Nitroglycerin Spray and Apomorphine: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Nitroglycerin Spray
Apomorphine
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
An increased risk of hypotension
Interaction Deep Dive
Concomitant use of subQ apomorphine and SL nitroglycerin caused greater decreases in blood pressure than with subQ apomorphine alone. Coadministration of nitroglycerin 0.4 mg with subQ apomorphine in healthy subjects did not have a significant impact on the pharmacokinetics of apomorphine. However, concomitant administration of nitroglycerin 0.4 mg with subQ apomorphine caused greater decreases in blood pressure than with subQ apomorphine alone. Advise patients taking apomorphine sublingual film to lie down before and after taking sublingual nitroglycerin123.
Why it happens (mechanism)
Additive hypotensive effects
Literature reports
1 report — tap to read
a) Coadministration of nitroglycerin 0.4 mg with subQ apomorphine in healthy subjects did not have a significant impact on the pharmacokinetics of apomorphine. However, concomitant administration of nitroglycerin 0.4 mg with subQ apomorphine caused greater decreases in blood pressure than with subQ apomorphine alone 21. When nitroglycerin and apomorphine were concomitantly administered to healthy subjects, the mean largest decrease (the mean of each subject's largest drop in blood pressure measured within the 6-hour period following administration of apomorphine) in supine systolic and diastolic blood pressure (measured over 6 hours) was 9.7 mm Hg and 9.3 mm Hg, respectively. The mean largest decrease in standing systolic and diastolic blood pressure was 14.3 mm Hg and 13.5 mm Hg, respectively. Some individuals experienced very large decreases in standing systolic and diastolic blood pressure, up to a maximum decrease of 65 mm Hg and 43 mm Hg, respectively. In comparison, the mean largest decrease in supine systolic and diastolic blood pressure when apomorphine was administered alone was 6.1 mm Hg and 7.3 mm Hg, respectively, and in standing systolic and diastolic blood pressure was 6.7 mm Hg and 8.4 mm Hg, respectively 3.
Common questions
Can I take Nitroglycerin Spray and Apomorphine together?
An increased risk of hypotension Always confirm with your pharmacist or prescriber before making any change.
How serious is the Nitroglycerin Spray and Apomorphine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Nitroglycerin Spray or Apomorphine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (3)
- Product Information: KYNMOBI(TM) sublingual film, apomorphine HCl sublingual film. Sunovion Pharmaceuticals Inc (per FDA), Marlborough, MA, 2020.
- Product Information: ONAPGO subcutaneous injection, apomorphine HCl subcutaneous injection. MDD US Operations LLC (per FDA), Rockville, MD, 2025. DailyMed
- Product Information: APOKYN(R) subcutaneous injection, apomorphine HCl subcutaneous injection. MDD US Operations LLC (per FDA), Rockville, MD, 2025. DailyMed
Keep reading about Nitroglycerin Spray
Keep reading about Apomorphine
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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