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Does Isordil (isosorbide dinitrate) cause side effects?
Isordil 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. To accomplish this work, the heart's muscle must produce and use energy, and this requires oxygen.
Angina 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.
Common side effects of Isordil include
- flushing, and
- a drop in blood pressure causing dizziness when rising from a sitting position (orthostatic hypotension).
Serious side effects of Isordil include
- lightheadedness like you might pass out,
- worsening angina pain,
- fast or slow heart rate, and
- pounding heartbeats or fluttering in the chest.
Severe blood pressure reduction, especially when changing posture, may occur when Isordil is combined with calcium channel blockers which also reduce blood pressure.
There are no adequate studies of Isordil in pregnant women.
What are the important side effects of Isordil (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
- To reduce the risk of these side effects, patients should rise slowly from a sitting position.
Isordil (ishosorbide dinitrate) side effects list for healthcare professionals
Adverse reactions to isosorbide dinitrate are generally dose-related, and almost all of these reactions are the result of isosorbide dinitrate’s activity as a vasodilator.
- Headache, which may be severe, is the most commonly reported side effect.
- Headache may be recurrent with each daily dose, especially at higher doses.
- Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur.
- Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy.
- Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon.
- Extremely rarely, ordinary doses of organic nitrates have caused methemoglobinemia in normalseeming patients. Methemoglobinemia is so infrequent at these doses that further discussion of its diagnosis and treatment is deferred.
- Data are not available to allow estimation of the frequency of adverse reactions during treatment with Isordil Titradose tablets.
To report SUSPECTED ADVERSE REACTIONS, contact Valeant Pharmaceuticals North America LLC at 1-800-321-4576 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What drugs interact with Isordil (isosorbide dinitrate)?
The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. Alcohol, in particular, has been found to exhibit additive effects of this variety.
- Concomitant use of Isordil Titradose with phosphodiesterase inhibitors in any form is contraindicated.
- Concomitant use of Isordil Titradose with riociguat, a soluble guanylate cyclase stimulator, is contraindicated.
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Related Disease Conditions
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Angina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
Heart Disease: Sudden Cardiac Death
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Stress and Heart Disease
The connection between stress and heart disease is not clear. Stress itself may be a risk factor, or high levels of stress may make risk factors for heart disease worse. The warning signs of stress can be physical, mental, emotional, or behavioral. Reducing stressors in an individuals life not only can lead to a more productive life, but may also decrease the risk for heart disease and causes of heart disease.
Heart Disease in Women
Heart disease in women has somewhat different symptoms, risk factors, and treatment compared to heart disease in men. Many women and health professionals are not aware of the risk factors for heart disease in women and may delay diagnosis and treatment. Lifestyle factors such as diet, exercise, tobacco use, overweight/obesity, stress, alcohol consumption, and depression influence heart disease risk in women. High blood pressure, high cholesterol, and diabetes also increase women's risk of heart disease. Electrocardiogram (EKG or ECG), stress-ECG, endothelial testing, ankle-brachial index (ABI), echocardiogram, nuclear imaging, electron beam CT, and lab tests to assess blood lipids and biomarkers of inflammation are used to diagnose heart disease. Early diagnosis and treatment of heart disease in women saves lives. Heart disease can be prevented and reversed with lifestyle changes.
Heart Disease Treatment in Women
Heart disease treatment in women should take into account female-specific guidelines that were developed by the American Heart Association. Risk factors and symptoms of heart disease in women differ from those in men. Treatment may include lifestyle modification (diet, exercise, weight management, smoking cessation, stress reduction), medications, percutaneous intervention procedure (PCI), and coronary artery bypass grafting (CABG). Heart disease is reversible with treatment.
Congenital Heart Defects
Congenital heart defects are heart problems that are present at birth. Genetics may play a role in some heart defects. Symptoms can range from nonexistent to severe and life-threatening. Fatigue, rapid breathing, and decreased blood circulation are a few possible symptoms of congenital heart defects. Many cases do not require any treatment. Procedures using catheters and surgery may be used to repair severe heart defects.
Smoking and Heart Disease
Smoking increases the risk of heart disease in women and men. Nicotine in cigarettes decrease oxygen to the heart, increases blood pressure, blood clots, and damages coronary arteries. Learn how to quit smoking today, to prolong your life.
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Medications & Supplements
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.
Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.