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Isosorbide Dinitrate
Isosorbide dinitrate is a nitrate medication primarily used for the prevention and treatment of angina pectoris (chest pain) due to coronary artery disease. It works by relaxing and dilating blood vessels, which decreases the heart's workload and improves blood flow to the heart muscle.
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Frequently Asked Questions
Can I take Isosorbide without food?
Yes, it s best to take isosorbide on an empty stomach with plenty of water.
How long does it take for isosorbide dinitrate to start working?
Isosorbide dinitrate typically starts to work within 30 minutes to 1 hour after administration, with peak effects occurring several hours later.
Does Isosorbide cause headaches?
Yes, headaches are a common side effect of isosorbide, especially when you first start taking it.
Can I take isosorbide dinitrate with other medications?
Always consult your healthcare provider before combining isosorbide dinitrate with other medications, especially phosphodiesterase inhibitors or other antihypertensives.
What should I do if I miss a dose?
Take the missed dose as soon as you remember. If it s near the time of your next dose, skip the missed dose. Just ensure you don t take a double dose to cover for the missed one.
What should I do if I miss a dose of isosorbide dinitrate?
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 the dose.
Is it safe to use isosorbide dinitrate during pregnancy?
Isosorbide dinitrate should be used during pregnancy only if clearly needed, and the risks and benefits should be discussed with a healthcare provider.
Can I just stop taking it when my symptoms improve?
No, sudden discontinuance could worsen your angina. Always follow your healthcare provider's advice on how to discontinue or change your dose.
Can isosorbide dinitrate cause weight gain?
Weight gain is not a common side effect of isosorbide dinitrate. Any significant changes in weight should be discussed with a healthcare provider.
Comprehensive Drug Guide
How Does Isosorbide Dinitrate Work?
Isosorbide dinitrate acts by releasing nitric oxide, which relaxes the smooth muscle in blood vessels, leading to dilation. This reduces venous return (preload) and decreases myocardial oxygen demand, thereby alleviating angina symptoms.
What is Isosorbide Dinitrate Used For?
Common Dosages
- Immediate-release tablets: Common dosages include 5 mg, 10 mg, and 20 mg.
- Extended-release tablets: Common dosages include 30 mg, 60 mg, and 120 mg.
Typical Dosing
- For immediate-release: The usual dose is 5 to 10 mg taken two to three times daily, as needed for angina.
- For extended-release: The typical starting dose is 30 mg taken once daily, which may be adjusted based on clinical response.
Typical Dosing
FDA Approved Indications
- Prevention and treatment of angina pectoris due to coronary artery disease
Off-Label Uses
Who Shouldn't Take Isosorbide Dinitrate?
- Known hypersensitivity to isosorbide dinitrate or any components of the formulation
- Severe anemia
- Increased intracranial pressure
- Concurrent use with phosphodiesterase inhibitors (e.g., sildenafil) due to the risk of severe hypotension
- Known hypersensitivity to isosorbide dinitrate or any components of the formulation
- Severe anemia
- Increased intracranial pressure
- Concurrent use with phosphodiesterase inhibitors (e.g., sildenafil) due to the risk of severe hypotension
Advice From The Pharmacist
- Patients should be advised to take isosorbide dinitrate with food to enhance absorption and minimize gastrointestinal side effects.
- Encourage patients to avoid sudden discontinuation of the medication, as this can lead to rebound angina.
- Inform patients about the possibility of headaches as a common side effect and advise them to manage these with over-the-counter analgesics.
Side Effects of Isosorbide Dinitrate
Common Side Effects
- Headache
- Dizziness or lightheadedness
- Flushing
- Nausea
- Fatigue
Uncommon/Severe Side Effects
- Severe hypotension (low blood pressure)
- Tachycardia (rapid heartbeat)
- Allergic reactions (anaphylaxis)
Risks and Warnings of Isosorbide Dinitrate
- Cardiovascular Risks: Monitor blood pressure regularly, especially after initiation or dose adjustment.
- Tolerance: Patients may develop tolerance to nitrates over time, which can reduce effectiveness. A nitrate-free interval may be beneficial to prevent tolerance.
Interactions with Isosorbide Dinitrate
Common Drug Interactions
- Phosphodiesterase Inhibitors: Concurrent use can lead to severe hypotension and should be avoided.
- Other Antihypertensives: Caution is advised as combined use may enhance the blood pressure-lowering effects.
Alternatives to Isosorbide Dinitrate
- Other Nitrates: Such as nitroglycerin for acute angina relief.
- Beta-blockers: For managing angina and reducing heart workload.
- Calcium Channel Blockers: For angina management.
