Isosorbide Dinitrate

Brand names of isosorbide dinitrate

  • Apo-ISDN
  • Cedocard-SR
  • Coradur
  • Coronex
  • Dilatrate-SR
  • Iso-BID
  • Isonate
  • Isordil
  • lsordil Tembids
  • Isordil Titradose
  • Isotrate Timecelles
  • Novo-Sorbide
  • Sorbitrate
  • Sorbitrate-SA

Isosorbide dinitrate is a prescription drug belonging to the class of medications known as nitrates and it is mainly used to treat as well as prevent angina or chest pain. Some of the other medications belonging to the class of nitrates include isosorbide mononitrate and nitroglycerin. Inside the body isosorbide dinitrate is changed into isosorbide mononitrate - an active chemical compound.

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All nitrates are basically dilators of blood vessels and hence called vasodilators. The blood carried from the body to the heart by the veins needs to be pumped by the heart to go to the lungs as well as into the arteries of the body against the high pressure prevailing in the arteries. Therefore, in order to complete this task, the muscle of the heart needs to generate and use energy and oxygen is essential for generating this energy.

Angina pectoris (commonly known as angina) or 'heart pain' is caused owing to insufficient flow of blood and oxygen to the heart muscle. All nitrates, counting isosorbide dinitrate, help to rectify the disparity between the flow of blood and oxygen to the heart and the work that must be performed by the heart by expanding (dilating) the arteries and veins in the body. Dilation of the veins lowers the amount of blood that returns to the heart and which the heart needs to pump. On the other hand, expansion of the arteries helps to reduce the pressure in the arteries against which the heart requires to pump the blood. As a result of these dual effects, the heart has to work less and also needs less blood and oxygen, since the process of pumping becomes much easy.

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Things you need to tell your physician before taking isosorbide dinitrate

Like in the case of starting treatment with any other drug, you need to adopt a number of precautions prior to taking isosorbide dinitrate. Before you commence treatment with this medication, tell your doctor or pharmacist if you have any allergic reactions to isosorbide dinitrate, any of its ingredients, any similar drugs (for instance, nitroglycerin) or if you have any other allergies. In effect, this drug may enclose a number of specific ingredients that may cause allergic reactions or other health problems. Therefore, it is advisable that you talk to your pharmacist for further details in this regard. Also, if you are not sure about the ingredients of isosorbide dinitrate, seek your pharmacist's help.

Before you start treatment with this medication, tell your doctor regarding all your medical conditions, especially if you have had any injury recently. Also tell your doctor or pharmacist regarding your entire medical history, particularly if you have or have had low blood pressure, anemia, dehydration (loss of excessive water from the body) and/ or any other heart ailments (for example, a recent heart attack).

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Women planning to take this medication should tell their doctor if they are pregnant or planning to become pregnant. Isosorbide dinitrate should be given to pregnant women only when it is absolutely necessary for their health and when all other medications fail to respond. Hence, they need to consult their doctor regarding the benefits and risks of taking this medication during pregnancy. Although it is not known whether isosorbide dinitrate passes on to the breast milk or if it hams the infant in any manner, new mothers should talk to their doctor before breast feeding.

Isosorbide dinitrate, or for that matter any drug belonging to the class of nitrates, may cause a dizzy feeling. Hence, it is advisable that people taking this medication should not undertake any work that requires alertness, such as driving a vehicle or operating a machine, till they are sure of the effects of the drug on them as well as they are confident that they would be able to perform the tasks safely. It may be noted that elderly people taking this medication are more susceptible to its adverse or side effects, particularly light-headedness and dizziness and may face increased risks of falls. Hence, they should exercise additional caution. Consumption of alcoholic beverages while taking isosorbide dinitrate should be limited or totally given up for it may result in adverse after effects as well as diminish the efficacy of the medication.

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In case you are taking isosorbide dinitrate and need to undergo a surgery or dental operation, tell your surgeon or dentist that you are using this medication.

Usage

Isosorbide dinitrate is used to prevent or treat attacks of angina - a chest pain related to heart ailment. In other words, using isosorbide dinitrate helps to provide relief from the excruciating pain caused by angina pectoris.

