Isosorbide Dinitrate
Description
Isosorbide Dinitrate is used in the prevention and treatment of angina (chest pain that occurs when your heart muscle does not get a sufficient amount of oxygen-rich blood). Angina is caused due to the narrowing of blood vessels that carries blood to your heart. This medicine relaxes the blood vessels and also decreases the pressure on your heart. Thus, it allows the blood to flow easily to your heart. It is available on prescription as tablets, sublingual tablets (placing the tablet under the tongue), capsules, or spray.
Isosorbide Dinitrate shows side effects like headache, flushing (redness of the face or neck), low blood pressure, alteration in the heartbeat, etc. It may also cause dizziness in some cases. Avoid driving vehicles or operating machines if you feel dizzy after taking this medicine.
Isosorbide Dinitrate may be taken on an empty stomach. Your doctor will decide the dose, dosage form (tablet, capsule, or spray), and duration of treatment based on your medical condition. Do not stop taking this medicine on your own, as your symptoms may get worse, especially if you stop taking it suddenly. Isosorbide Dinitrate may not work well when used for a long time. Hence, consult your doctor if your symptoms occur more often or become worse.
Isosorbide Dinitrate is not recommended for use if you are allergic to it. Use this medicine with caution if you have any medical condition affecting your liver, kidney, heart, eyes, etc. Inform your doctor if you are pregnant, planning a pregnancy, or are breastfeeding.
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Side effects
Major & minor side effects for Isosorbide Dinitrate
- Irregular heartbeat
- Low blood pressure
- Dizziness
- Headache
- Nausea or Vomiting
- Difficulty in swallowing
- Flushing or redness of skin
- Weakness
- Difficulty in breathing
Uses of Isosorbide Dinitrate
What is it prescribed for?
- Angina pectoris
- Chronic heart failure
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Concerns
Commonly asked questions
- Onset of actionIsosorbide Dinitrate may start to show its action within 30 minutes (conventional tablet or capsule). The sublingual tablet (placing a tablet under the tongue) may start to show its action in 2-5 minutes. It is not known how long the spay will take to start its action.
- Duration of effectThe effect of Isosorbide Dinitrate may last for an average duration of 4-6 hours (conventional tablet or capsule). The effect of a sublingual tablet may last for 1-2 hours. It is not known how long the spray will remain effective in your body.
- Safe with alcohol?Consumption of alcohol is not recommended during treatment with Isosorbide Dinitrate as it may increase the risk of dizziness, lightheadedness, etc. Avoid performing activities that require high mental alertness like driving vehicles or operating machines while you are taking this medicine.
- Is it habit forming?Isosorbide Dinitrate has no habit-forming tendency.
- Usage in pregnancy?Isosorbide Dinitrate is not recommended for use during pregnancy unless necessary. Discuss the risks and benefits with your doctor before taking this medicine.
- Usage while breast-feeding?Isosorbide Dinitrate is not recommended for use while breastfeeding unless necessary. Discuss the risks and benefits with your doctor before taking this medicine.
Allergy
Isosorbide Dinitrate is not recommended for use if you are allergic to it. Seek immediate medical attention if you notice any symptoms such as skin rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, breathing difficulty, etc.
Anaemia
Isosorbide Dinitrate is not recommended for use if you have severe anaemia (low levels of haemoglobin in the blood) due to the increased risk of worsening your condition.
Hypertrophic obstructive cardiomyopathy
Hypertrophic obstructive cardiomyopathy is a heart condition in which the heart muscle becomes abnormally thick. Isosorbide Dinitrate is not recommended for use if you have hypertrophic obstructive cardiomyopathy as it may further worsen your condition.
Head trauma/ Increased intracranial pressure
Intracranial hypertension refers to increased pressure around the brain. Isosorbide Dinitrate is not recommended for use if you recently had a severe head injury or have intracranial hypertension. This medicine may increase the pressure within the skull and further worsen your condition.
Medicine for erectile dysfunction
Isosorbide Dinitrate is not recommended for use if you are taking medicines such as Sildenafil, Tadalafil, or Vardenafil for the treatment of erectile dysfunction (inability to get or keep an erection firm enough for sexual intercourse in men). Combined use of these medications may cause low blood pressure.
Warnings for special population
Pregnancy
Isosorbide Dinitrate is not recommended for use during pregnancy unless necessary. Discuss the risks and benefits with your doctor before taking this medicine.
Breast-feeding
Isosorbide Dinitrate is not recommended for use while breastfeeding unless necessary. Discuss the risks and benefits with your doctor before taking this medicine.
