How often may nitroglycerin be used for acute chest pain before seeking emergency care?

• A. One tablet every 10 minutes
• B. One tablet every hour
• C. One tablet every 5 minutes, up to three doses; call 911 after the second dose
• D. Only one dose and seek help if pain continues

Answer: (C)

The key idea is using nitroglycerin in a fast, stepwise way for suspected acute chest pain, with clear escalation if relief isn’t achieved promptly. A nitroglycerin tablet is placed under the tongue for quick absorption. If pain persists, you may repeat the dose every 5 minutes, up to a total of three doses. Importantly, if the pain remains after the second dose, you should call emergency services immediately because this could be a heart attack and time matters. Do not exceed three doses without medical guidance. Sit or lie down when taking nitroglycerin to reduce the risk of lightheadedness from lowered blood pressure, and avoid using it with PDE5 inhibitors. This protocol explains why the recommended approach is to give doses every 5 minutes up to three, and to seek urgent help after the second dose.