- What Are They
- Drug List
- Side Effects
- Pregnancy & Breastfeeding
- Drug Interactions
What are nitrates (nitrate medications)?
Nitrates are vasodilators (dilators of blood vessels that increase their diameter) that allow blood to flow more easily. Blood returning from the body in the veins must be pumped by the heart through the lungs and into the body's arteries against the high pressure in the arteries. In order to accomplish this work, the heart's muscle must produce and use energy ("fuel"), and this requires consumption of oxygen that is supplied by the blood. Angina (angina pectoris or "heart pain") is due to an inadequate flow of blood (and oxygen) to the muscle of the heart.
Nitrates, including isosorbide dinitrate, increase the flow of blood and oxygen to the heart and thereby increase the amount of work that the heart can do by dilating (expanding) the arteries and veins in the body. Dilation of the veins reduces the amount of blood that returns to the heart that must be pumped, while dilation of the arteries lowers the pressure in the arteries against which the heart must pump. As a consequence of both effects, the heart works less and requires less blood and oxygen.
What are examples of nitrates available in the United States?
Examples of generic and brand names of nitrates include:
- nitroglycerin sublingual tablet (Nitrostat)
- nitroglycerin lingual aerosol (Nitromist)
- nitrolinglycerin pumpspray (Nitrolingual Pumpsprapy)
- nitroglycerin lingual (Nitrolingual Pumpspray)
- nitroglycerin transdermal ointment (Nitro-Bid)
- nitroglycerin transdermal infusion system (Nitro-Dur)
- nitroglycerin transdermal therapeutic system (Transderm-Nitro)
- Nitroglycerin oral capsule (Nitro-Time)
- nitroglycerin intravenous
- isosorbide mononitrate and dinitrate (Isordil, Isordil Titradose, Dilatrate-SR))
What are the side effects of nitrates?
Common side effects of nitrates include:
- Burning and tingling under the tongue
- Low blood pressure
Other side effects include:
Are nitrates safe to take during pregnancy or while breastfeeding?
- The FDA classifies nitrates as pregnancy category C, which means that safe and effective use of nitrates in pregnant women has not been established. Nitrates should be given to pregnant women only if clearly needed.
- It is not known whether nitrates enter breast milk; therefore, nitrates must be used with caution in women who are breastfeeding.
What drugs interact with nitrates?
- Nitrates can slow down metabolism of cabergoline and ergonovine, resulting in an increase in systolic blood pressure and an increased likelihood of angina symptoms.
- Sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) increase the blood pressure lowering effects of nitrates and may cause excessive blood pressure reduction. Men taking nitrates should not take sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra).
What preparations of nitrates are available?
Nitrates are available in various formulations. Nitroglycerin is available in:
- oral capsule
- sublingual tablet
- sublingual spray
- intravenous solution
- topical ointment
- topical patch
- isosorbide mononitrate and isosorbide dinitrate are available as immediate and extended-release tablets
Only sublingual tablets, intravenous, or immediate release tablets are used for immediate treatment of angina because the onset of action of the other formulations is not fast enough.
Nitrates or nitrate medications are drugs prescribed to prevent or treat angina (heart pain or chest pain) caused by heart disease. Common side effects of nitrates include flushing, nausea, low blood pressure, burning and tingling under the tongue. Nitrates are classified as a category C drug, which means that its safety in women who are pregnant has not been established. Nitrates may or may not enter breast milk so women who are taking nitrates and breastfeeding should use caution.
Multimedia: Slideshows, Images & Quizzes
Heart Healthy Diet: 25 Foods You Should Eat
What foods are heart healthy? Learn what foods help protect your cardiovascular system from heart attack, coronary heart disease,...
Heart Disease: Foods That Are Bad for Your Heart
If you want a healthy ticker, there are some foods you’ll want to indulge in every now and then only. Find out which ones and how...
Heart Disease: Causes of a Heart Attack
Heart disease prevention includes controlling risk factors like diet, exercise, and stress. Heart disease symptoms in women may...
