ISORDIL/ISDN (Isosorbide Dinitrate)
ISORDIL/ISDN (Isosorbide Dinitrate)
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ISORDIL/ISDN (Isosorbide Dinitrate)

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What is this medication?

ISORDIL/ISDN (Isosorbide Dinitrate)
Antianginal Agent, Vasodilator

Brand Name US: Isordil Titradose
Canadian Equivalent: ISDN

ISORDIL/ISDN (Isosorbide Dinitrate) is indicated for prevention of angina pectoris.

How does this medication work?

ISORDIL/ISDN (Isosorbide Dinitrate) and other nitrates form free radical nitric oxide. In smooth muscle, nitric oxide activates guanylate cyclase which increases guanosine 3’5’ monophosphate (cGMP) leading to dephosphorylation of myosin light chains and smooth muscle relaxation. Produces a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins. Primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure); may modestly reduce afterload. Additionally, coronary artery dilation improves collateral flow to ischemic regions.

How should I take this medication?

Immediate Release:

Initial dosing starts with 5mg to 20mg taken 2 to 3 times a day.  Maintenance dose is 10mg to 40mg taken 2 to 3 times daily.  Allow for a 14 hour nitrate-free period after the evening dose and before the morning dose to minimize the risk of tolerance.

Note: For twice-daily dosing, consider administering at 8 AM and 1 PM. For 3-times-daily dosing, consider 8 AM, 1 PM, and 6 PM.

Sustained Release:
Take 40mg to 160mg once daily. Allow for an 18 hour nitrate-free period to minimize the risk of tolerance.

Note: Consider once daily in morning or twice-daily dosing at 8 AM and between 1 PM and 2 PM.

What should I watch for while using this medication?

Before taking ISORDIL/ISDN (Isosorbide Dinitrate), speak with your doctor about your medical history especially if you have heart failure or recently suffered an acute myocardial infarction, orthostatic hypotension, and intracranial hypertension.  Isosorbide Dinitrate can cause severe hypotension and bradycardia.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication?

Hypotension, rebound hypertension, syncope, unstable angina pectoris, headache.

Note this is not a complete list of side effects for ISORDIL/ISDN (Isosorbide Dinitrate), only common ones.