Isosorbide Dinitrate

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Toxicological Effects
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Isoket, Isomack; Belgium: Cedocard; Bulgaria: Isodinit, Isoket, Kardiket; Cyprus: Cedocard, Isoket, Isorem, Pensordil; Czech Republic: Cradiket, Isomack, Isoket, Isopelet; Denmark: Cardopax; Estonia: ISDN, Isoket, Isoket; Finland: Dinit, Nitrosid; France: Dinitrate d’Isosorbide, Isocard, Risordan; Germany: Diconpin, Duranitrat, ISDN, Iso-Puren, Isoket, Isosorbiddinitrat, Jenacard, Nitrosorbon; Greece: Pensodril; Ireland: Isoket; Italy: Carvasin, Diniket, Nitrosorbide; Latvia: Cardiket, ISDN, Isoket, Nitrosorbīds; Lithuania: Cardiket, Isoket; Luxembourg: Cedokart, ISDN, Isokart, Isodinit, Isoket, Isomack, Isordil, Isotonax, Sorbitrate, TD Spray Iso Mack; Malta: Isoket, Isorem, Pensordil; Netherlands: Cedocard, Isordil, Isosorbidedinitraat, Isosorbide Dinitraat; Poland: Aerosonit, Cardonit, Iso Mack, Isodinit, Isoket, Sorbonit; Portugal: Flindix, Isoket; Romania: Diniter, Elantan Long, Isodinit, Isoket, Isosorbid Dinitrat; Slovakia: Cardiket, Isoket, Isopelet; Spain: Iso-Lacer; Sweden: Sorbangil; UK: Isoket, Isosorbide Dinitrate.

North America

Canada: ISDN, Isosorbide-5, Novo-Sorbide; USA: Dilatrate-SR, Isordil, Isosorbide Dinitrate, Sorbitrate.

Latin America

Argentina: Isoket, Isordil, Isosorbide Dinitrato; Brazil: Angil-Isossorbida, Isordil; Mexico: Biordyn, Debisor, Isoket, Isorbid, Insucar, Zanisor.

Asia

Japan: Antup R, Apatya, Circres, Conspit, Diasera L, Frandol, Helpinin-R, Isobide, Isocoronal R, Isopit, Isosorbidedi nitrate, Kalliant SR, L-Ohnesgen, Nitorol, Nitrobide, Nitrofix, Nitrous, Nytosorbide, Rifatac L, Sawadol.

Drug combinations

Isosorbide Dinitrate and Hydralazine

Isosorbide Dinitrate and Pindolol

Chemistry

Isosorbide Dinitrate: C~6~H~8~N~2~O~8~. Mw: 236.14. D-Glucitol, 1,4:3,6-dianhydro-, dinitrate. CAS-87-33-2 (1966).

Pharmacologic Category

Vasodilating Agents; Nitrates and Nitrites. Vasodilator. (ATC-Code: C01DA08; C05AE02).

Mechanism of action

Stimulation of intracellular cyclic-GMP results in vascular smooth muscle relaxation of both arterial and venous vasculature.

Therapeutic use

Acute relief of angina pectoris, prophylactic management in situations likely to provoke angina attacks, and long-term prophylactic management of angina pectoris. Also used to relieve pain, dysphagia, and spasm in esophageal spasm with gastroesophageal reflux.

Pregnancy and lactiation implications

Caution if used during pregnancy or in nursing women.

Unlabeled use

Esophageal spastic disorders.

Contraindications

Hypersensitivity to isosorbide dinitrate or any component of the formulation. Hypersensitivity to organic nitrates. Concurrent use with PDE-5 inhibitors (sildenafil, tadalafil, or vardenafil). Angle-closure glaucoma. Head trauma or cerebral hemorrhage. Severe anemia.

Warnings and precautions

Hypotension, paradoxical bradycardia and increased angina pectoris can occur. Postural hypotension can also occur (use with caution in volume depletion, hypotension, and right ventricular infarctions). Use with caution in hypertrophic cardiomyopathy. Avoid concurrent use with PDE-5 inhibitors (e.g. sildenafil, tadalafil, vardenafil). Sensitivity reactions occur extremely rarely. Nitrate dependence possible.

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