Isosorbide Dinitrate

Isosorbide Dinitrate

Isosorbide dinitrate is a drug to prevent and relieve angina pectoris (chest pain) due to coronary heart disease. This drug can also be used in the treatment of heart failure.

Isosorbide dinitrate (ISDN) works as a vasodilator by dilating blood vessels, so that blood flow to the heart muscle is smoother and the heart's workload is reduced. With proper use, isosorbide dinitrate can prevent and treat angina, as well as treat heart failure.

Isosorbide dinitrate is available in tablets, sublingual tablets, and sustained release tablets. Sublingual tablets work the fastest, so they can be used to relieve angina that is happening. Meanwhile, tablets and slow release tablets are prioritized for the treatment and prevention of long-term angina.

Isosorbide dinitrate trademarks: Cedocard, Cedocard Retard, Farsorbid, Isorbid, Isosorbide Dinitrate, Isonat, Monecto 20, and Nosorbid.

What is Isosorbide Dinitrate

class Nitrate
Category Prescription drug
Benefit To prevent and treat angina pectoris in patients with coronary heart disease , as well as for the treatment of heart failure.
Used by Mature
Isosorbide dinitrate for pregnant and lactating women




Category C: Studies in experimental animals show an adverse effect on the fetus, but there are no controlled studies in pregnant women. The drug should only be used if the expected benefit outweighs the risk to the fetus.

Isosorbide dinitrate is not known whether it is absorbed into breast milk or not. If you are breastfeeding, do not use this medication without consulting your doctor first.

Drug form Tablets, sustained release tablets, sublingual tablets and injectables.

Precautions Before Using Isosorbide Dinitrate

There are several things that need to be considered before undergoing treatment with isosorbide dinitrate, including:

  • Tell your doctor if you are allergic to isosorbide dinitrate or other nitrate drugs, such as isosorbide mononitrate or nitroglycerin.
  • Tell your doctor if you are taking other medications, especially drugs for impotence, such as sildenafil or tadalafil. Isosorbide dinitrate should not be used in patients who are currently being treated with these drugs.
  • Tell your doctor if you have recently had a heart attack or if you have any other heart disease, especially mitral stenosis, chronic pericarditis, or cardiomyopathy
  • Tell your doctor if you have or have ever had glaucoma , hypothyroidism, malnutrition , hypotension, orthostatic hypotension , anemia, lung disease, kidney disease, or liver disease .
  • Do not immediately drive a vehicle or operate heavy machinery if you feel dizzy after using isosorbide dinitrate.
  • Do not consume alcoholic beverages during treatment with isosorbide dinitrate, because it can worsen the side effects of this drug.
  • Tell your doctor if you are pregnant, planning to become pregnant, or are
  • Tell your doctor if you are taking other medicines, including supplements and herbal products, to avoid drug interactions.
  • Tell your doctor if you are taking isosorbide dinitrate before having any medical procedure or surgery, including dental surgery.
  • Tell your doctor immediately if you have an allergic reaction or overdose after using isosorbide dinitrate.

Dosage and Rules for Using Isosorbide Dinitrate

The dose of isosorbide dinitrate given by the doctor can be different for each patient, depending on the drug preparation, the conditions being treated, and the patient's body's response to treatment.

The following is the distribution of isosorbide dinitrate doses for adults based on drug preparations and the conditions being treated:

I sosorbide dinitrate tablet

  • Angina pectoris
    The dose is 20–120 mg per day in divided doses. Dosage may be gradually increased according to patient response. The maximum dose is 240 mg per day.
  • Heart failure
    The dose is 40–160 mg per day in divided doses. Maximum dose of 240 mg per day.

I sosorbide dinitrate slow release tablet

  • Angina pectoris
    The dose is 20 mg, 2 times a day, 6–8 hours apart. Dosage may be increased to 20 mg, 3 times daily, depending on the patient's response to treatment.

