Nitrate Medication (Nitrates): Types, Side-Effects
What are Nitrate Medication (Nitrates)?
Nitrates are medications that help to treat and prevent heart-related problems such as angina or chest pain. These drugs work as Vasodilators that allows the blood to flow more easily by increasing the diameter of the blood vessels.
Blood from the body in the veins is pumped by the heart through organs like the lungs and into the body's arteries.
The heart has to pump in against the high pressure in the arteries. The heart's muscles must produce and use energy; it needs to consume the oxygen the blood supplies to do its work.
Conditions like chest pain or angina appear when there is an inadequate flow of blood (and oxygen) to the heart muscles.
Nitrate class of medications includes Isosorbide, isosorbide mononitrate and glyceryl trinitrate(GTN).
Each comes under various brand names and is taken under a valid prescription. Nitrate drugs do not alter the underlying cause of conditions like angina. However, Nitrates effectively ease and prevent angina pains(chest pain).
Types of nitrates
Based on working Nitrate medications are divided into two categories-
Short-acting nitrate preparations
Short-acting forms of nitrates are quite suitable for bringing immediate relief to angina pains when they develop.
To ease angina pains (chest pain), Glyceryl trinitrates(GTN) in the form of tablets or sprays are commonly prescribed. However, Isosorbide dinitrate is sometimes used as an alternative to Glyceryl trinitrates (GTN). And nitrates such as Isosorbide dinitrate come as tablets and sprays.
Long-acting nitrate preparations
Fast-acting forms of nitrates help relieve angina or prevent its symptoms from appearing. Taking it before activities that may bring the symptoms on may help prevent them. Also, if you frequently have angina pains, these long-acting forms of nitrates may help prevent the pain from developing.
All nitrates, such as glyceryl trinitrates(GTN), isosorbide mononitrate, and Isosorbide dinitrate, come under long-acting nitrates.
Long-acting nitrate preparation takes longer to start work. Due to this reason, the long-acting form of nitrates is not used for immediate pain relief. But, this form of nitrate is quite effective and has more long-lasting work after each dose than short-acting nitrates. In comparison, short-acting nitrate preparation loses its effects after 20 minutes.
How do nitrate medications work?
Nitrates work as Vasodilators that relax the blood vessels' walls and widen their diameter. During conditions like angina, these drugs relax the veins' walls that return blood to the heart. During high pressure in these blood vessels, the heart has to work more to pump the blood. Thus, they lower blood pressure by widening the blood routes and reducing the heart's workload. Additionally, Nitrates also widens the blood vessels that feed the heart muscle.
Possible side effects of nitrates medications
These are some common side effects that may appear during the use of medication like nitrates-
- Headache
- Flushing of face
- Nausea
- Dizziness
- Lightheadedness(due to the low blood pressure caused by nitrates)
- Burning or tingling sensation under the tongue due to the use of spray that is used under the tongue
The above-given side effects of nitrates are unpleasant but not appears to be serious. If any of its side effects persist or cause severe effects on the body, you must consult a doctor.
Precaution to taking while using Nitrates
Excessive nitrate may lead to tolerance, so follow the doctor's advice on dosing and scheduling to prevent tolerance.
Taking nitrates in conditions such as hypertrophic cardiomyopathy can cause chest pain to worsen. It is a health condition in which the heart muscle gets abnormally thick.
Erectile dysfunction medications, such as Viagra, Cialis, Levitra or Stendra, should not be taken when you are already taking nitrates. The combination of these drugs can cause a serious drop in blood pressure.
Nitrates medications may interact with other medications, especially with-
- Hypertension medications include calcium channel blockers, ACE inhibitors, and beta blockers.
- Certain heart medications
- Antidepressants
- Migraine medications
- Over-the-counter medications used to treat cough and cold
Do not drink alcohol while taking nitrates; combining them can lower your blood pressure.
Consult a doctor about adequate hydration to prevent dehydration while taking nitrates.
Discuss with a doctor before taking nitrates during pregnancy or breastfeeding a baby.
How do Viagra(Sildenafil) and nitrates interact?
The Food and drug administration(FDA) has warned against the combined use of nitrates and Viagra. Also, there are other Erectile dysfunction(Ed) medicines, such as Cialis and Levitra, that should be avoided while taking nitrates.
As a PDE5 Inhibitor, Viagra(Sildenafil) and nitrates have the same effects, such as expanding the diameter of the blood vessels. When used together, the drug interaction between Viagra and nitrates can cause a serious drop in blood pressure. A sudden and serious drop in blood pressure can affect your consciousness and heart health.
Nitrates that may interact with Viagra include-
- Isosorbide dinitrates
- Nitroglycerin
- Amyl nitrates
- Erythrityl tetranitrate
- Isosorbide Mononitrate
- Sodium nitroprusside
- Pentaerythritol tetranitrate
These nitrate medications are primarily used to treat conditions like systemic Hypertension. Before using them, know their drug interactions and prevent using Viagra while taking nitrate medications.
Other cardiovascular medications such as alpha-blockers, riociguat, and other drugs used to treat Hypertension can also interact with Viagra.
Also, Recreational drugs containing nitrates, such as amyl nitrates and butyl nitrates "poppers," can potentially interact with Viagra, Cialis, and Levitra. So make sure to prevent drug interactions between nitrates and PDE5 inhibitors used to treat Erectile dysfunction(Ed).
Frequently asked questions about Nitrates
When should I avoid taking Nitrates?
You should avoid taking Nitrates if you have any of the following medical problems-
- Mitral stenosis
- Hypertrophic obstructive cardiomyopathy
- Constrictive pericarditis
- Aortic stenosis
- Closed-angle glaucoma
Using Nitrates under these medical conditions can make these conditions worse. However, Closed-angle glaucoma is a less common form of glaucoma in which the use of nitrates can be unsafe. Nitrates are fine to use if you have the more common form of glaucoma.
What other medications should I avoid taking if I'm already taking nitrates?
The use of some other medications with Nitrates can appear to be unsafe.
In particular, medications like Sildenafil(Viagra) or similar medicines used to treat Erectile dysfunction(Ed) should not take while taking Nitrates. The interaction between these medications could cause a serious fall in blood pressure that can be fatal.
Can nitrate medication prevent a heart attack?
Although, Nitrates may help you to relieve and prevent the symptoms of angina, chest pain. But nitrate drugs do not change the underlying reason for chest pain. So, Nitrates can make you feel better, but they don't prevent conditions like a heart attack.
Are nitrates Viagra?
Like Viagra, nitrates lower blood pressure. However, nitrates primarily treat angina, chest pain, and other heart-related conditions. Combining both medications can result in a serious fall in blood pressure that can be fatal.
