Isordil

Acute & chronic CHF (including that associated w/ MI). Patients w/ increased left ventricular end diastolic pressure, & normal or approx normal cardiac output in whom pulmonary congestion or edema is the primary problem. Tab: Prophylaxis of ischemic heart pain associated w/ coronary insufficiency. SL tab: Treatment of angina pectoris & for prophylaxis in situations likely to provoke an angina attack ie, physical or emotional stress.

Angina pectoris Tab 5-30 mg qid. SL tab 5-10 mg every 2-3 hr as prophylaxis. May be supplemented by 5-10 mg prior to stressful situations likely to provoke an attack. Acute CHF Tab 10-40 mg qid or as needed. SL tab 5-10 mg every 2 hr or as needed. Chronic CHF Initially 5-10 mg by SL every 2 hr or as needed. Maintenance dose: 20-40 mg qid orally or as needed.

Should be taken on an empty stomach: Take 30 min before meals.

Hypersensitivity or idiosyncrasy to isosorbide dinitrate or related compd. Concomitant use w/ soluble guanylate cyclase (GC) stimulator eg, riociguat.

May cause paradoxical side effects in sensitive patients, which may increase ischemia & may even lead to extension of myocardial damage & advanced CHF. Hemodynamic monitoring & frequent clinical assessment in the early infarction. Severe hypotensive response, particularly w/ upright posture may occur. Paradoxical bradycardia & increased angina pectoris may accompany nitrate-induced hypotension. Patients w/ blood vol depletion from diuretic therapy or those w/ low systolic BP (eg, <90 mmHg). Pulmonary capillary pressure must not fall <15 mmHg or systolic BP below the physiological range in normal or hypertensive patients. May aggravate angina caused by hypertrophic cardiomyopathy. Cross-tolerance to other nitrates & nitrites may occur. Avoid abrupt w/drawal. Concomitant use w/ sildenafil. In combination w/ Ca channel blockers. Pregnancy & lactation. Childn. Elderly. Tab: Not indicated for the treatment of an angina attack.

Vascular headache. Cutaneous vasodilation w/ flushing; transient episodes of dizziness & weakness, other signs of cerebral ischemia associated w/ postural hypotension; marked sensitivity to the hypotensive effects; drug rash &/or exfoliative dermatitis.

Enhanced hypotension effect w/ alcohol. Possible additive hypotensive effects w/ antihypertensive drugs, β-adrenergic blockers, or phenothiazines. Vasodilatory effect may be amplified w/ sildenafil. Hypotensive effects may be potentiated w/ riociguat. Marked symptomatic, orthostatic hypotension w/ Ca channel blockers.

Anti-Anginal Drugs

C01DA08 - isosorbide dinitrate ; Belongs to the class of organic nitrate vasodilators. Used in the treatment of cardiac disease.

Rx