Indications/Uses
Listed in Dosage.
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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.
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Administration
Should be taken on an empty stomach. Take 30 min before meals.
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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.
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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.
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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. |
Drug Interactions
Reduced effect w/ disopyramide (sublingual). Additive hypotensive effects w/ antihypertensive drugs or phenothiazines.
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CIMS Class
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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. |