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- What are vasodilators, and how do they work (mechanism of action)?
- Why does a blood vessel dilate?
- What diseases or other health conditions are vasodilators used to treat?
- Are there herbal, natural, or over-the-counter (OTC) vasodilator products available?
- Is caffeine a vasodilator?
- Vasodilator side effects and adverse effects
- Drug, Supplement, and Food interactions with vasodilators
- List of types and examples of generic and brand name vasodilators
- What are pulmonary vasodilators?
- Is it safe to use these drugs if I’m pregnant or breastfeeding?
- What forms (preparations) are available for these drugs?
What are vasodilators, and how do they work (mechanism of action)?
A vasodilator is a drug that causes vasodilation, a widening (opening) of blood vessels that results from relaxation of the smooth muscle of the vessels. What widens in vasodilation actually is the diameter of the interior (lumen) of the vessel. The opposite of vasodilation is vasoconstriction.
This type of medicine works through several mechanisms. For example:
- ACE (angiotensin converting enzyme) inhibitors: ACE inhibitors slows (inhibits) the activity of the enzyme ACE, which decreases the production of a chemical (angiotensin) that causes the blood vessels to narrow. As a result, blood pressure reduces (lowers) because of the enlarged (dilated) blood vessels.
- ARBs (angiotensin receptor blockers): ARBs is another type of medicine that enlarges blood vessels. They work by blocking angiotensin from attaching to the smooth muscle of blood vessels. This causes vasodillation.
- CCBs (calcium channel blockers): The smooth muscles cells of the arteries use calcium for muscle contraction. CCBs block calcium from entering into the smooth cells, which relax the artery muscles. This leads to dilation (opening) of the artery.
- Nitrates: Nitrates are converted to nitric oxide, which activates another chemical that causes the veins and arteries to open. Doctors prescribe nitrates to treat angina (heart or cardiac pain).
This article does not contain the complete information about vasodilators. Please refer to the individual drug class or drug articles for further medical reference.
Why does a blood vessel dilate?
A blood vessel carries blood. They also help the body regulate blood pressure and blood flow to organs. When a blood vessel dilates (opens), it allows more blood flow.
Widening of arteries (a type of blood vessel) reduces blood pressure because dilation of the arteries makes it is easier for the heart to pump blood to the rest of the body.
- When arteries open, it increases the blood flow and oxygen supply to the heart.
- When veins open, it reduces the amount of blood returned to the heart chambers.
What diseases or other health conditions are vasodilators used to treat?
Doctors prescribe this type of medicine to treat several diseases and health conditions, and their symptoms. Some of the cardiovascular diseases and other health problems treated with these medications include:
- High blood pressure (hypertension)
- Congestive heart failure (CHF)
- Cardiac pain or heart pain (angina)
- Prevention of stroke
- Prevention of a heart attack
- Prevention of heart failure after a heart attack
- High blood pressure in pregnant women (Preeclampsia)
- High blood pressure in the lungs (pulmonary hypertension)
- Diabetic nephropathy
- Raynaud's syndrome
- Subarachnoid hemorrhage
Are there herbal, natural, or over-the-counter (OTC) vasodilator products available?
Examples of natural herbs or supplements that cause blood vessels to open include:
Is caffeine a vasodilator?
Vasodilator side effects and adverse effects
If you take this type of drug therapy for high blood pressure (hypertension) or another medical condition, it may reduce your blood pressure too much. If your blood pressure is too low (hypotension), you may feel dizzy, which is a symptom of low blood pressure.
Other side effects patients may experience include:
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Drug, Supplement, and Food interactions with vasodilators
Combining vasodilators may reduce blood pressure too much. However, in some patients, two or more vasodilators are combined to treat high blood pressure that cannot be controlled with only one antihypertensive medication. This is a list of examples of drug interactions that patients being treated with some types of vasodilators may experience.
Examples of ACE inhibitor interactions
- The use of potassium supplements, salt substitutes (which often contain potassium), or any medication that increase the body's potassium may result in excessive blood potassium levels because ACE inhibitors also increase blood levels of potassium.
- Angiotensin converting enzyme inhibitors also may increase the blood concentration of lithium (Eskalith, Lithobid) and lead to an increase in side effects from lithium. Symptoms of too much lithium include nausea, vomiting, cramping, and sometimes diarrhea.
- Combining ACE inhibitors with ARBs increases the risk of low blood pressure, high blood potassium, and kidney problems.
- Facial flushing, nausea, vomiting and low blood pressure (nitritoid reactions) may occur when injectable (gold sodium aurothiomalate [Myochrysine]), used in the treatment of patients with rheumatoid arthritis, is combined with ACE inhibitors.
Example of calcium channel blocker (CCBs) interactions
- Verapamil (Calan, Isoptin) and diltiazem (Cardizem) decrease the elimination of a number of medications that are broken down by the liver. Through this mechanism, verapamil and diltiazem may reduce the elimination and increase the blood levels of carbamazepine (Tegretol), simvastatin (Zocor), atorvastatin (Lipitor), and lovastatin (Mevacor). This can lead to toxicity from these medications.
