GENERIC NAME: isosorbide dinitrate

BRAND NAMES: Isordil, Sorbitrate

DRUG CLASS AND MECHANISM: The chest pain of coronary heart disease (angina) usually occurs when the heart requires more blood and oxygen than its coronary vessels can deliver. This demand for oxygen is related, in part, to blood pressure. The demand for oxygen can be reduced in one of two ways. First, dilating the veins and pooling the blood lowers the blood pressure. Second, dilating the arteries reduces the pressure that the heart has to pump against. Isosorbide dinitrate reduces angina by dilating both the veins and the arteries. Isosorbide dinitrate is in the class of drugs called anti-anginal medications.

PRESCRIPTION: yes

GENERIC AVAILABLE: yes

PREPARATIONS: Sublingual tablets (2.5mg, 5mg, 10mg); Tablets (5mg, 10mg, 20mg, 30mg, 40mg); Controlled release capsules (40mg).

STORAGE: Isosorbide dinitrate should be stored at room temperature in a tight moisture-proof container.

PRESCRIBED FOR: Isosorbide dinitrate reduces the blood pressure as well as the capillary pressure (vascular resistance), improving the heart's efficiency. Isosorbide dinitrate is used for the treatment and prevention of angina. Isosorbide dinitrate can be used to decrease the frequency and severity of anginal (chest pain) episodes and to reduce the need for sublingual (taken under the tongue) nitroglycerine.

DOSING: Isosorbide dinitrate tablets can be taken with or without food. The sublingual tablets should be dissolved under the tongue. Isosorbide dinitrate is metabolized mainly by the liver and dosages may need to be reduced in patients with liver dysfunction.

DRUG INTERACTIONS: Isosorbide dinitrate can cause a severe fall in blood pressure (hypotension) and should be used cautiously in patients with low blood volumes (on diuretics), those with low blood pressure, or who are on other blood pressure medicines (calcium channel blockers). Tolerance to isosorbide dinitrate can develop, leading to increased dosages. Isosorbide dinitrate dosages should be decreased slowly to avoid cardiac problems.

SIDE EFFECTS: Headaches are the most common side effect and usually are dose related (increase with higher dosages). Flushing can occur because of the dilating of the blood vessels (vasodilatation). Transient dizziness, palpitations, and weakness can occur, which reflect the lowering of the blood pressure. Nausea, vomiting, and rash are rare side effects.

Last Editorial Review: 12/31/1997

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