General warnings
Withdrawal symptoms
Abrupt discontinuation of Isosorbide Dinitrate may increase the risk of side effects. Hence, a gradual dose reduction may be necessary. Do not stop the use of this medicine without consulting your doctor.
Use in children
Isosorbide Dinitrate is not recommended for use in children less than 18 years of age as the safety and efficacy data are not clinically established.
Driving and operating machines
Isosorbide Dinitrate may cause symptoms such as dizziness, lightheadedness, weakness, low blood pressure, etc. in some cases. If you experience any of these symptoms, avoid performing activities such as driving vehicles or operating machines.
Missed Dose
Take the missed dose of Isosorbide Dinitrate as soon as you remember. If it is time for your next scheduled dose, skip the missed dose. Do not double your dose to make up for the missed dose.
Overdose
Never take more than the prescribed dose. Seek emergency medical treatment if you suspect an overdose of Isosorbide Dinitrate.
All drugs interact differently for person to person. You should check all the possible interactions with your doctor before starting any medicine.
Interaction with Alcohol
Description
N/A
Instructions
Consumption of alcohol is not recommended during treatment with Isosorbide Dinitrate as it may increase the risk of dizziness, lightheadedness, etc. Avoid performing activities that require high mental alertness like driving vehicles or operating machines while you are taking this medicine.
Interaction with Medicine
Amitriptyline
Riociguat
Alprazolam
Flurazepam
Baclofen
Alteplase
Disease interactions
Heart Disease
Isosorbide Dinitrate should be avoided if you have an acute myocardial infarction (a serious condition that occurs due to the death of the heart muscle when blood flow to the heart decreases or stops) or congestive heart failure (a condition where the heart cannot pump enough blood to meet the body's demand). If this medicine is recommended in such conditions, your doctor may periodically monitor the functioning of your heart.
Hypotension
Isosorbide Dinitrate may cause hypotension (low blood pressure). Hence, this medicine should be used with caution if you have hypotension. Your doctor may monitor your blood pressure closely while you are taking this medicine.
Glaucoma
Glaucoma is a condition in which the optic nerve (the nerve connecting the eye to the brain) is damaged, usually due to high pressure within your eyeballs. Isosorbide Dinitrate should be used with caution if you have glaucoma as it may increase the pressure inside the eyes and worsen your condition.
Liver Disease
Isosorbide Dinitrate is broken down in the liver. Hence, this medicine should be used with caution if you have severe liver problems as it may increase the risk of accumulation of this medicine in the liver.
Kidney Disease
Isosorbide Dinitrate is removed from the body by the kidneys. If you have kidney problems, it may alter the excretion process and increase the risk of accumulation of this medicine in the kidneys. Thus, this medicine should be used with caution if you have severe kidney problems.
Food interactions
Information not available.
Lab interactions
Information not available.
Take Isosorbide Dinitrate oral forms on an empty stomach or as instructed by your doctor.
Spray the Isosorbide Dinitrate spray in the mouth beneath your tongue.
Isosorbide Dinitrate may cause dizziness or low blood pressure. Do not drive vehicles or perform activities that require mental alertness until you know how it affects you.
Avoid consuming alcohol during treatment with this medicine as it may increase the risk of dizziness and lightheadedness.
Avoid taking medications like Sildenafil or Tadalafil (medicines prescribed for erectile dysfunction) while on treatment with this medicine as it may cause low blood pressure.
Isosorbide Dinitrate may cause a fall in blood pressure and make you feel dizzy, especially while getting up from a lying or sitting position.
Miscelleneous
How it works
Isosorbide Dinitrate works by relaxing the blood vessels and reducing the strain on the heart.
Legal Status
Classification
Category
Antianginal agents
Schedule
Schedule H
Medicines.org.uk. 2021. Isosorbide Dinitrate Tablets BP 10mg - Summary of Product Characteristics (SmPC) - (emc). [online] Available at: [Accessed 19 October 2021].
Stewart, M., 2021. Isosorbide dinitrate side-effects & dosage info. [online] Patient.info. Available at: o/medicine/isosorbide-dinitrate-isoket-retard [Accessed 19 October 2021].
Accessdata.fda.gov. 2021. [online] Available at: [Accessed 19 October 2021].
Dailymed.nlm.nih.gov. 2021. Isosorbide Dinitrate Tablets, USP (Oral). [online] Available at: [Accessed 19 October 2021].
Rad-ar.or.jp. 2021. Search results detail| Kusurino-Shiori(Drug information Sheet). [online] Available at: [Accessed 19 October 2021].
Information, P., 2021. [PDF] Prescribing Information - Free Download PDF. [online] Silo.tips. Available at: s/download/prescribing-information-5 [Accessed 19 October 2021].
Information on this page was last updated on 28 Feb 2023
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