Am I Having a Heart Attack? Symptoms of Heart Disease
Heart attacks symptoms vary greatly for men and women, from anxiety and fatigue to nausea and sweating. Learn the warning signs...
High-Fiber Super Foods: Whole Grains, Fruits, & More
Learn about high-fiber foods. From fresh fruits to whole grains, these fiber-rich foods can lower cholesterol, prevent...
Heart Disease: Symptoms, Signs, and Causes
What is heart disease (coronary artery disease)? Learn about the causes of heart disease, arrhythmias and myopathy. Symptoms of...
Heart Disease: How to Help Prevent an AFib Attack
These simple things can make a flare-up of atrial fibrillation less likely.
Heart Disease: Pill-Free Ways to Cut Your Heart Disease Risk
You don't have to take medicine to lower your heart disease risk. Find out more about how diet, exercise, and other lifestyle...
How to Lower Your Cholesterol & Save Your Heart
Need to lower your cholesterol levels? Use these smart diet tips to quickly and easily lower your blood cholesterol levels....
Heart Disease: Alternative Treatments for AFib
Medication and surgery aren't the only things that can improve or prevent your AFib symptoms. Talk to your doctor about these...
Cardiac Arrest: What You Should Know
Cardiac arrest is a serious medical emergency that requires immediate medical care. Use this WebMD slideshow to know whether you...
Heart Disease Quiz: Test Your Medical IQ
Take our Heart Disease Quiz to get answers and facts about high cholesterol, atherosclerosis prevention, and the causes,...
Picture of Heart Detail
The heart is composed of specialized cardiac muscle, and it is four-chambered, with a right atrium and ventricle, and an...
Picture of Heart
The muscle that pumps blood received from veins into arteries throughout the body. See a picture of the Heart and learn more...
Heart Disease: Best and Worst Foods for Heart Failure
Learn which dietary changes help your heart, and which ones make it work harder.
Heart Disease: Understand Your Blood and Urine Test Results
Your blood and urine can reveal a lot about your health. Here's how to understand your lab test results.
Food Swaps for Meals and Snacks for Heart Health in Pictures
Explore 10 food swaps for heart-wise dining. Learn what food to buy and how to cook in order to make a big difference for your...
Related Disease Conditions
How the Heart Works
The heart is a very important organ in the body. It is responsible for continuously pumping oxygen and nutrient-rich blood throughout your body to sustain life. It is a fist-sized muscle that beats (expands and contracts) 100,000 times per day, pumping a total of five or six quarts of blood each minute, or about 2,000 gallons per day.
High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Arrhythmias (Abnormal Heart Rhythms)
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus bradycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-Parkinson-White syndrome, brachycardia, or heart blocks. Treatment is dependent upon the type of heart rhythm disorder.
Lower Cholesterol Levels with Diet and Medications
High-density lipoprotein (HDL) cholesterol is considered "good" cholesterol because it actually works to keep the LDL or "bad" cholesterol from building up in your arteries. Foods like extra lean meats, skim milk, and vegetable-based "butter-like" substitutes may help decrease LDL levels in the bloodstream.
Heart Disease: Sudden Cardiac Death
Second Source WebMD Medical Reference
Heart Attack (Myocardial Infarction)
A heart attack occurs when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. Learn about warning signs, causes, complications, risk factors, and treatment.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
What Are the 7 More Dangerous Medicines to Mix?
Some drug interactions can have serious side effects, while others may be lethal. You should avoid dangerous drug mistakes like mixing alcohol and opioids, warfarin and acetaminophen and few others.
Omega-3 Fatty Acids
Omega-3 fatty acids are essential fats that help decrease one's cholesterol and triglyceride levels as well as reduce the risk of coronary artery disease. Omega-3s are found in salmon, sardines, walnuts, and canola oil. These fats may help reduce the risk of ventricular fibrillation and sudden cardiac death.
Heart Attack Treatment
A heart attack involves damage or death of part of the heart muscle due to a blood clot. The aim of heart attack treatment is to prevent or stop this damage to the heart muscle. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury.
