- A Visual Guide to Heart Disease
- Medical Illustrations of the Heart Image Collection
- Take the Heart Disease Quiz!
- What is isosorbide dinitrate, and how does it work (mechanism of action)?
- What brand names are available for isosorbide dinitrate?
- Is isosorbide dinitrate available as a generic drug?
- Do I need a prescription for isosorbide dinitrate?
- What are the side effects of isosorbide dinitrate?
- What is the dosage for isosorbide dinitrate?
- Which drugs or supplements interact with isosorbide dinitrate?
- Is isosorbide dinitrate safe to take if I'm pregnant or breastfeeding?
- What else should I know about isosorbide dinitrate?
What is isosorbide dinitrate, and how does it work (mechanism of action)?
Isosorbide dinitrate is in the class of drugs called nitrates, and it is used for treating and preventing angina or heart pain. Other nitrates include nitroglycerin (Nitrostat, Nitroquick, Nitrolingual, Nitro-Dur and others) and isosorbide mononitrate (Imdur, Ismo, Monoket). Isosorbide dinitrate is converted in the body to isosorbide mononitrate which is the active chemical.
Nitrates are vasodilators (dilators of blood vessels). Blood returning from the body in the veins must be pumped by the heart through the lungs and into the body's arteries against the high pressure in the arteries. In order to accomplish this work, the heart's muscle must produce and use energy ("fuel"), and this requires oxygen. Angina pectoris (angina) or "heart pain" is due to an inadequate flow of blood (and oxygen) to the muscle of the heart. Nitrates, including isosorbide dinitrate, improve the flow of blood and oxygen to the heart and reduce the work that the heart must do by dilating (expanding) the arteries and veins in the body. Dilation of the veins reduces the amount of blood that returns to the heart that must be pumped. Dilation of the arteries lowers the pressure in the arteries against which the heart must pump. As a consequence of both effects, the heart works less and requires less blood and oxygen. In addition, nitrates dilate the arteries that supply the heart with blood so that the heart receives more blood and oxygen. The FDA approved isosorbide dinitrate in January 1968.
What are the side effects of isosorbide dinitrate?
Headaches are the most common side effect of isosorbide dinitrate and usually are dose-related (increase with higher doses). Flushing may occur because isosorbide dinitrate dilates blood vessels. Isosorbide dinitrate may cause a drop in blood pressure when rising from a sitting position (orthostatic hypotension), causing dizziness, palpitations, and weakness. To reduce the risk of these side effects, patients should rise slowly from a sitting position.
What is the dosage for isosorbide dinitrate?
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.
Which drugs or supplements interact with isosorbide dinitrate?
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.
Is isosorbide dinitrate safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of isosorbide dinitrate in pregnant women.
It is not known if isosorbide dinitrate is excreted in human breast-milk.
What else should I know about isosorbide dinitrate?
What preparations of isosorbide dinitrate are available?
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
How should I keep isosorbide dinitrate stored?
Isosorbide dinitrate should be stored at room temperature, 15 C - 30 C (59 F - 86 F).
Quick GuideHeart Disease: Symptoms, Signs, and Causes

Summary
Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is a medication in the nitrate drug class. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. This medications comes in tablets, sustained release, and immediate release via sublingual administration. Side effects, drug interactions, and safety during pregnancy information should be reviewed prior to taking this medication.
Multimedia: Slideshows, Images & Quizzes
-
Heart Disease Quiz: Test Your Medical IQ
Take our Heart Disease Quiz to get answers and facts about high cholesterol, atherosclerosis prevention, and the causes,...
-
Picture of Heart Detail
The heart is composed of specialized cardiac muscle, and it is four-chambered, with a right atrium and ventricle, and an...
-
Picture of Heart Catheter
Catheter procedures are much easier than surgery on patients because they involve only a needle puncture in the skin where the...
-
Heart Disease: Symptoms, Signs, and Causes
What is heart disease (coronary artery disease)? Learn about the causes of heart disease. Symptoms of heart disease include chest...
-
Lower Your Cholesterol, Save Your Heart
Need to lower your cholesterol levels? Use these smart diet tips to quickly and easily lower your blood cholesterol levels....
-
Heartburn: Foods to Eat, Foods to Avoid
Learn the symptoms of heartburn and which foods cause heartburn or GERD. Discover home remedies and which foods may provide...
-
Heart-Healthy Diet: 25 Foods to Protect Your Cardiovascular System
See 25 foods loaded with heart-healthy nutrients that help protect your cardiovascular system. Plus, find easy meal/recipes and...
-
Heart Disease: Causes of a Heart Attack
Learn about heart disease and heart attack symptoms and signs of a heart attack in men and women. Read about heart disease...
-
Am I Having a Heart Attack? Symptoms of Heart Disease
Heart attacks symptoms vary greatly for men and women, from anxiety and fatigue to nausea and sweating. Learn the warning signs...
-
High-Fiber Super Foods: Whole Grains, Fruits, & More
Learn about high-fiber foods. From fresh fruits to whole grains, these fiber-rich foods can lower cholesterol, prevent...
-
Food Swaps for Meals and Snacks for Heart Health in Pictures
Explore 10 food swaps for heart-wise dining. Learn what food to buy and how to cook in order to make a big difference for your...
Related Disease Conditions
-
Angina (Symptoms, Causes, Types, Diagnosis, and Treatment)
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning,...
-
12 Congestive Heart Failure Symptoms, Stages, Causes, and Life Expectancy
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease,...
-
Achalasia
Esophageal achalasia is a disease of the esophagus that mainly affects young adults. Achalasia makes it difficult to swallow, can...
-
Heart Failure
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and...
-
Chest Pain
Chest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy,...
-
Heart Disease
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to...
Treatment & Diagnosis
- Heart Disease FAQs
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Medication Disposal
- Dangers of Mixing Medications
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
From 
Healthy Heart Resources
Featured Centers
Health Solutions From Our Sponsors
Health Solutions From Our Sponsors

Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.