SummaryThe use of the organic solvents ethanol and propylene glycol in injectable nitroglycerin is potentially hazardous, because of the possibility of cardiodcpression, arrhythmias and/or coronary vasospasm; neurotoxicity and depression of the central nervous system; hyperosmolality, lactic acidosis and hemolysis, especially in patients with diminished renal function; interaction with disulfiram and compounds with a disulfiram-like action; interaction with oral antidiabetics and with heparin. Nitroglycerin itself can cause methemoglobinemia.Obviously, the use of NTG solutions containing no ethanol nor PG could solve most of the cited problems, except methemoglobinemia. However, when used in low doses (up to 150200 /xg/min) in patients with normal liver and kidney function, NTG remains a very effective and safe drug, usually free of any side-cffects. ISDN which is a watery solution without organic solvents, could be used as a safe alternative.