of sublingual administration.The absolute bioavailability after sublingual administration is approximately 39%. Most people can take it with no problems.Talk to your doctor if you want to stop taking GTN.If you have been using GTN regularly and you stop taking it, your angina may get worse. These include:If you have used one of these medicines, do not use or take GTN for at least 24 hours after sildenafil or vardenafil, and at least 48 hours after tadalafil.If you have an angina attack after using one of these medicines for erection problems, stop sexual activity immediately and rest. Remember to carry them with you all the time. physical effort, emotional stress, exposure to cold) one or two 400 microgram metered doses sprayed under the tongue within 2-3 minutes of the event starting.Glyceryl Trinitrate Spray is not recommended for children. Angina is caused due to the narrowing of blood vessels that carries blood to the heart muscle. If your doctor and health visitor say your baby is healthy, GTN could be used during breastfeeding.If your doctor decides that you need to take GTN it is important that you keep taking it to keep you well. This information is intended for use by health professionalsGlyceryl Trinitrate Spray 400 micrograms/metered dose, sublingual spray.This product contains small amounts of ethanol (alcohol) less than 100mg per spray.Metered dose oromucosal (sublingual) spray solutionPrevention of inducible angina (e.g. If the patient does not need to use Glyceryl Trinitrate Spray very often, the spray should be checked regularly to see that it still works properly.At the onset of an attack: one or two metered doses (400 to 800 micrograms glyceryl trinitrate) to be sprayed under the tongue for the relief of anginal pain while the breath is held. Do not use GTN.GTN is not likely to affect your sex life in any other way.Talk to your doctor if you are having problems with your sex life.You might worry that exercising could trigger your symptoms or cause a heart attack, but the risk is low if you:Talk to your doctor if you're not sure it's safe for you to exercise.GTN can make some people feel dizzy, sleepy or faint. This effect is potentiated by alcohol consumption. Regular monitoring of coagulation parameters and adjustments of the heparin dose may be necessary.In patients pretreated with organic nitrates a higher dose of glyceryl trinitrate may be necessary to achieve the desired haemodynamic effect.The safety of glyceryl trinitrate in human pregnancy, especially during the first trimester has not been established. It is not known whether glyceryl trinitrate is excreted into human breast milk. The usual dose is between 2cm and 5cm (1 to 2 inches) of ointment, repeated every 3 to 4 hours if you need it.If you need to use the ointment several times a day, your doctor may change your dose.It's a good idea to have a spare, unopened bottle of tablets. If you notice that your baby is not feeding as well as usual, or seems unusually sleepy, or if you have any other concerns about your baby, talk to your health visitor or doctor.Some medicines can interfere with the way GTN works.If you take other medicines that lower blood pressure with GTN, it can sometimes lower your blood pressure too much. Glyceryl Trinitrate is an effective medicine to prevent and treat chest pain (angina). No more than three doses are recommended at any one time.For the prevention of inducible angina (e.g. The canister should be held vertically with the valve head uppermost and the spray orifice as close to the mouth as possible. 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