Inform Your Physician Before Taking This Drug If

• you have had an unfavorable response to other nitrate drugs in the past.

• you have low blood pressure.

• you have any form of glaucoma.

Possible Side-Effects (natural, expected and unavoidable drug actions) Flushing of face, headaches (50%), orthostatic hypotension, rapid heart rate, palpitation.

Possible Adverse Effects (unusual, unexpected and infrequent reactions) If any of the following develop, consult your physician promptly for guidance.

Mild Adverse Effects

Allergic Reaction: Skin rash.

Throbbing headaches (may be severe and persistent), dizziness, fainting.

Nausea, vomiting.

Serious Adverse Effects

Allergic Reactions: Severe skin reactions with peeling.

Idiosyncratic Reaction: Methemoglobinemia (very rare).

Possible Effects on Sexual Function

Correction of impotence (1 report following sublingual use).

The preventive use of nitroglycerin prior to sexual activity has been

recommended to eliminate or reduce the risk of angina. Consult your

physician for guidance.

Adverse Effects That May Mimic Natural Diseases or Disorders

Hypotensive spells (sudden drops in blood pressure) due to this drug may be mistaken for late-onset epilepsy.

Possible Effects on Laboratory Tests

Blood platelet count: decreased.

CAUTION

1. This drug can provoke migraine headaches in susceptible individuals.

2. In the presence of impaired brain circulation (cerebral arteriosclerosis), this drug can cause transient ischemic attacks — periods of temporary speech impairment, paralysis, numbness etc.

3.The development of tolerance to long-acting forms of nitrates will render the sublingual tablets ineffective for the relief of acute angina. Sensitivity to the drug's antianginal effect is restored after one week of abstinence from the long-acting forms.

4. Many over-the-counter (OTC) drug products for allergies, colds and coughs contain drugs that may counteract the desired effects of this drug. Ask your physician or pharmacist for guidance before using any such medications.

Precautions for Use

By Infants and Children: Limited usefulness and experience in this age group. Dosage schedules not established.

By those over 60 Years of Age: Begin treatment with small doses and increase dose cautiously as needed and tolerated. You may be more susceptible to the development of flushing, throbbing headache, dizziness, "blackout" spells, fainting and falling.

Advisability of Use During Pregnancy

Pregnancy Category: С (tentative). See Pregnancy Code inside back cover. Animal studies: No information available. Human studies: Information from adequate studies of pregnant women is not available. Use this drug only if clearly needed. Ask physician for guidance.

Advisability of Use if Breast-Feeding

Presence of this drug in breast milk: Unknown.

Monitor nursing infant closely and discontinue drug or nursing if ad­verse effects develop.

Habit-Forming Potential: None.

Effects of Overdosage: Throbbing headache, dizziness, marked flushing, nausea, vomiting, abdominal cramps, confusion, delirium, paralysis, seizures, circulatory collapse.

Possible Effects of Long-Term Use: The development of tolerance and the temporary loss of effectiveness.

Suggested Periodic Examinations While Taking This Drug (at physician's

discretion)

Measurements of blood pressure and internal eye pressures.

Evaluation of hemoglobin.

While Taking This Drug, Observe the Following

Foods: No restrictions.

Beverages: No restrictions. May be taken with milk.

Alcohol: Use extreme caution until the combined effects have been determined. Avoid alcohol completely in the presence of any side-effects or

adverse effects from nitroglycerin. Never use alcohol in the presence of a nitroglycerin headache.

Tobacco Smoking: Nicotine can reduce the effectiveness of this drug. Follow your physician's advice regarding smoking.

Marijuana Smoking: Possible reduced effectiveness of this drug; mild to moderate increase in angina; possible changes in the electrocardiogram, confusing interpretation.

Other Drugs Nitroglycerin taken concurrently with

•antihypertensive drugs may cause excessive lowering of blood pres­ sure. Careful dosage adjustments may be necessary.

The following drugs may increase the effects of nitroglycerin

•aspirin, in analgesic doses (500 mg or more).

Driving, Hazardous Activities: Usually no restrictions. This drug may cause dizziness or faintness. Restrict activities as necessary.

Aviation Note: Coronary artery disease is a disqualification for piloting. Consult a designated Aviation Medical Examiner.

Exposure to Sun: No restrictions.

Exposure to Heat: Use caution. Hot environments can cause significant lowering of blood pressure.

Exposure to Cold: Cold environments can increase the need for this drug and limit its effectiveness.

Heavy Exercise or Exertion: This drug can increase your tolerance for exercise. Use good judgment regarding excessive exertion in the absence of anginal pain.

Discontinuation: Do not stop this drug abruptly after long-term use. It is advisable to reduce the dose (of the prolonged-action dosage forms) gradually over a period of to 6 weeks. Observe for rebound angina.

Special Storage Instructions: For sublingual tablets, to prevent loss of stren keep tablets in the original glass container.

• do not transfer tablets to a plastic or metallic container (such as a pillbox).

• do not place absorbent cotton, paper (such as the prescription label), or other material inside the container.

• do not store other drugs in the same container.

• close the container tightly immediately after each use.

TEXT 2. Read the following text and translate it into Ukrainian using a dictionary.