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

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

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

STORAGE: Isosorbide dinitrate should be stored at room temperature, 15 C - 30 C (59 F - 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 other forms of 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): 2.5-5 mg 15 minutes before activities likely to cause chest pain. For treating chest pain, 2.5 to 5 mg is taken every 5 to 10 minutes.
  • 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 take 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.

Medically Reviewed by a Doctor on 10/29/2014

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