Isosorbide Dinitrate

Angina, Percutaneous transluminal coronary angioplasty

Oral Angina Pectoris Immediate release: 5-20 mg 2-3 times daily initially; Maintenance: 10-40 mg PO 2-3 times daily.

Should be taken on an empty stomach. Take on an empty stomach ½ hr before meals.

Severe hypotension or anaemia, hypovolaemia, heart failure due to obstruction, or raised intracranial pressure due to head trauma or cerebral haemorrhage.

Raised intracranial pressure, hypotension, hypovolaemia. Mitral valve prolapse, arterial hypoxaemia, glaucoma, elderly, hypothyroidism, malnutrition, pregnancy, lactation Lactation: Unknown whether drug is distributed into breast milk

C Pregnancy category: C Lactation: Unknown whether drug is distributed into breast milk

Increased hypotensive effects with alcohol or vasodilators. Marked orthostatic hypotension may occur when used with calcium channel blockers. Vasodilatory effect may be reduced with dihydroergotamine. Ergotamine effects may be enhanced. Reduced effectiveness of sublingual form with disopyramide. Potentially Fatal: Significant hypotension may occur with phosphodiesterase-5 inhibitors.

Cardiovascular: Rebound hypertension (uncommon), syncope, unstable angina flushing, hypotension/orthostatic hypotension, lightheadedness, palpitations, tachyarrhythmia Central nervous system (CNS): Dizziness, headache, restlessness, weakness Gastrointestinal (GI): Nausea Hematologic: Methemoglobinemia (infrequent) Potentially Fatal: Severe hypotension, circulatory collapse.

Isosorbide dinitrate relaxes vascular smooth muscles by stimulating cyclic-GMP. It decreases left ventricular pressure (preload) and arterial resistance (afterload).