If you have been diagnosed with angina, then your doctor will want to prescribe you a medication to help alleviate your symptoms and keep blood flowing to your heart muscle. While there are several types of medications that can be used to treat angina, one of the most common ones — and the one that is often prescribed first — is nitrates. There are a few different options on the market, including nitroglycerin and isosorbide dinitrate, but they all work in about the same way and share more similarities than differences. What do you need to know as you begin to take nitrates for angina? Here are the basics.
How do nitrates work?
Nitrates basically work by opening up your blood vessels. Both your arteries and veins relax and expand in response to the medication. This allows more blood to reach your heart tissue through the arteries that lead directly to the heart. The widening of the veins also ensures blood flows back to the heart efficiently so that it can be pumped out again. With better blood flow to the heart, the symptoms of angina — chest pain and fatigue — will dissipate. You should have fewer angina attacks and less discomfort throughout the day, too.
In some cases, angina is made worse by spasms in the coronary arteries. Nitrates also reduce or eliminate these spasms.
How do you use nitrates?
There are two common forms of nitrates that are prescribed. One is a sublingual preparation. You put the pill under your tongue, and it dissolves, allowing the nitrates to be absorbed into your bloodstream through the close-to-the-surface blood vessels beneath your tongue. The other form of nitrates is a spray. You essentially spritz the liquid spray into your mouth (a set amount comes out of the container each time), and the medication is absorbed rapidly.
While some patients may need to use nitrates on a daily basis, others will be told to carry them and use them as needed when they feel an angina attack coming on. Your doctor will give you explicit dosing instructions in tune with your unique needs.
What side effects can nitrates cause?
Most side effects of nitrates are mild. Some patients experience headaches and flushing. These symptoms tend to diminish as you get used to the medication. Sometimes, nitrates may cause the blood pressure to drop too low, leading to lightheadedness. Reducing your dose may help ward this off.
If you have any other questions about the nitrates you're being prescribed for your angina treatment, consult with your physician or pharmacist.