Adverse effects
- Circulatory dysregulation: hypotension, reflex sympathetic activity → reflex tachycardia → nitrate syncope
- Beta blockers can be applied to counter this mechanism
- Nitrate-induced headache (due to the dilation of the cerebral arteries)
- Development of tolerance
- Prevention: intermittent therapy with nitrate-free intervals of at least 8 hours
- Cyanide toxicity after sodium nitroprusside infusion (see cyanide poisoning)