Isosorbide dinitrate: Drug information

For additional information see "Isosorbide dinitrate: Patient drug information"

For abbreviations, symbols, and age group definitions show table

Brand Names: US

Dilatrate-SR [DSC];
Isordil Titradose

Brand Names: Canada

ISDN

Pharmacologic Category

Antianginal Agent;
Vasodilator

Dosing: Adult

Note: Dilatrate SR has been discontinued in the United States for >1 year.

Achalasia

Achalasia (alternative agent) (off-label use):

Sublingual [Canadian product]: Immediate release: 5 mg administered 10 to 15 minutes before meals. Note: Clinical response is short acting and use does not provide complete relief of symptoms; consider risks before use (Ref).

Angina, prevention

Angina, prevention:

Note: For prevention of recurrent angina, may use in combination with other anti-anginal therapy (eg, beta-blocker) (Ref).

Immediate release: Oral: Initial: 5 to 20 mg 2 to 3 times daily; maintenance dose: 10 to 40 mg 2 to 3 times daily; allow for a 14-hour nitrate-free period after the evening dose and before the morning dose to minimize risk of tolerance.

Extended release: Oral: 40 to 160 mg/day; once daily dosing allows for an 18-hour nitrate-free period to minimize the risk of tolerance; maximum dose: 160 mg/day.

Sublingual [Canadian product]: 5 to 10 mg every 2 to 4 hours; consider supplementing with 5 to 10 mg prior to activities that may provoke angina.

Heart failure with reduced ejection fraction

Heart failure with reduced ejection fraction (off-label use):

Note: Alternative therapy for patients with persistent NYHA class III or IV heart failure with reduced ejection fraction (HFrEF) who cannot tolerate an angiotensin II receptor-neprilysin inhibitor, angiotensin-converting enzyme inhibitor, or angiotensin II receptor blocker or additional therapy in patients who have residual symptoms despite an optimal medical regimen for HFrEF (Ref).

Oral: Immediate release: Initial: 20 mg 3 times daily in combination with hydralazine; titrate dose as tolerated every ≥1 to 2 weeks; target dose: 40 mg 3 times daily (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: No dosage adjustment necessary for any degree of kidney dysfunction (Ref).

Hemodialysis, intermittent (thrice weekly): Not significantly dialyzed (Ref): No supplemental dose or dosage adjustment necessary (Ref).

Peritoneal dialysis: Not likely to be significantly dialyzed (large V_d): No dosage adjustment necessary (Ref).

CRRT: No dosage adjustment necessary (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): No dosage adjustment necessary (Ref).

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Administer the lowest recommended adult daily dose initially and titrate upward. Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined.

Cardiovascular: Hypotension, rebound hypertension, syncope, unstable angina pectoris

Central nervous system: Headache

Contraindications

Hypersensitivity to isosorbide dinitrate or any component of the formulation; concurrent use with phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil, or avanafil); concurrent use with riociguat.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Canadian labeling: Additional contraindications (not in US labeling): Cardiogenic shock or risk of cardiogenic shock developing

Warnings/Precautions

Concerns related to adverse effects:

• Hypotension/bradycardia: Severe hypotension can occur; paradoxical bradycardia and increased angina pectoris can accompany hypotension. Orthostatic hypotension can also occur; ethanol can accentuate this. Use with caution in volume depletion and hypotension, and use with extreme caution with inferior wall MI and suspected right ventricular infarctions. Severe hypotension, particularly with upright posture, may occur with even small doses.

• Intracranial pressure increased: Nitrates may precipitate or aggravate increased intracranial pressure and subsequently may worsen clinical outcomes in patients with neurologic injury (eg, intracranial hemorrhage, traumatic brain injury) (Rangel-Castilla 2008).

Disease-related concerns:

• Cardiovascular disease: Not recommended in patients with acute MI or HF (cannot easily reverse effects if adverse events develop).

• Hypertrophic cardiomyopathy: Avoid use in patients with hypertrophic cardiomyopathy with left ventricular outflow tract obstruction; nitrates may reduce preload, exacerbating obstruction and cause hypotension or syncope and/or worsening of heart failure (AHA/ACC [Ommen 2024]).

Other warnings/precautions:

• Tolerance: Appropriate dosing intervals are needed to minimize tolerance development. Tolerance can only be overcome by short periods of nitrate absence from the body. Dose escalation does not overcome this effect. When used for HF in combination with hydralazine, tolerance is less of a concern (Gogia 1995).

Special populations:

• Bariatric surgery: Presurgical assessment of the indication for use, symptoms, and goals of therapy should be documented to enable postsurgical assessment. Monitor for continued efficacy and tolerability after bariatric surgery and consider switching to an alternate medication if symptoms worsen.

