Isosorbide Dinitrate

It is a solid & can be used sublingually at the time of attack as well as orally for chronic prophylaxis of exertional and vasospastic angina.The t1/2 is 40 mins but sustained release formulations provide protection, for 6-10 hrs.

Indications

In acute attacks (Sublingually) & chronic prophylaxis (orally) of angina pectoris and coronary insufficiency. In acute myocardial infarction and CHF and acute LVF.

Dosage

For quick relief : 5-10 mg sublingually. Chronic prophylaxis : 5-10 mg 3-4 times daily or as required. SR formulations. 40-80 mg orally daily.

Contra-Indications

Acute M.I. when shock is present. Hypersensitivity.

Special Precautions

May result in increase of intraocular pressure (Glaucoma). Hypotension. Paediatrics: Not prescribed. Pregnancy and lactation:Safety not established. Elderly: No special problem.

Side Effects

Fullness in head, throbbing headache, flushing weakness, sweating, palpitation, dizziness.

Drug Interactions

Orthostatic hypotension when combined with calcium channel blockers, antihypertensives, phenothiazines, tricyclic antidepressants. Alcohol may produce severe hyotension & collapse. Increases bioavailability of dihydroergotamine.