isosorbide dinitrate


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Related to isosorbide dinitrate: prochlorperazine, Isosorbide mononitrate

isosorbide dinitrate

Angitak (UK), Apo-ISDN (CA), Cedocard (UK), Cedocard-SR (CA), Dilatrate-SR, Isochron, Isoket (UK), Isordil Titradose, Novo-Sorbide (CA), PMS-Isosorbide (CA), Soni-Slo SR, Sorbid

isosorbide mononitrate

Angeze (UK), Chemydur (UK), Cibral (UK), Cibral XL (UK), Dynamin (UK), Dynamin XL (UK), Elantan (UK), Elantan LA (UK), Imazin XL (UK), Imdur (UK), Imo LA (UK), Isib (UK), ISMO (UK), Isodur (UK), Ketanodur (UK), Modisal (UK), Monigen (UK), Monigen XL (UK), Monit (UK), Monit LS (UK), Monoket (UK), Monomax (UK), Monomax SR (UK), Monomax XL (UK), Monomil (UK), Monosorb (UK), Trangina (UK), Trangina XL (UK), Xismox (UK), Zemon (UK), Zemon XL (UK)

Pharmacologic class: Nitrate

Therapeutic class: Antianginal

Pregnancy risk category C

Action

Promotes peripheral vasodilation and reduces preload and afterload, decreasing myocardial oxygen consumption and increasing cardiac output. Also dilates coronary arteries, increasing blood flow and improving collateral circulation.

Availability

isosorbide dinitrate

Capsules: 40 mg

Capsules (extended-release): 40 mg

Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

Tablets (chewable): 5 mg, 10 mg

Tablets (extended-release): 20 mg, 40 mg

Tablets (sublingual): 2.5 mg, 5 mg, 10 mg

isosorbide mononitrate

Tablets: 10 mg, 20 mg

Tablets (extended-release): 30 mg, 60 mg, 120 mg

Indications and dosages

Treatment and prophylaxis in situations likely to provoke acute angina pectoris

Adults: 2.5 to 5 mg S.L. May repeat dose q 5 to 10 minutes for a total of three doses in 15 to 30 minutes.

Prophylaxis of angina pectoris

Adults: 5 to 40 mg P.O. (dinitrate conventional tablets) two to three times daily. Or 5 to 20 mg (mononitrate conventional tablets) b.i.d. Or 30 to 60 mg (mononitrate extended-release tablets) once daily. After several days, dosage may be increased to 120 mg (given as single 120-mg tablet or two 60-mg tablets) once daily. Rarely, 240 mg/day (mononitrate extended-release tablets) may be needed.

Off-label uses

• Heart failure

Contraindications

• Hypersensitivity to drug

• Severe anemia

• Acute myocardial infarction

• Angle-closure glaucoma

• Concurrent sildenafil therapy

Precautions

Use cautiously in:

• head trauma, volume depletion

• elderly patients

• pregnant or breastfeeding patients

• children.

Administration

• Give oral form 30 minutes before or 1 to 2 hours after a meal. Make sure patient swallows tablets or capsules whole.

• Have patient wet S.L. tablet with saliva before placing it under tongue. To avoid tingling sensation, have him place tablet in buccal pouch.

Adverse reactions

CNS: dizziness, headache, apprehension, asthenia, syncope

CV: orthostatic hypotension, tachycardia, paradoxical bradycardia, rebound hypertension

EENT: sublingual burning (with S.L. route)

GI: nausea, vomiting, dry mouth, abdominal pain

Skin: flushing

Interactions

Drug-drug. Aspirin: increased isosorbide blood level and effects

Beta-adrenergic blockers, calcium channel blockers, phenothiazines: additive hypotension

Dihydroergotamine: antagonism of dihydroergotamine effects

Sildenafil: severe and potentially fatal hypotension

Drug-diagnostic tests. Cholesterol: decreased level

Methemoglobin, urine vanillylmandelic acid: increased levels

Patient monitoring

• Monitor ECG and vital signs closely, especially blood pressure.

