isosorbide dinitrate, Isordil Titradose, Dilatrate-SR, Isochron (cont.)

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PREPARATIONS: Tablets (sublingual): 2.5, 5, 10 mg. Tablets (immediate release): 5, 10, 20, 30, 40 mg. Tablets (extended release): 40 mg. Capsules (sustained release): 40 mg

STORAGE: Isosorbide dinitrate should be stored at room temperature, 15-30 C (59-86 F).

PRESCRIBED FOR: Isosorbide dinitrate is used for the treatment and prevention of angina caused by coronary artery disease. Only sublingual tablets are used for immediate treatment of angina because the onset of action of oral isosorbide dinitrate is not fast enough. Isosorbide dinitrate sometimes is used for treating congestive heart failure.

DOSING: Isosorbide dinitrate tablets can be taken with or without food. The sublingual tablets should be dissolved under the tongue and should not be crushed or chewed. Tolerance (reduced effect after several doses) may develop, so a drug free period of at least 14 hours is recommended. The recommended doses of isosorbide dinitrate are:

  • Tablets: 5-40 mg 2 or 3 times daily
  • Tablets: (sublingual): 2.5-10 mg
  • Tablets: (extended-release) and capsules (sustained-release): 40-80 mg once or twice daily.

DRUG INTERACTIONS: Sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) increase the blood pressure lowering effects of isosorbide dinitrate and may cause excessive blood pressure reduction. Patients taking isosorbide dinitrate should not receive sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). Severe blood pressure reduction, especially when changing posture, may occur when isosorbide dinitrate is combined with calcium channel blockers, for example, diltiazem (Cardizem, Tiazac, etc.) and verapamil (Calan, Verelan, etc.) which also reduce blood pressure.

PREGNANCY: There are no adequate studies of isosorbide dinitrate in pregnant women.

NURSING MOTHERS: It is not known if isosorbide dinitrate is excreted in human breast-milk.

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