Isosorbide dinitrate: Indication, Dosage, Side Effect, Precaution

Concise Prescribing Info Full Prescribing Info

Dosage/Direction for Use Administration Contraindications Special Precautions Adverse Reactions Pregnancy Category (US FDA) Overdosage Drug Interactions Food Interaction Action Storage CIMS Class ATC Classification

Concise Prescribing Info

Indications/Uses

Listed in Dosage.

Dosage/Direction for Use

Adult: PO Management of angina 20-120 mg/day in divided doses. Max: 240 mg/day. Heart failure 30-160 mg/day in divided doses. Max: 240 mg/day. Sublingual Heart failure 5-10 mg 2 hrly. Acute angina 2.5-10 mg. IV Heart failure; Unstable angina 2-12 mg/hr, up to 20 mg/hr if needed. Intracoronary Percutaneous transluminal coronary angioplasty 1 mg as bolus inj before balloon inflation, give additional doses as needed at a Max of 5 mg over 30 min.

Administration

Should be taken on an empty stomach. Take 30 min before meals.

Contraindications

Aortic or mitral stenosis, marked anaemia, cardiac tamponade, hypertrophic cardiomyopathy, hypotension, hypovolaemia, raised intracranial pressure. Concomitant use of a phosphodiesterase 5 (PDE5) inhibitors and riociguat.

Special Precautions

Patients w/ susceptibility to angle-closure glaucoma, hypothermia, hypothyroidism, hypoxaemia, malnutrition, MI, toxic pulmonary oedema, constrictive pericarditis, ventilation and perfusion abnormalities. Severe renal and hepatic impairment. Pregnancy and lactation. Patient Counselling This drug may cause dizziness on standing, sit or lie down before use and get up gradually to minimise this effect. Monitoring Parameters Monitor BP and heart rate closely during IV admin.

Adverse Reactions

Significant: Postural hypotension. Nervous: Dizziness, headache, syncope. CV: Tachycardia, rebound hypertension, severe hypotension, rebound angina, paradoxical bradycardia, palpitation, peripheral oedema. GI: Heartburn, nausea, vomiting. Haematologic: Hypoxaemia, haemolysis; methaemoglobinaemia (IV). Ophthalmologic: Angle-closure glaucoma. Immunologic: Hypersensitivity. Others: Flushing; restlessness.
Potentially Fatal: Severe hypotension and bradycardia.

Pregnancy Category (US FDA)

Drug Interactions

Reduced effect w/ disopyramide (sublingual). Additive hypotensive effects w/ antihypertensive drugs or phenothiazines.

CIMS Class

Anti-Anginal Drugs

ATC Classification

C05AE02 - isosorbide dinitrate ; Belongs to the class of muscle relaxants. Used in the topical treatment for the treatment of hemorrhoids and anal fissures.
C01DA08 - isosorbide dinitrate ; Belongs to the class of organic nitrate vasodilators. Used in the treatment of cardiac disease.

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