Side effects are given with a frequency distribution and organ systems. The incidence of side effects was classified as follows: very often (≥10%), often (≥1%, <10%), infrequently (≥0.1%, <1%) and very rarely (<0.01%).
From the nervous system: very often: a "nitrate" headache, which usually lasts for several days with the continuation of therapy; often: stiffness, drowsiness, blurred vision, decreased speed of psychomotor reactions (especially at the beginning of treatment).
From the cardiovascular system: often: after the first dose, or after increasing the dose of drug may be a reduction in blood pressure and / or the development of orthostatic hypotension, that may be accompanied by tachycardia, lethargy, dizziness, malaise, pallor, etc. Uncommon:. in severe hypotension may increase angina (paradoxical response to nitrates) and / or severe paradoxical bradycardia, collapse, syncopal conditions; methemoglobinemia (with long-term treatment), cases of collapoid states, sometimes with bradyarrhythmia and syncope, were noted.
From the gastrointestinal tract: infrequently: nausea, vomiting, there may be a slight burning sensation of the tongue, dryness of the oral mucosa.
From the skin and subcutaneous tissues: infrequently: skin allergic reactions (including rash), redness of the skin of the face; very rarely: angioedema, Stevens-Johnson syndrome, exfoliative dermatitis.
Other: sweating, increased levels of catecholamines and vanillin-succinic acid in the urine.
Prolonged use of the drug may cause transient hypoxemia due to the relativeredistribution of blood flow to hypoventilated alveolar areas (in patients with coronary heart disease - may lead to myocardial hypoxia).