- Grapefruit juice (approximately 200 ml) may increase blood concentrations of felodipine (Plendil), verapamil (Calan, Isoptin), nisoldipine (Sular), nifedipine (Adalat, Procardia), nicardipine (Cardene), and possibly amlodipine (Norvasc). Patients should not drink grapefruit juice within 2 hours before or 4 hours after taking of affected CCBs.
Examples of nitrate drug interactions
List of types and examples of generic and brand name vasodilators
List of ACE inhibitors
- benazepril (Lotensin)
- captopril (Capoten)
- enalapril (Vasotec, Epaned)
- fosinopril (Monopril)
- lisinopril (Prinivil, Zestril)
- moexipril (Univasc)
- perindopril (Aceon)
- quinapril (Accupril)
- ramipril (Altace)
- trandolapril (Mavik)
List of ARBs
- azilsartan (Edarbi)
- candesartan (Atacand)
- eprosartan (Teveten)
- irbesartan (Avapro)
- telmisartan (Micardis)
- valsartan (Diovan)
- losartan (Cozaar)
- olmesartan (Benicar)
List of CCBs
- amlodipine (Norvasc)
- clevidipine (Cleviprex)
- diltiazem (Cardizem)
- felodipine (Cardene, Cardene SR)
- nisoldipine (Sular)
- verapamil (Calan)
List of nitrates
What are pulmonary vasodilators?
Pulmonary vasodilators are medicines that dilate small arteries in the lungs. Doctors prescribe pulmonary vasodilators to treat patients with pulmonary arterial hypertension, a health condition that involves constriction of pulmonary arteries. Examples of pulmonary vasodilators include:
Is it safe to use these drugs if I’m pregnant or breastfeeding?
- ACE inhibitors and ARBs: You should not take Ace inhibitors or ARBs if you are pregnant because they cause birth defects in the newborn. Doctor’s also do not recommend taking this type of drug if you are breastfeeding.
- CCBs: Researchers have not evaluated the safety of calcium channel in pregnant women.
- Verapamil crosses the placenta and affects the fetus. Verapamil and diltiazem are present in breast milk and doctors and other medical professionals do not recommend them for nursing mothers.
- Nitrates: Researchers have not adequately evaluated the safety of nitrates in pregnant or nursing women.
- Minoxidil and hydralazine: Researchers have not adequately evaluated the safety of these medicines in pregnant women. They are present in breast milk, and doctors and other health care professionals do not recommend in women who are breastfeeding.
What forms (preparations) are available for these drugs?
Vasodilators are available as tablets, capsules, and injections. Nitrates are available as sublingual tablets or spray, translingual spray, ointment, transdermal patches, and injectable solution.
Vasodilators are a class of drugs that doctors prescribe for many diseases and conditions. This type of medicine dilates, or opens, blood vessels (arteries and veins) so that the heart can pump fresh oxygen and blood to the body more efficiently. Vasodilators are available within a variety of other drug types that have many brand and generic names. Talk with your doctor about all medications and herbal supplements you use and review side effects before taking this or any medication.
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How the Heart Works: Sides, Chambers, and Function
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.
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
Heart Attack Symptoms and Early Warning Signs
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Early Warning Signs and Symptoms of Stroke (FAST)
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Omega-3 Fatty Acids
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Heart Attack Pathology: Photo Essay
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Heart Attack Prevention
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Heart Attack Prevention Overview
Heart attacks are the major causes of unexpected, sudden death among men and women. A heart attack also is a significant cause of heart failure. The process of developing atherosclerosis (hardening of the arteries) begins early in life. Heart attack prevention should begin in childhood because the atherosclerosis process can not be reversed. The risk of having a heart attack increases if you have diseases or conditions such as high blood pressure, diabetes, and other heart conditions.
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.
Treatment & Diagnosis
Medications & Supplements
- ACE Inhibitors (Side Effects, List of Names, Uses, and Dosage)
- lisinopril (Zestril, Prinivil, Qbrelis) ACE Inhibitor
- Angiotensin II Receptor Blockers (ARBs)
- captopril (Capoten)
- enalapril (Vasotec, Epaned)
- benazepril (Lotensin HTC)
- trandolapril (Mavik)
- perindopril - oral, Aceon
- fosinopril sodium, Monopril
- abatacept (Orencia)
- quinapril (Accupril)
- moexipril - oral, Univasc
Prevention & Wellness
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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.
Collard, CL., et al. "Medication Update." Medscape.
FDA. "Angiotensin-Converting Enzyme Inhibitor (ACE inhibitor) Drugs."
FDA. "Angiotensin Receptor Blockers (ARBs) Information."
Kannam, JP., MD, et al. "Nitrates in the management of stable angina pectoris." UpToDate. Updated: May 25, 2019.