Isordil Dosage/Direction for Use

The initial dose should not be more than 5 mg since severe hypotensive response occasionally occurs.
Angina Pectoris: Sublingual Tablets: (Tablets dissolve within 20 seconds) 5 mg to 10 mg sublingually every 2 to 3 hours for the prophylaxis of acute angina; this may be supplemented by a dose of 5 mg to 10 mg prior to stressful situations likely to provoke an attack of angina.
Oral tablets: 5 mg to 30 mg orally 4 times daily, preferably on an empty stomach.
Congestive Heart Failure: In acute and chronic heart failure, both sublingual and oral forms may be used. The selection of sublingual or oral isosorbide dinitrate should be made on the basis of duration of action rather than the magnitude of response, since this is the major difference observed for these dosage forms.
In order to obtain full therapeutic effect, it is important that the dosage of sublingual and oral forms be individualized in accordance with each patient's needs, clinical response and hemodynamic monitoring.
Isosorbide dinitrate therapy should begin with the lowest effective dose and further adjusted as necessary, based on the left ventricular performance. The initial dose really depends on the assessment of how severe the heart failure is. For the treatment of acute congestive heart failure, the rapidly acting sublingual form of isosorbide dinitrate is preferred and should first be administered to stabilize the patient's symptoms or determine the magnitude of hemodynamic response; then it should be followed by the oral form for maintenance therapy.
The average recommended doses for acute and chronic congestive heart failure are the following: Acute Congestive Heart Failure: Sublingual Tablet: 5 to 10 mg every two hours or as needed.
Oral Tablet: 10 to 40 mg four times daily or as needed.
Chronic Congestive Heart Failure: Initial dosage, sublingual tablet: 5 to 10 mg every two hours or as needed.
Maintenance dosage: Oral tablet: 20 to 40 mg four times daily or as needed.