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.

Nitrates/Vasodilators:

  • 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
    (Apresoline®)
  • Minoxidil
    (Loniten®)
  • Nesiritide
    (Natrecor®)
  • Levosimendan
    (Simdax®)

Animation

Animation explaining how vasodilators work in heart failure

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