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List of Nitrates (Don’t Take These With ED Meds!)

Highlights 

  • Most nitrate medications are used to treat heart conditions, such as chest pain, stroke, and heart attack.
  • Nitrate medications and erectile dysfunction (ED) medications both cause your blood pressure to lower.
  • Experts recommend against taking nitrate medications and ED medications together, as it can have life-threatening consequences.

Dr. Michael DiLeo
Latest posts by Dr. Michael DiLeo (see all)

Millions of men suffer from erectile dysfunction. Many of these also suffer from heart conditions that require the use of nitrate medications, which can’t be taken with oral ED medications like Viagra. In fact, the circulation problems that cause ED can be similar to the ones causing heart problems.

Fortunately, there are ways to support your erectile health that don’t compromise your heart health.

What Are Nitrate Medications?

Nitrate medications are commonly used to treat heart conditions, like chest pain and stroke. They are sometimes administered during emergencies, like during heart attacks. They work by dilating blood vessels, increasing blood flow and oxygenating the heart muscle better to reduce the heart’s workload. 

You can find nitrates in different forms, such as:

  • Pills or tablets
  • Topical ointments
  • Transdermal patches
  • Sublingual tablets
  • Translingual sprays

Nitrates vs. Nitrites

People sometimes confuse nitrates and nitrites. Both nitrates and nitrites are chemical compounds composed of nitrogen and oxygen. However, nitrites are chemically less stable. 

This may not sound like a big difference, but that single atom makes nitrates more stable and less volatile than nitrites. Nitrites have limited medical application. 

We mention nitrites here because one, amyl nitrite, is sometimes used recreationally and referred to as “poppers.” They are typically inhaled for a brief headrush, but they pose significant health risks to users and should never be used with any oral ED medication.

Nitrate Medications and ED Medications Don’t Mix!

doctor and patient in consultation

Some medications have the potential to cause serious interactions with ED drugs, including nitrates. This means nitrate medications and ED drugs, like Viagra, shouldn’t be taken together.

ED Medications and Your Blood Pressure

Erectile dysfunction medications like Viagra, Cialis, and Levitra belong to a class known as phosphodiesterase-5 inhibitors (PDE-5is). These medications are designed to enhance blood flow to the genitals by inhibiting an enzyme that restricts blood vessels from dilating. This makes it easier for men to achieve and keep erections. 

These ED drugs also affect your blood pressure. Most people will experience a temporary, mild drop in blood pressure when taking medications like Viagra. Some people will experience a more noticeable drop. 

Men with conditions that affect their heart, or who take medications that affect their blood pressure, can experience severe drops in blood pressure when taking oral ED medications.

Nitrate Medications and Your Blood Pressure

Like ED meds, nitrates work by dilating blood vessels throughout the body, especially those around the heart. This increased vessel diameter allows for improved blood flow, relieving chest pain associated with angina and aiding heart attack recovery. 

Regardless of how or why they are used, nitrates work by increasing blood flow throughout your body. 

A Potentially Deadly Combination

Taking nitrate medications and ED medications together can cause a dramatic drop in blood pressure. This is due to their combined effect on blood vessel dilation. While each medication relaxes blood vessels and lowers blood pressure in its own way, their simultaneous use can magnify this effect to an unsafe level.

A significant drop in blood pressure can cause mild to severe discomfort, or even life-threatening effects. There’s no way to predict the severity of the interaction for each person.

More mild side effects can include:

  • Dizziness
  • Fainting
  • Lightheadedness
  • Rapid heartbeat

More severe side effects include:

  • Heart attack
  • Loss of consciousness
  • Stroke

List of Nitrate Medications

Nitrates are most commonly used to treat heart conditions, but they are sometimes used “off-label” for other conditions. There are also various generic and brand-name medications available under this drug category. The best way to know if you’re taking a nitrate medication is to check the label and to speak with your provider.

