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Nitrates for Coronary Artery Disease

Examples

Generic NameBrand Name
isosorbide dinitrateDilatrate, Isordil
isosorbide mononitrateISMO
nitroglycerinNitro-Dur, Nitrolingual, Nitrostat

How It Works

Nitrates open (dilate) the arteries to the heart. This increases blood flow to the heart, relieving angina symptoms such as chest pain or pressure.

Nitrates also dilate veins throughout the body so that they can hold more blood. This reduces the amount of blood going back to the heart, reducing the heart's workload.

Why It Is Used

Nitrates are used to:

  • Relieve angina.
  • Prevent angina, when used before stressful activities that can cause angina (such as sexual intercourse or walking up stairs or a hill).
  • Prevent angina that occurs during daily activities (long-term use).

How Well It Works

Nitrates can relieve angina symptoms and may improve quality of life.footnote 1

If the usual dose of nitroglycerin does not relieve your symptoms, it might mean that the angina may be getting worse or becoming unstable. If this happens, call your doctor immediately.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor right away if you have:

  • Hives.
  • Blurred vision.
  • Severe headache that does not go away.
  • Skin rash.

Common side effects of this medicine include:

  • Dizziness or lightheadedness.
  • Headache.
  • Flushing, or feeling warm, in the face and neck.
  • Nausea.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Nitroglycerin can help you manage symptoms of angina. Nitroglycerin for angina is taken as a pill or a liquid spray. Skin patches or paste are also available to prevent angina. For more information, see:

Using Nitroglycerin for Angina

Do not take an erection-enhancing medicine such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) if you are taking a nitrate. Combining these two drugs can cause a life-threatening drop in blood pressure.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)( What is a PDF document? ) to help you understand this medication.

References

Citations

  1. O'Toole L (2008). Angina (chronic stable), search date June 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Credits

ByHealthwise Staff
Primary Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica, MD - Family Medicine
Specialist Medical ReviewerE. Gregory Thompson, MD - Internal Medicine

Current as ofOctober 5, 2017

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