Glyceryl trinitrate should not be used in the following cases: Hypersensitivity to the active substance, other nitrates, or any of the excipients.
Severe anemia; Severe cerebral hemorrhage; Head trauma; Uncorrected hypovolemia and hypotensive shock.
Arterial hypoxemia and angina caused by hypertrophic obstructive cardiomyopathy.
Constrictive pericarditis; Pericardial tamponade; Toxic pulmonary edema; Acute circulatory failure (shock, collapse).
Cardiogenic shock (unless a sufficient end-diastolic pressure is maintained by appropriate measures).
During nitrate therapy, phosphodiesterase inhibitors type 5 (PDE5) (e. g. sildenafil, vardenafil, tadalafil) must not be used because PDE5 inhibitors may amplify the vasodilatory effects of glyceryl trinitrate resulting in severe hypotension.
Conditions associated with an increased intracranial pressure.
Myocardial insufficiency due to obstruction, aortic or mitral stenosis, hypertrophic obstructive cardiomyopathy, or constrictive pericarditis.
During nitrate therapy, the soluble guanylate cyclase stimulator riociguat must not be used.