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Dilatrate-SR
Dilatrate-SR is a brand name for isosorbide dinitrate, a medication used to prevent angina pectoris (chest pain) caused by coronary artery disease. It belongs to the nitrate class of medications and works by dilating blood vessels, improving blood flow, and reducing the workload on the heart. Dilatrate-SR is an extended-release formulation designed to provide prolonged symptom relief throughout the day.
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Frequently Asked Questions
Can I take Dilatrate-SR for an ongoing angina attack?
No, Dilatrate-SR is used to prevent angina attacks, not treat them once they occur. Fast-acting nitrates like nitroglycerin sublingual tablets are typically used for acute angina attacks.
What should I do if I miss a dose of Dilatrate-SR?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Can I drink alcohol while taking Dilatrate-SR?
It’s best to avoid alcohol while taking Dilatrate-SR, as it can increase the risk of dizziness, fainting, and low blood pressure.
How long does it take for Dilatrate-SR to start working?
Dilatrate-SR begins to work within 1 to 2 hours after taking the dose, and its effects last for approximately 12 hours.
Is Dilatrate-SR safe for long-term use?
Yes, Dilatrate-SR is often used long-term to prevent angina. However, regular follow-up with your healthcare provider is important to monitor for effectiveness and side effects.
Comprehensive Drug Guide
How Does Dilatrate-SR Work?
Isosorbide dinitrate, the active ingredient in Dilatrate-SR, works by releasing nitric oxide, which relaxes the smooth muscles in the blood vessels. This dilation reduces the oxygen demand of the heart and improves blood flow to the heart muscle, preventing angina. It also reduces the heart's workload by lowering blood pressure.
What is Dilatrate-SR Used For?
- Prevention of angina pectoris (chest pain) due to coronary artery disease
Common Dosages
Dilatrate-SR is available in the following dosage form:
- 40 mg extended-release capsules
Typical Dosing
FDA Approved Indications
- The usual adult dose for angina prevention is one 40 mg capsule taken twice daily, approximately 6 hours apart.
- To avoid the development of tolerance (reduced effectiveness over time), there must be a nitrate-free interval (typically overnight) during which no medication is taken.
Who Shouldn't Take Dilatrate-SR?
Dilatrate-SR should not be used in individuals with:
- Known hypersensitivity to isosorbide dinitrate, other nitrates, or any component of the formulation
- Severe hypotension (low blood pressure)
- Acute myocardial infarction (heart attack)
- Concomitant use of PDE5 inhibitors (e.g., sildenafil, tadalafil) due to the risk of severe hypotension
Advice From The Pharmacist
- Take Dilatrate-SR as prescribed, typically twice daily, with at least 6 hours between doses.
- Do not crush or chew the capsules, as this can interfere with the extended-release mechanism.
- Avoid taking Dilatrate-SR with PDE5 inhibitors like sildenafil (Viagra), as this can cause a dangerous drop in blood pressure.
- It is important to have a nitrate-free period every 24 hours to prevent tolerance.
Side Effects of Dilatrate-SR
Common Side Effects
- Headache
- Dizziness or lightheadedness
- Flushing
- Nausea
Uncommon/Severe Side Effects
- Severe hypotension (low blood pressure)
- Fainting
- Allergic reactions (rash, itching, swelling, difficulty breathing)
Risks and Warnings of Dilatrate-SR
Tolerance: Continuous use of nitrates can lead to tolerance, where the medication becomes less effective. To prevent this, patients should follow a dosing schedule that includes a nitrate-free interval.
Severe Hypotension: Taking Dilatrate-SR with alcohol, other blood pressure medications, or PDE5 inhibitors can result in dangerously low blood pressure.
Dizziness and Fainting: Due to the risk of low blood pressure, patients may experience dizziness or fainting, especially when standing up quickly.
Interactions with Dilatrate-SR
Common Drug Interactions
- PDE5 Inhibitors: Combining Dilatrate-SR with medications like sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) can cause severe drops in blood pressure.
- Antihypertensives: Concurrent use with other blood pressure-lowering medications (e.g., beta-blockers, ACE inhibitors) may increase the risk of hypotension.
- Alcohol: Drinking alcohol can enhance the blood pressure-lowering effect of Dilatrate-SR, increasing the risk of dizziness and fainting.
Alternatives to Dilatrate-SR
- Nitroglycerin: Available in various forms, including tablets, sprays, and patches, nitroglycerin is another nitrate used to prevent and treat angina.
- Imdur (isosorbide mononitrate): A similar nitrate used for the prevention of angina, typically taken once daily.
- Beta-blockers (e.g., metoprolol, atenolol): Often used in combination with nitrates for angina prevention.
- Calcium Channel Blockers (e.g., amlodipine, verapamil): Another class of medications used to treat angina by relaxing blood vessels.