Nitrates / Vasodilators

What they do

Nitrates are vasodilators, which cause your blood vessels to dilate or relax and therefore reduce resistance. This will lower your blood pressure, allow blood to flow more easily around your body and improve your symptoms.

Some nitrates are taken regularly. However, some short-acting nitrates (such as glyceryl trinitrate/nitroglycerin) may be taken as a spray or tablets that are used under the tongue ‘when needed’ for chest pain (angina). There are several other types of vasodilators, which are not nitrates that are used in heart failure. They may also be given in the form of patches and ointments, which are applied to the skin (angina) . There are several other types of vasodilators, which are not nitrates that are used in heart failure. They may also be given in the form of patches and ointments, which are applied to the skin.

What are the expected benefits?

Nitrates reduce the occurrence and intensity of chest pain (angina pectoris) and are therefore given for symptom relief. Other vasodilators, such as Hydralazine and Minoxidil may be used to improve symptoms such as shortness of breath.

Side effects

Vasodilators may cause low blood pressure, which can make you feel faint or dizzy when sitting or standing up too quickly. Other side effects include headaches, flushing, heart palpitations and nasal congestion. Headaches are especially common with long-acting vasodilators, such as nitrates.

Top tips

Dizziness is common with any drug that lowers blood pressure, but your heart can function better at these lower pressures.

If you do feel dizzy in the morning, try moving your feet back and forth about ten times before you stand up. Or, you may find it helpful to dangle your legs over the side of the bed before sitting up, and then sit at the side of the bed for a minute before standing. You should avoid standing up too quickly, either from sitting or bending down, as this can make you feel dizzy. Take your time and allow your body to adjust.


  • Glyceryl trinitrate / GTN / nitroglycerin preparations
    (Coro-Nitro Pump Spray®, Glytrin Spray®, Nitrolingual Pumpspray®, Nitromin®, Suscard®, Deponit®, Minitran®, Nitro-Dur®, Percutol®, Transiderm-Nitro®)
  • Isosorbide dinitrate
    (Angitak®, Isoket Retard®)
  • Isosorbide mononitrate
    (Angeze®, Angeze SR®, Chemydur 60X®, Elantan®, Ismo®, Elantan LA®, Imdur®, Isib 60XL®, Ismo Retard®, Isodur®, Isotard®, Modisal LA®, Modisal XL®, Monomax®, Monomil X®, Monosorb XL 60®, Zemon®)
  • Hydralazine
  • Minoxidil
  • Nesiritide
  • Levosimendan


Animation explaining how vasodilators work in heart failure

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ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

  • main types of heart failure
  • medicines used to treat heart failure
  • devices that may be appropriate
  • importance of rehabilitation
  • management by a multidisciplinary team
  • importance of self-care in managing your own condition

Learn more


A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.


In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.


and share your own views and experiences with other patients, families and caregivers. is a European Society of Cardiology website

The website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

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