NITRATES

DISCLAIMER: THIS PAGE CONTAINS A GENERAL EDUCATIONAL DISCUSSION ON THE ABOVE TOPIC. IT IS NOT HEALTH ADVICE AND SHOULD NOT BE CONSTRUED AS SUCH. YOU SHOULD NEVER RELY UPON THE INFORMATION GIVEN HERE. YOUR PARTICULAR CIRCUMSTANCES MAY WELL REQUIRE AN ENTIRELY DIFFERENT APPROACH. YOU SHOULD NOT MAKE ANY CHANGES IN YOUR MEDICATIONS, DIET, ACTIVITY, LIFESTYLE, ETC. WITHOUT FIRST CONSULTING A LICENSED PHYSICIAN IN YOUR AREA.

CHEMICAL NAME	BRAND NAME(S)
ERYTHRITYL TETRANITRATE	CARDILATE
ISOSORBIDE DINITRATE	*BiDil, DILATRATE, ISO-BID, ISORDIL (SUBLINGUAL, ORAL TEMBIDS AND ORAL TITRADOSE), SORBITRATE(SUBLINGUAL, CHEWABLE, ORAL)
ISOSORBIDE MONONITRATE	IMDUR, ISMO, ISOTRATE ER, MONOKET
NITROGLYCERINE-(SUB)LINGUAL, BUCCAL, CAPSULE, SPRAY	NITROGARD BUCCAL TABLETS, NITROGLYN, NITROLINGUAL SPRAY, NITRONG, NITROQUICK, NITROSTAT, NITROTAB, NITRO-TIME
NITROGLYCERINE-TOPICAL	DEPONIT, MINITRAN, NITREK, NITROBID OINTMENT, NITRODISC, NITRODUR, NITROGLYCERINE TRANSDERMAL SYSTEM, NITROL OINTMENT, TRANSDERM NITRO, TRANSDERMAL-NTG
PENTAERYTHRITOL TETRANITRATE	PERITRATE

Sublingual nitroglycerine, sublingual isordil and sublingual sorbitrate are used to abort an attack of angina. If 3 doses at 5 minute intervals do not fully relieve the angina, or if the angina reoccurs frequently, it is generally recommended that the patient call 911. Patients are also advised to call 911 immediately if there is no change or worsing angina after a dose - even after the first dose. Sublingual nitrates may also be taken prophylactically before an activity that may cause angina to develop.

The other nitrates are used on a regular schedule to prevent angina from occuring.

Nitrates work by dilating the veins in the body, which decreases the workload of the heart. They also dilate the arteries in the heart to improve blood flow to the heart muscle. They also have a mild antiplatelet effect.

If the body is exposed to nitrates continuously, the body becomes tolerant to them and they stop having any effect at all. Therefore, it essential to have a "nitrate-free" interval every day. This is most commonly done at night, when angina is least likely to occur for most people. Nitropatches may be removed at night and oral nitrates are taken at specified times so their effect wears off at night. If needed, other antianginal medications can be given so that they are in effect during the nitrate-free interval.

The most common side effect of nitrates is a headache. This can generally be relieved with acetaminophen (Tylenol) and generally resolves after several days of use.