In suspected overdose, assess for signs and symptoms of increased intracranial pressure.

• Monitor arterial blood gas values and methemoglobin levels.

Patient teaching

• Teach patient to take oral drug 30 minutes before or 1 to 2 hours after a meal.

• Inform patient that drug may cause headache. Advise him to treat headache as usual and not to alter drug schedule. If headache persists, tell him to contact prescriber.

• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure decrease.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

i·so·sor·bide di·ni·trate

(ī'sō-sōr'bīd dī-nī'trāt),
A coronary vasodilator that acts via the formation of nitric oxide.

isosorbide dinitrate

(ī′sō-sôr′bīd′ dī-nī′trāt′)
n.
A vasodilator drug, C6H8N2O8, used to treat and prevent angina pectoris.

isosorbide dinitrate

Cardiology A venodilating nitrate used with hydralazine in CHF; ID ↓ cardiac filling pressure, ↑ exercise tolerance. See Nitrates.

isosorbide dinitrate

A drug used to prevent or relieve ANGINA PECTORIS and in to treat HEART FAILURE. The drug is on the WHO official list. Brand names are Angitak, Cedocard Retard, Isoket and Isotek Retard.
References in periodicals archive ?
Isosorbide dinitrate infusion at rate of 0.2 Ug/kg/minutes was started when patient was rewarmed at peripheral temperature to 32 degC in control group.
Steare, "A comparison of nifedipine once daily (Adalat LA), isosorbide mononitrate once daily, and isosorbide dinitrate twice daily in patients with chronic stable angina," International Journal of Cardiology, vol.
Treatment with PE low dose and PE high dose, just as with isosorbide dinitrate, both inhibited the AMI-induced increases in serum TNF-[alpha] (Fig.
(1982): "Glyceryl Trinitrate (Nitroglycerin) Ointment and Isosorbide Dinitrate: A Review of their Pharmacological Properties and Therapeutic Use".
"Nitorol(R) Injection 5 mg Syringe" and "Nitorol(R) Continuous Intravenous Infusion 25 mg Syringe" are pre-filled syringes that contain the same solution as Eisai's existing ampoule formulation of "Nitorol(R) Injection 5 mg" (0.05% solution of isosorbide dinitrate).
A study comparing the formulations of isosorbide dinitrate (ISDN) and hydralazine (HYD) used in V-HeFT I and V-HeFT II, and BiDil, the proprietary fixed dose combination, used in the African American Heart Failure Trial (A-HeFT) demonstrated no bioequivalence.
One example of a medicine targeted at racial categories is BiDil (fixed-dose isosorbide dinitrate and hydralazine), an antihypertensive drug that was approved specifically for use in blacks.
Don't use PDE5 inhibitors if you take nitrates--drugs such as nitroglycerine, isosorbide dinitrate (Isordil) and isosorbide mononitrate (Imdur) used to treat angina-because the combination can cause a dangerous drop in blood pressure and lead to heart attack or stroke.
Oral medications that may reduce lower esophageal sphincter pressure include groups of drugs called nitrates (e.g., isosorbide dinitrate), calcium-channel blockers, diazepam, barbiturates, nonsteroidal anti-inflammatory drugs, theophylline, and nicotine.
Less than a month later, NitroMed went public, raising $66 million (even though isosorbide dinitrate and hydralazine are available separately in generic formulations, making it possible to closely approximate NitroMed's combination at a cost of about 44 cents per dose).'
The drug is BiDil, an experimental combination of two already approved drugs, isosorbide dinitrate (Isordil), which provides nitric oxide, and hydralazine (Apresoline), which helps the body better use nitric oxide.
The staggering number of heart disease deaths in the Black community has set off an alarm throughout the medical community, generating studies like the so-called "African-American Heart Failure Trial." The study of 1,050 Black patients found that a combination of two rarely used heart drugs, isosorbide dinitrate and hydralazine, cut the annual death rate of African-American heart failure patients by 43 percent and contributed to a 33 percent reduction in first-time hospitalizations.