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Nitrates for Coronary Artery Disease


Generic NameBrand Name
isosorbide dinitrateDilatrate, Isordil, ISMO, Nitro-Dur, Nitrolingual, Nitrostat
isosorbide mononitrateDilatrate, Isordil, ISMO, Nitro-Dur, Nitrolingual, Nitrostat
nitroglycerinDilatrate, Isordil, ISMO, Nitro-Dur, Nitrolingual, Nitrostat

How It Works

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

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 reduce strain on the heart and improve blood flow to the heart, which relieves and prevents angina pain.

If the usual dose of nitroglycerin does not relieve chest pain, it often means that the angina may be getting worse or becoming unstable. If this happens, call your doctor immediately.

Side Effects

Side effects of nitrates may include:

  • Feeling of pulsating fullness in the head (most common side effect); can also cause headache.
  • Drop in blood pressure, which can cause dizziness.
  • Burning sensation under the tongue (with sublingual nitroglycerin).

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

What To Think About

Nitrates come in different forms including pills, sprays, skin patches, and skin pastes. Pills and spray forms of quick-acting nitroglycerin help relieve sudden angina. Longer-acting pills or skin patches may be used for long-term prevention of chest pain during daily activities.

For help using nitroglycerin, see the topic:

Using Nitroglycerin for Sudden Chest Pain.

Do not take the erection-enhancing medicine sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis) if you are taking a nitrate. Combining these two drugs can cause a life-threatening drop in blood pressure. If you develop chest pain and have taken one of these erection-enhancing medicines, be sure to tell your health professionals so that they do not attempt to treat you with nitroglycerin or another nitrate medicine.

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


ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerJohn A. McPherson, MD, FACC, FSCAI - Cardiology
Last RevisedMay 10, 2010

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