When first taking a nitrate, patients should avoid operating heavy machinery (e.g., driving) until they know how the medication will affect them. Some patients will become temporarily dizzy or lightheaded immediately after taking nitrate medication. To minimize the risk of injury, patients are advised to sit down when taking nitrates. In addition, some patients get severe headaches after each dose of the medication. These headaches usually fade quickly and become less noticeable after they have been on the medication for several weeks.

When nitrates are taken regularly, patients may develop a tolerance for them. Therefore, physicians will prescribe the lowest dose that is still effective. Incorporating an 8- to 12-hour “nitrate-free” period into each day is also recommended for long-term nitrate users. For instance, patients wearing nitrate skin patches could remove the patch in the early evening and replace it in the morning.  Additionally, some studies have shown that folic acid therapy or L-arginine therapy may decrease nitrate tolerance. However, these therapies should only be attempted under the guidance of a physician.

Long-term nitrate users who need to stop taking the medication should do so gradually and under the direction of a physician. Abruptly discontinuing use of the medication could cause withdrawal symptoms.