The efficacy of nitroglycerin (in the form of chewable capsules or an oral spray) for the treatment of angina pectoris seizures is well documented. Nitroglycerin acts quickly and reliably and at least as effectively as other antianginal agents; it is the drug of choice for the treatment of seizures. For effort-induced angina pectoris seizures one can administer nitroglycerin prophylactically which produces an effect that lasts 20 to 30 minutes.

For long-term treatment of angina pectoris oral preparations or skin patches are available; however, a nitrate-free interval has to be observed every day. With either kind of application a reduction of seizures is only demonstrable for effort-induced angina pectoris. It is not known if the mortality of patients with coronary heart disease is affected in the long run.

Intravenous administration of nitroglycerin can be indicated for unstable angina pectoris and hypertension emergencies. The use of nitroglycerin (i.v., maybe by mouth) has been demonstrated for left ventricular insufficiency. Furthermore there are suggestions that this therapy can reduce infarct expansion and mortality from acute cardiac infarction.

There is little documentation on the advantages of nitroglycerin in connection with esophageal and bile duct spasms and for erection problems.

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