Isosorbide-dinitrate

Oral tablets: The recommended dose of isosorbide oral tablets for long-term prevention of angina is 5 mg to 30 mg taken 4 times daily, leaving a period of time called the nitrate-free period (as discussed with your doctor) where the body is relatively free of the medication. For example, the medication may be taken at 8 am, 12 pm, 4 pm, and 8 pm. This schedule allows the medication to keep working effectively as it prevents your body from getting too used to its effects.

Sublingual tablets (tablets dissolve in 20 seconds under the tongue): Isosorbide sublingual (under the tongue) tablets are dissolved under the tongue to prevent an angina attack. Dissolve 1 or 2 tablets (5 mg to 10 mg) under the tongue, between the cheek and gum, or between the lip and gum every 2 to 4 hours. An extra dose of 5 mg to 10 mg may be taken before stressful situations that are likely to cause an angina attack. Do not eat, drink, smoke, or chew tobacco while the tablet is dissolving. Talk to your doctor about the dose and nitrate-free period that are right for you.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Isosorbide-Dinitrate (Isosorbide-dinitrate) exactly as prescribed by the doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is close to the time of your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Isosorbide-Dinitrate (Isosorbide-dinitrate) at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause redness of the face; it may cause nausea or, rarely, vomiting; it may cause palpitations (rapid and strong heart beat); it may lower your blood pressure, which could cause weakness and/or dizziness. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

Sublingual tablets

5 mg
Each pink, round, flat-faced sublingual tablet engraved "5" on one side contains 5 mg of isosorbide dinitrate. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, 6 magnesium stearate, colloidal silicon dioxide, and D&C Red No. 30 Aluminum Lake.

Tablets

10 mg
Each white, round, flat-faced, scored tablet engraved "10" on one side contains 10 mg of isosorbide dinitrate. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, and 6 magnesium stearate.

30 mg
Each white, round, flat-faced, scored tablet engraved "30" on one side contains 30 mg of isosorbide dinitrate. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, 6 magnesium stearate, and colloidal silicon dioxide.

Do not take isosorbide dinitrate if you:

• are allergic to isosorbide or any ingredients of the medication
• have or are at risk for a heart condition known as cardiogenic shock (e.g., after a Heart Attack)
• are taking a type of medication known as PDE-5 inhibitors, which are used for Erectile Dysfunction; e.g., Sildenafil (Viagra®), Tadalafil (Cialis®), vardenafil (Levitra®)

There may be an interaction between isosorbide dinitrate and any of the following:

• Abiraterone acetate
• alcohol
• Aldesleukin
• Aliskiren
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• alpha agonists (e.g., Clonidine, methyldopa)
• Amiodarone
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., candasartan, Irbesartan, Losartan)
• second generation anti-psychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• Aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, pentobarbital Phenobarbital)
• Bicalutamide
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• boceprevir
• Bosentan
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• Carbamazepine
• conivaptan
• Crizotinib
• Cyclosporine
• Dabrafenib
• Dapsone
• Dasatinib
• Deferasirox
• Desipramine
• Dexamethasone
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Dronedarone
• Duloxetine
• Enzalutamide
• ergot alkaloids
• grapefruit juice
• Guanfacine
• Haloperidol
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• Hydralazine
• imatinib
• levodopa
• Lomitapide
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• mifepristone
• Modafinil
• Morphine
• nefazodone
• Obinutuzumab
• other nitrates (e.g., nitroglycerin, isosorbide mononitrate)
• Norfloxacin
• Pentoxifylline
• Phenytoin
• medications for erectile dysfunction called phosphodiesterase 5 inhibitors (PDE-5 inhibitors; e.g., sildenafil, tadalafil, vardenafil)
• prilocaine
• primidone
• rifabutin
• rifampin
• Riociguat
• Rosiglitazone
• St. John's wort
• Sertraline
• siltuximab
• simeprevir
• Tizanidine
• Tocilizumab
• tolcapone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Isosorbide-Dinitrate (Isosorbide-dinitrate). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Isosorbide-Dinitrate (Isosorbide-dinitrate).

Medical conditions: If you have Low Blood Pressure, Glaucoma, or Kidney Disease, discuss with your doctor how Isosorbide-Dinitrate (Isosorbide-dinitrate) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Isosorbide-Dinitrate (Isosorbide-dinitrate), and whether any special monitoring is needed.

Low Blood Pressure: When isosorbide dinitrate relaxes the blood vessels, the blood vessels become wider, allowing blood to flow more easily. This can cause blood pressure to decrease. While this usually isn't a problem, some people experience dizziness, headache or fainting, particularly when rising from a seated or lying position. If you have low blood pressure or experience these symptoms when you are taking isosorbide dinitrate, talk to your doctor.

Tolerance: The body can get used to the effects of isosorbide dinitrate (develop a tolerance), especially if the medication is taken throughout the day without a "nitrate-free period" (a 10 to 12-hour break from the medication). If you find that your symptoms of angina are getting worse or lasting longer, call your doctor.

Withdrawal: Stopping Isosorbide-Dinitrate (Isosorbide-dinitrate) suddenly may occasionally aggravate chest pain or other symptoms of angina. To avoid possible withdrawal effects, isosorbide dinitrate should be gradually reduced and not stopped suddenly. Talk to your doctor about how to stop the medication safely.

Pregnancy: Isosorbide-Dinitrate (Isosorbide-dinitrate) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Isosorbide-Dinitrate (Isosorbide-dinitrate), contact your doctor immediately.

Breast-feeding: It is not known if isosorbide dinitrate passes into breast milk. If you are a breast-feeding mother and are taking Isosorbide-Dinitrate (Isosorbide-dinitrate), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Isosorbide-Dinitrate (Isosorbide-dinitrate) have not been established for children.

Seniors: Seniors may be more likely to experience dizziness or lightheadedness taking isosorbide dinitrate.

<p>Isosorbide dinitrate belongs to the class of medications called <i>anti-anginals</i>. It is used to<b> prevent chest pain associated with Angina.</b> It works by relaxing blood vessels and increasing the blood and oxygen supply to the heart. Isosorbide dinitrate may reduce the number, length, and severity of angina attacks. Tolerance for exercise may be increased and the need for fast-acting <a href="/drug/trinipatch">Nitroglycerin</a> (tablets and spray) may be reduced.</p><p><b>Isosorbide-Dinitrate (Isosorbide-dinitrate) may be available under multiple brand names and/or in several different forms.</b> Any specific brand name of Isosorbide-Dinitrate (Isosorbide-dinitrate) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Isosorbide-Dinitrate (Isosorbide-dinitrate) may not be used for all of the conditions discussed here.</p><p><b>Your doctor may have suggested Isosorbide-Dinitrate (Isosorbide-dinitrate) for conditions other than those listed in these drug information articles.</b> If you have not discussed this with your doctor or are not sure why you are taking Isosorbide-Dinitrate (Isosorbide-dinitrate), speak to your doctor. <b>Do not stop taking Isosorbide-Dinitrate (Isosorbide-dinitrate) without consulting your doctor.</b></p><p><b>Do not give Isosorbide-Dinitrate (Isosorbide-dinitrate) to anyone else, even if they have the same symptoms as you do.</b> It can be harmful for people to take Isosorbide-Dinitrate (Isosorbide-dinitrate) if their doctor has not prescribed it.</p>