Stress and Heart Disease
Stress itself may be a risk factor for heart disease, or high levels of stress may make risk factors for heart disease worse. The warning signs of stress can be physical, mental, emotional, or behavioral. Check out the center below for more medical references on stress and heart disease, including multimedia (slideshows, images, and quizzes), related diseases, treatment, diagnosis, medications, and prevention or wellness.
Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
What Are the Fastest Ways to Treat Angina?
Learn what medical treatments can help ease your angina symptoms and speed up your recover.
What Can I Do to Relieve Angina Pain?
Learn what medical treatments can help ease your angina pain symptoms and help you manage this condition.
Heart Attack Pathology: Photo Essay
A heart attack is a layperson's term for a sudden blockage of a coronary artery. This photo essay includes graphics, pictures, and illustrations of diseased heart tissue and the mechanisms that lead to coronary artery disease, and possible heart attack. A coronary artery occlusion may be fatal, but most patients survive it. Death can occur when the occlusion leads to an abnormal heartbeat (severe arrhythmia) or death of heart muscle (extensive myocardial infarction).
How Much Does Treatment for Heart Disease Cost?
Treatment costs for heart disease depend on the type of treatment, doctors, hospitals, and insurance plans. The cost could be a couple of hundred dollars for medication and $20,000 (USD) for surgery.
Heart Attack Prevention
Heart disease and heart attacks can be prevented by leading a healthy lifestyle with diet, exercise, and stress management. Symptoms of heart attack in men and women include chest discomfort and pain in the shoulder, neck, jaw, stomach, or back.
What Does an Angina Attack Feel Like?
Angina is chest pain caused by a lack of oxygen supply to the heart. Learn the signs of an angina attack, what causes it, how doctors diagnose it, and what you can do to treat it.
Smoking and Heart Disease
Smoking increases the risk of heart disease in women and men. Nicotine in cigarettes decrease oxygen to the heart, increases blood pressure, blood clots, and damages coronary arteries. Learn how to quit smoking today, to prolong your life.
Can Angina Lead to a Heart Attack?
Angina, or angina pectoris, is a sudden chest pain caused by low blood flow to the heart. Yes, some types of angina attacks can lead to heart complications.
Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
Vitamins & Exercise: Heart Attack Prevention Series
Vitamins and exercise can lower your risk for heart attack and heart disease. Folic acid, vitamins, and homocysteine levels are interconnected and affect your risk for heart disease or heart attack. For better heart health, avoid the following fried foods, hard margarine, commercial baked goods, most packaged and processed snack foods, high fat dairy, and processed meats such as bacon, sausage, and deli meats.
Treatment & Diagnosis
- Heart Disease FAQs
- Medication Disposal
- Angina: Don't Take It Lightly
- Dangers of Mixing Medications
- Beta Carotene Supplements Not the Answer for Cancer or Heart Disease
- Heart Disease Risks Reduced With Running
- Heart Risks - Reduced By Walking & Vigorous Exercise
- Heart Disease In Women
- Ramipril, Heart Disease, Stroke & Diabetes
- Heart Disease & Stroke - Progress
- Heart Disease Stroke and Diabetes
- Exercise Therapy in Type 2 Diabetes - Part 1
- Heart Disease Risk and C-reactive Protein (CRP)
- Hormone Therapy and and Heart Disease in Women
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Heart Disease - Lessons Learned From Pitcher's Early Death
- Heart Disease: Antioxidant Supplements and Women
- What are The Complications of Rheumatic Heart Disease?
- Can I Still Get Heart Disease if I Take Blood Pressure Medication?
- Do I Have Angina?
- Does Hashimoto's Affect Heart Disease and Osteoporosis?
- Heart Disease Prevention in Women
- Angina Diagnosis
- Angina Symptoms
- Generic Drugs, Are They as Good as Brand-Names?
- Heart Healthy Diet: Hypertension & Heart Disease
Medications & Supplements
Prevention & Wellness
IMAGESBrowse through our medical image collection to see illustrations of human anatomy and physiology See Images
Health Solutions From Our Sponsors
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.