Product Availability

Dilatrate SR has been discontinued in the United States for >1 year.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Capsule Extended Release, Oral:

Dilatrate-SR: 40 mg [DSC] [contains quinoline yellow (d&c yellow #10)]

Tablet, Oral:

Isordil Titradose: 5 mg [scored; contains fd&c red #40 (allura red ac dye)]

Isordil Titradose: 40 mg [scored; contains fd&c blue #1 (brilliant blue), fd&c yellow #6 (sunset yellow), quinoline yellow (d&c yellow #10)]

Generic: 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

Generic Equivalent Available: US

May be product dependent

Pricing: US

Tablets (Isordil Titradose Oral)

5 mg (per each): $11.00

40 mg (per each): $24.22

Tablets (Isosorbide Dinitrate Oral)

5 mg (per each): $0.95 - $0.99

10 mg (per each): $0.73 - $1.08

20 mg (per each): $0.86 - $1.19

30 mg (per each): $1.31

40 mg (per each): $20.54 - $21.78

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet, Oral:

Generic: 10 mg, 30 mg

Tablet Sublingual, Sublingual:

Generic: 5 mg [DSC]

Administration: Adult

Oral: Do not administer around the clock to prevent tolerance to nitrate effect; allow nitrate-free interval ≥14 hours (immediate-release products) and >18 hours (sustained-release products). Do not chew or crush sublingual tablets or sustained-release formulations. Note: In patients with heart failure with reduced ejection fraction who are prescribed hydralazine in combination with isosorbide dinitrate, nitrate tolerance is prevented by coadministration of hydralazine (Ref). When prescribed for this indication and in combination with hydralazine, isosorbide dinitrate can be administered 3 or 4 times daily with no nitrate-free period.

IR products: For twice-daily dosing, consider administering at 8 AM and 1 PM. For 3-times-daily dosing, consider 8 AM, 1 PM, and 6 PM.

ER products: Consider once daily in morning or twice-daily dosing at 8 AM and between 1 PM and 2 PM.

Bariatric surgery: Isosorbide dinitrate may be available in an ER formulation and the release characteristics may be significantly altered in an unknown manner in patients who have undergone bariatric surgery. Providers should determine if the condition being treated can be safely monitored or if a switch to an alternative formulation is necessary (Ref). Isosorbide dinitrate is also available as an IR formulation.

Use: Labeled Indications

Angina pectoris, prevention: Prevention of angina pectoris due to coronary artery disease.

Note: Due to slower onset of action, isosorbide dinitrate is not the drug of choice to abort an acute anginal episode.

Use: Off-Label: Adult

Achalasia; Heart failure with reduced ejection fraction

Medication Safety Issues

Sound-alike/look-alike issues:

Isordil may be confused with Inderal, Isuprel, Plendil

Metabolism/Transport Effects

Substrate of CYP3A4 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Alcohol (Ethyl): May increase vasodilatory effects of Vasodilators (Organic Nitrates). Risk C: Monitor

Alfuzosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Amifostine: Blood Pressure Lowering Agents may increase hypotensive effects of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider Therapy Modification

Amisulpride (Oral): May increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may increase hypotensive effects of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor

Arginine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Barbiturates: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Benperidol: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Blood Pressure Lowering Agents: May increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Brimonidine (Topical): May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Bromperidol: May decrease hypotensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase hypotensive effects of Bromperidol. Risk X: Avoid

Dapoxetine: May increase orthostatic hypotensive effects of Vasodilators (Organic Nitrates). Risk C: Monitor

Dapsone (Topical): May increase adverse/toxic effects of Methemoglobinemia Associated Agents. Risk C: Monitor

Diazoxide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

DULoxetine: Blood Pressure Lowering Agents may increase hypotensive effects of DULoxetine. Risk C: Monitor

Herbal Products with Blood Pressure Lowering Effects: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Hypotension-Associated Agents: Blood Pressure Lowering Agents may increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Iloperidone: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may increase hypotensive effects of Levodopa-Foslevodopa. Risk C: Monitor

Local Anesthetics: Methemoglobinemia Associated Agents may increase adverse/toxic effects of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor

Lormetazepam: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Metergoline: May decrease antihypertensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase orthostatic hypotensive effects of Metergoline. Risk C: Monitor

Molsidomine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Molsidomine: May increase hypotensive effects of Vasodilators (Organic Nitrates). Risk C: Monitor

Naftopidil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicergoline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicorandil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nitric Oxide: May increase adverse/toxic effects of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor

Nitroprusside: Blood Pressure Lowering Agents may increase hypotensive effects of Nitroprusside. Risk C: Monitor

Obinutuzumab: May increase hypotensive effects of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider Therapy Modification

Pentoxifylline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Pholcodine: Blood Pressure Lowering Agents may increase hypotensive effects of Pholcodine. Risk C: Monitor

Phosphodiesterase 5 Inhibitors: May increase vasodilatory effects of Vasodilators (Organic Nitrates). Risk X: Avoid

Prilocaine: Methemoglobinemia Associated Agents may increase adverse/toxic effects of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor for signs of methemoglobinemia when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid use of these agents with prilocaine/lidocaine cream in infants less than 12 months of age. Risk C: Monitor

Primaquine: Methemoglobinemia Associated Agents may increase adverse/toxic effects of Primaquine. Specifically, the risk for methemoglobinemia may be increased. Management: Avoid concomitant use of primaquine and other drugs that are associated with methemoglobinemia when possible. If combined, monitor methemoglobin levels closely. Risk D: Consider Therapy Modification

