isosorbide dinitrate




Concise Prescribing Info
Isosorbide dinitrate
Acute & chronic CHF (including that associated w/ MI). Patients w/ increased left ventricular end diastolic pressure. Tab Prophylaxis of ischemic heart pain associated w/ coronary insufficiency. SL tab Treatment of angina pectoris & for prophylaxis in situations likely to provoke an angina attack ie, physical or emotional stress.
Dosage/Direction for Use
Angina pectoris Tab 5-30 mg qid. SL tab 5-10 mg every 2-3 hr as prophylaxis. May be supplemented by 5-10 mg prior to stressful situations likely to provoke an attack. Acute CHF Tab 10-40 mg qid or as needed. SL tab 5-10 mg every 2 hr or as needed. Chronic CHF Initially 5-10 mg by SL every 2 hr or as needed. Maintenance: 20-40 mg qid orally or as needed.
Should be taken on an empty stomach: Take 30 min before meals.
Hypersensitivity or idiosyncrasy. Concomitant use w/ soluble guanylate cyclase (GC) stimulator eg, riociguat.
Special Precautions
Paradoxical side effects in sensitive patients. Hemodynamic monitoring & frequent clinical assessment w/ the use of organic nitrates in early infarction. Severe hypotensive response. Paradoxical bradycardia & increased angina pectoris may accompany nitrate-induced hypotension. Blood vol depletion from diuretic therapy; low systolic BP (eg, <90 mmHg). Monitor pulmonary capillary pressure not to fall below 15 mmHg or systolic BP below physiological range. In combination w/ Ca channel blockers. May aggravate angina caused by hypertrophic cardiomyopathy. Tolerance & cross-tolerance to other nitrates & nitrites may occur. Avoid abrupt w/drawal. Pregnancy & lactation. Childn. Elderly.
Adverse Reactions
Vascular headache. Cutaneous vasodilation w/ flushing; transient episodes of dizziness & weakness, other signs of cerebral ischemia associated w/ postural hypotension; drug rash &/or exfoliative dermatitis.
Drug Interactions
May enhance effect w/ alcohol. Possible additive hypotensive effects w/ antihypertensive drugs, β adrenergic blockers, or phenothiazines. May amplify the vasodilatory effect w/ sildenafil. Potentiate hypotensive effects w/ riociguat.
MIMS Class
ATC Classification
C01DA08 - isosorbide dinitrate ; Belongs to the class of organic nitrate vasodilators. Used in the treatment of cardiac disease.
Isordil tab 10 mg
100's (P1,796.1/pack)
Isordil SL tab 5 mg
100's (P1,892.41/pack)
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