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Drug Information
Pharmacokinetics
| Indication
& Dosage | Action
| Interactions
Precautions |
Brands available in Market
When given orally it undergoes extensive first pass metabolism hence it is administered sublingual.
Sublingual
ACUTE ATTACKS OF ANGINA: 5-10mg
Oral
PREVENTION OF ATTACKS IN ALL TYPES OF ANGINA AND RELIEF OF CORONARY ARTERY
SPASM: 5-10mg q.i.d. Occasionally 20mg q.i.d may be needed. Sust. rel.
20-40mg b.i.d
CONGESTIVE HEART FAILURE: 30-60mg q.i.d.
Aerosol Spray
TREATMENT AND PROPHYLAXIS OF ANGINA: (1.25mg/metered dose) 1-3 sprays
under the tongue and close the mouth.
Action
Like all organic nitrates, isosorbide dinitrate relaxes plain
muscle. It has no action on any other tissue. At lower doses this drug
dialtes venous capacitance vessels therby reducing venous return
(preload), conducting arteries and coronary collaterals.At higher doses
arterioles are dilated reducing afterload. In anginal patients, exercise
tolerance and time to one minute ST depression are increased.
Anginal attacks and intesity are reduced.
Interactions
Orthostatic
hypotension occurs when used together with: calcium channel
blockers, phenothiazines or tricyclic antidepressants.
Headache is a common adverse effect. Dizziness
or lightheadedness may be more likely to occur in the elderly.
Anemia (severe) and Glaucoma: May be worsened by nitrates.In
Intracerebral hemorrhage (Recent): Nitrates may worsen the
condition. In recent Myocardial Infarction : Nitrates may cause
hypotension, which can aggravate problems associated with MI. In
renal disease and hepatic disease : Effects may be increased
because of slower removal of nitroglycerin from the body.
Preaction: Glaucoma, hypertension
Pregnancy: Use with caution.
Breast Feeding: Use with caution.
Man: use with caution.