I sosorbide dinitrate tablet sublingual _

  • Ongoing
    angina pectoris The dose is 2.5–5 mg every 5–10 minutes. Should not be consumed more than 3 times in 15-30 minutes.
  • Prevention of angina pectoris due to strenuous activity
    The dose is 2.5–5 mg, 15 minutes before activities that commonly cause angina, such as intense exercise
  • Acute or chronic
    heart failure As initial treatment, the dose is 5–10 mg every 2 hours.

I sosorbide dinitrate s injection

Isosorbide dinitrate injectable form can be given as part of an angioplasty procedure . In addition, injectable isosorbide dinitrate can also be given to angina pectoris that is severe or does not improve and heart failure caused by a heart attack. The dose of injectable isosorbide dinitrate is determined by the doctor, according to the patient's condition and response.

How to Use Isosorbide Dinitrate Properly

Isosorbide dinitrate in injection form should only be given by a doctor or medical officer under the supervision of a doctor. Isosorbide dinitrate will be given by infusion or injected directly into the patient's vein.

If you are prescribed isosorbide dinitrate to drink, follow your doctor's advice and read the instructions on the medicine package before starting to take it. Do not increase or decrease your dose without consulting your doctor first.

Isosorbide dinitrate tablets consist of ordinary tablets, slow release tablets, and sublingual tablets. Regular and sustained release tablets are usually taken regularly, while sublingual tablets are only used when chest pain occurs.

Isosorbide dinitrate tablets and slow-release tablets can be taken 30 minutes before meals or on an empty stomach. Swallow isosorbide dinitrate tablets with plain water. For isosorbide dinitrate sustained release tablets, swallow this drug whole without splitting, chewing, or crushing it first.

If you forget to take isosorbide dinitrate tablets, consume them immediately if it is not yet close to the schedule for taking the next drug. If it is close, ignore the missed dose and do not double the dose at the time of taking the next drug.

Sublingual tablets should be used as soon as symptoms of chest pain appear. Place it under the tongue and leave it until the medicine dissolves. Do not chew or swallow the sublingual tablet.

While undergoing treatment with isosorbide dinitrate, do not rush to get up when getting up from sitting or when getting up from a lying position, as this can cause severe dizziness and fainting.

If possible, check your blood pressure and pulse every day using a tensimeter at home while using isosorbide dinitrate. Consult a doctor if your pulse or blood pressure is too low.

Do not stop the medication suddenly, because you run the risk of worsening your symptoms. The doctor will reduce the dose gradually if the use of the drug needs to be stopped.

Store isosorbide dinitrate in tablet form, sustained release tablet, or sublingual tablet in a cool place away from sunlight. Keep medicine out of reach of children.

Interaction of Isosorbide Dinitrate with Other Drugs

Interactions that can occur if isosorbide dinitrate is used with certain drugs are:

  • Increased risk of fatal side effects, such as severe hypotension and heart attack, when used with impotence drugs in the phosphodiesterase type 5 (PDE5) inhibitor class, such as sildenafil and tadalafil
  • Increased risk of developing hypotension when used with antihypertensive drugs
  • Increased risk of orthostatic hypotension when used with phenothiazines , monoamine oxidase inhibitors ( MAOIs ), or tricyclic antidepressants
  • Decreased effectiveness of isosorbide dinitrate when used with phenobarbital , apalutamide, phenytoin , or carbamazepine

Isosorbide Dinitrate Side Effects and Dangers

Using isosorbide dinitrate has the potential to cause the following side effects:

  • Dizziness or lightheadedness
  • Headache
  • Nauseous
  • Flushing or hot sensation around the face and neck

Check with your doctor if the complaints mentioned above do not go away or get worse. Immediately see a doctor if you experience  an allergic drug reaction  or experience more serious side effects, such as:

  • Severe dizziness as if you were about to faint
  • Heart rate too fast or slow, or irregular
  • Heart pounding or feeling like it's shaking
  • Chest pain that gets worse
  • Blue lips, fingers, or palms
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