Here is a list of common nitrate medications:

  • Glyceryl trinitrate. Glyceryl trinitrate is the chemical compound commonly known as nitroglycerin. Branded options include: 
    • Anginine
    • Angised
    • Deponit
    • Go-Nitro
    • Minitran
    • Nitrek (transdermal)
    • Nitro-Bid
    • Nitro-Bid IV
    • Nitrocine
    • Nitro-Dur
    • Nitrogard
    • Nitrogesic
    • Nitrol
    • Nitrolingual
    • NitroMist
    • Nitronal
    • Nitronalspray
    • Nitrong
    • Nitro-Par
    • Nitrospan
    • Nitro-Quick
    • Nitrostat
    • Nitro-Time
    • Nitro-Trans System
    • Rectiv
    • Transderm-Nitro
    • Tridil 
  • Hydralazine (brand name Apresoline) 
  • Isosorbide dinitrate. Branded options include: 
    • BiDil
    • Dilatrate-SR
    • IsoDitrate
    • ISDN
    • Isobid
    • Isochron
    • Isoket
    • Isordil
    • Isordil Tembids
    • Isordil Titradose
    • Sorbitrate
    • Sorbitrate SA 
  • Isosorbide mononitrate. Branded options include:
    • Imdur
    • ISMO
    • Isotrate ER
    • Monoket 
  • Pentaerythritol tetranitrate (not sold in the United States). 
  • Erythrityl tetranitrate (Cardilate). This medication isn’t commonly used. 
  • Sodium nitroprusside (Nitropress, Nipride)

Nitrates and Viagra Alternatives

happy young couple in bedViagra isn’t the only ED medication that doesn’t mix well with nitrate medications. Other drugs that fall under the category of PDE-5is, such as Cialis and Levitra, also carry the same risk when combined with nitrates. 

This means your provider is unlikely to prescribe you a PDE-5 inhibitor if you’re taking nitrate medications, and vice versa. Your provider can walk you through your personal risk for side effects with either type of medication.

Other ED Treatment Options

Facing erectile dysfunction (ED) can feel overwhelming, especially if you’re already managing other health conditions that require nitrate medications. The good news is that you don’t have to compromise your overall well-being to address your ED concerns. 

With the right guidance and medical supervision, other treatment options can prioritize both your heart health and your erectile function. 

While oral ED medications shouldn’t be taken with nitrate medications, you still have options. Your healthcare provider might recommend other effective methods to boost your erections, such as:

  • Vacuum erection devices (VEDs). These devices use a vacuum to draw blood into the penis, creating an erection. VEDs can be effective for some men, including those on nitrate medications.
  • Penile injections or suppositories. Alprostadil (Caverject, Caverject Impulse, Edex, Muse, Prostin VR), a medication injected directly into the penis, can trigger an erection. Alprostadil can also be inserted into the urethra as a suppository. Your healthcare provider will show you how to use these options safely and effectively.
  • Lifestyle changes. Making adjustments to your lifestyle can have a positive impact on both your heart health and erectile function. Regular exercise, a balanced diet, stress management, and a solid sleep routine all support better health and well-being. 

Beware “Natural Viagra”

Dozens of online and over-the-counter male enhancement products, also known as gas station sex pills, claim to treat ED or improve sexual function. However, these products are considered supplements, which aren’t regulated — or safeguarded — by the FDA. 

There isn’t evidence to suggest that these options support erectile health and sexual function. More importantly, some of these products contain unlisted ingredients, like Viagra or other prescription medications. If you’re taking a nitrate medication, a supplement tainted with hidden sildenafil (the active ingredient in Viagra) can put you in danger.

Never take over-the-counter ED or male enhancement products without first consulting your provider.

Better Heart Health and Better Erections with eDrugstore.com

Healthy erections depend on a healthy heart. Mixing nitrate medications with ED drugs can result in serious health risks, including dangerously low blood pressure. Never take ED medications without consulting a healthcare provider. 

At eDrugstore, we make it easier than ever to maintain optimal sexual health and sexual function. We offer a free consultation with a U.S.-licensed physician who can help you to choose the best medication for erectile dysfunction. And when you shop with eDrugstore, shipping is always fast and free.

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