How to use isosorbide dinitrate

Prior to using isosorbide dinitrate, the patient needs to sit down. As instructed by your doctor, place one tablet under the tongue and allow it to dissolve. Never chew or swallow the isosorbide dinitrate tablet. The dosage of isosorbide dinitrate totally depends on the medical condition of the patient and his/ her response to the therapy. In the event of using this medication to prevent chest pain prior to any physical activity, use the medication at least 15 minutes before undertaking the physical activity. On the other hand, if you are taking isosorbide dinitrate to alleviate chest pain when it has already occurred, use the medication instantly. In case you still endure the chest pain or if it deteriorates even five minutes after taking the drug, seek emergency medical help. Having called for emergency medical help, use another dose of the medication. In case the ambulance has not arrived even after five minutes of taking the second dose and your chest pain persists, take a third dose of the medication. Unless directed by your doctor, never take more than three doses of the drug under any circumstance.

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In case you suspect of having taken an overdose of isosorbide dinitrate, immediately get in touch with the poison control center in your locality or call an emergency room as soon as possible. The signs of an overdose of the drug may include vomiting, nausea, fainting, dizziness, unconsciousness, confusion, slow or very fast heartbeat, fever and/ or unrelenting throbbing headache.

How isosorbide dinitrate works

Belonging to the class of drugs known as nitrates, isosorbide dinitrate works by unwinding the smooth muscles of the blood vessels and enhancing the supply of blood and oxygen to the heart. In addition, this medication also helps to lessen the workload of the heart as well as its oxygen requirement.

Side effects

Serious
Common
  • dizziness or light-headedness
  • restlessness
  • nausea and vomiting
Less common

Possible interactions

As is the case with most drugs, isosorbide dinitrate is also known to interact with certain medications, especially herbal products and/ or minerals, specific foods, alcoholic beverages, smoking tobacco and smoking marijuana and, hence, people taking this medication should keep away from these substances. In addition, people taking isosorbide dinitrate are also susceptible to exposure to heat as well as cold.

It has been found that herbs like hawthorn as well as co-enzyme Q10 have the ability to have an influence on the manner in which the heart functions. In addition, co-enzyme Q 10 also interacts very adversely with aspirin. Since soy (for instance, soy milk, tofu and others) enclose phytoestrogens, it has resulted in a health claim approved by the Food and Drug Administration (FDA) that it is useful in lowering the risk of heart ailments, provided they contain a minimum of 6.25 grams of soy protein in each serving. In addition, patients who have excessive body fluid (edema) caused to do weakness of the heart should not take couch grass or nettle. Although hawthorn has been used to treat heart failure, it should never be taken concurrently with any heart medication. If you are being treated with any nitrate, ensure that you tell your doctor about all the herbs you are using or planning to use. In addition, do not add any herbs to your list of medications without consulting your doctor.

It is advisable that you take isosorbide dinitrate tablets on an empty stomach, as it helps in speedy absorption of the drug. In addition, taking vitamin C also aids in alleviating nitrate tolerance.

People using nitrates, including isosorbide dinitrate, should use extreme caution while taking alcoholic beverages. In fact, it is still better if they are able to quit drinking alcohol completely with a view to avoid any side effects caused by the use of this drug. It needs to be mentioned that consumption of alcoholic beverages is likely to inflate the blood pressure-lowering effect of isosorbide dinitrate. Similarly, people using this drug should give up smoking tobacco, as nicotine has the potential to diminish the benefits of this medication. Smoking marijuana is forbidden for people using isosorbide dinitrate owing to the several harmful effects caused by this substance. Smoking marijuana not only reduces the effectiveness of this medication, but may also result in gentle to moderate increase in attacks of angina. At the same time, it may bring about possible alterations in electrocardiogram and result in confusing reading.

Patients using isosorbide dinitrate should avoid exposure to heat. They ought to exercise great caution, as hot environments may result in a considerable and sudden drop in the blood pressure. Exposure to cold may also prove to be detrimental for the health of patients taking this drug. In effect, cold environments may not only enhance the requirement for isosorbide dinitrate, but also restrict the benefits of the medication. People using isosorbide dinitrate should also exercise caution and keep away from undertaking excessive exertion, as this medication has the potential to enhance the patient's ability to become more active when they are not enduring the pain caused by angina pectoris.

Discontinuation

People taking isosorbide dinitrate should never stop taking the drug suddenly. It is advisable that after a prolonged used of this medication, it should be withdrawn gradually. The dosage as well as the frequency of the protracted-action dose forms of isosorbide dinitrate ought to be decreased step by step over a period of four to six weeks.

Storage instructions

Remember, isosorbide dinitrate should always be stored in a place that is away from heat or flame. It is essential to store isosorbide dinitrate in the same container in which the medication came. Always keep the container tightly closed with a view to avoid moisture.

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