isosorbide dinitrate

Action and Spectrum

Actions and Spectrum 

Blood vessel walls smooth muscles are relaxed by isosorbide dinitrate, which causes blood vessels to dilate.  

By lowering peripheral resistance and enhancing blood flow to the coronary arteries, this dilatation lessens the workload on the heart.

Drug Interaction

Adverse Reaction

Frequency not defined  

Hematologic: Methemoglobinemia  

Cardiovascular: Rebound hypertension, lightheadedness, palpitations, tachyarrhythmia, syncope, unstable angina flushing, hypotension 

Gastrointestinal (GI): Nausea 

Central nervous system (CNS): restlessness, weakness, dizziness, headache 

Black Box Warning

Black Box Warning 

None  

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• isosorbide dinitrate should not be used in individuals who have a known hypersensitivity or allergy to isosorbide dinitrate or any of its components. 
• isosorbide dinitrate is contraindicated in patients with severe anemia.  

Caution: 

• It should be used with caution in patients with hypotension or those who are at risk of developing low blood pressure. 
• isosorbide dinitrate should be used with caution in patients with impaired liver or kidney function. 
• isosorbide dinitrate should be used with caution in patients with certain heart conditions, including hypertrophic obstructive cardiomyopathy.

Pregnancy / Lactation

Pregnancy consideration: 

Pregnancy category: C 

Lactation: Excretion into human milk is unknown  

Pregnancy Categories:         

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.  

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women. 

Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 

Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology  

isosorbide dinitrate is converted in the body into nitric oxide (NO), which acts as a potent vasodilator. It stimulates the production of cyclic guanosine monophosphate (cGMP), which leads to relaxation of smooth muscle cells in the blood vessels. 

Pharmacodynamics 

isosorbide dinitrate’s vasodilatory effects extend to the coronary arteries, improving blood flow to the heart. By dilating coronary arteries, isosorbide dinitrate enhances oxygen and nutrient supply to the cardiac muscle, which can be beneficial in the treatment of angina. 

Pharmacokinetics 

Absorption   

isosorbide dinitrate drug is absorbed from the gastrointestinal tract. 

Distribution 

isosorbide dinitrate have a relatively large volume of distribution approximately 2 to 4 L/kg. They are widely distributed throughout the body. 

Metabolism 

isosorbide dinitrate undergoes extensive first-pass metabolism in the liver. 

Elimination and excretion 

isosorbide dinitrate are excreted in the urine.

Adminstartion

Administration 

isosorbide dinitrate is available in immediate-release tablets that are taken orally. 

isosorbide dinitrate may also be available in extended-release formulations. 

isosorbide dinitrate sublingual tablets are designed to dissolve under the tongue for rapid absorption.

Patient Information Leaflet

Patient information leaflet 

Generic Name: isosorbide dinitrate 

Why do we use isosorbide dinitrate? 

isosorbide dinitrate is primarily used for the treatment and prevention of angina pectoris, a condition characterized by chest pain.  

isosorbide dinitrate can also be used as a preventive medication to reduce the frequency and severity of angina episodes.   

isosorbide dinitrate is used to relieve acute episodes of angina.