Prostacyclin Analogues: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Quinagolide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Rilmenidine: Vasodilators (Organic Nitrates) may increase hypotensive effects of Rilmenidine. Risk C: Monitor

Riociguat: Vasodilators (Organic Nitrates) may increase hypotensive effects of Riociguat. Risk X: Avoid

Rosiglitazone: Vasodilators (Organic Nitrates) may increase adverse/toxic effects of Rosiglitazone. Specifically, a greater risk of ischemia and other adverse effects has been associated with this combination in some pooled analyses. Risk C: Monitor

Silodosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Sodium Nitrite: Methemoglobinemia Associated Agents may increase adverse/toxic effects of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor

Tiapride: May increase hypotensive effects of Vasodilators (Organic Nitrates). Risk C: Monitor

Pregnancy Considerations

Adverse events have been observed in some animal reproduction studies.

Nitric oxide donors, such as isosorbide, have been evaluated for cervical ripening and induction of labor (Abu-Zaid 2022; Ghosh 2016); however, use of isosorbide dinitrate is not currently recommended for this indication (ACOG 2009; NICE 2021). Nitric oxide donors have also been evaluated for the prevention of preterm birth (Duckitt 2014; Wilson 2022); additional study is needed for this indication and use is not currently recommended (McDougall 2023; WHO 2022).

Breastfeeding Considerations

It is not known if isosorbide dinitrate is present in breast milk.

The manufacturer recommends that caution be exercised when administering isosorbide dinitrate to patients who are breastfeeding.

Monitoring Parameters

BP, heart rate

Bariatric surgery: Monitor BP and for symptoms of hypotension since bariatric surgery causes an immediate decrease in BP; dose reduction or discontinuation of therapy may be necessary (Ref).

Mechanism of Action

Isosorbide dinitrate and other nitrates form free radical nitric oxide. In smooth muscle, nitric oxide activates guanylate cyclase which increases guanosine 3’5’ monophosphate (cGMP) leading to dephosphorylation of myosin light chains and smooth muscle relaxation. Produces a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins. Primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure); may modestly reduce afterload. Additionally, coronary artery dilation improves collateral flow to ischemic regions.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Sublingual tablet: ~2 to 5 minutes; Oral tablet and ER capsule: ~1 hour.

Duration: Sublingual tablet: 1 to 2 hours; Oral tablet and ER capsule: Up to 8 hours.

Distribution: V_d: 2 to 4 L/kg.

Metabolism: Extensively hepatic to conjugated active metabolites isosorbide 5-mononitrate and 2-mononitrate.

Bioavailability: Highly variable (10% to 90%); increases with chronic therapy.

Half-life elimination: Parent drug: ~1 hour; Metabolites (5-mononitrate: 5 hours; 2-mononitrate: 2 hours).

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Apo isdn | Cedocard | Iso Mack | Isoket | Isordil | Sorbitrate | Vascardin;
(AR) Argentina: Cortespasmo | Isoket | Isordil | Isosorbide vannier;
(AT) Austria: Cedocard | Hexanitrat | Isoket | Isomack | Isostad | Sorbidilat | Vasorbate;
(AU) Australia: Isordil | Sorbidin;
(BD) Bangladesh: Cedocard | Esordin | Isocard | Isordil | Lomilan | Sorbid | Vascardin;
(BE) Belgium: Cedocard | Isordil | Sorbitrate;
(BF) Burkina Faso: Isonit;
(BG) Bulgaria: Isodinit | Isoket | Kardiket;
(BR) Brazil: Angil | Dinatrato de isossorbida | Isocord | Isogreen | Isorbid | Isordil | Isordil ap;
(CH) Switzerland: Acordin | Cedocard | Esconitro | Isoket | Isosifar | Sorbidilat;
(CI) Côte d'Ivoire: Apo isdn;
(CL) Chile: Isorbid | Isosorbida dinitrato;
(CN) China: Angiolong | Ao shu jing | De yi xin | Iso Mack | Isoket | Li bo | Pu xin qing | Weixin haoxin;
(CO) Colombia: Dinitrato de isosorbida | Dinitrato de isosorbide | Isocord | Isordil | Isosorbida;
(CZ) Czech Republic: Apo isdn | Cardiket | Cornilat | Dinisan | Isoket | Isomack | Isopelet | Maycor | Wesorbide;
(DE) Germany: Corovliss | Diconpin | Dignonitrat | Duranitrat | Ibd | Isdn | Isdn 3mm | Isdn al | Isdn beta | Isdn hexal | Isdn Isis | Isdn klast | Isdn merck | Isdn ratiopharm | Isdn Sandoz | Isdn stada | Iso Mack | Isodinit | Isoket | Jenacard | Maycor | Nitro-tablinen | Nitrosorbon;
(DO) Dominican Republic: Isocard | Isoket | Isordil | Nitorol;
(EC) Ecuador: Iso Mack | Isoket | Isordil | Isosorbide;
(EE) Estonia: Cardiket | Isdn ratiopharm | Iso Mack | Isodinit | Isoket | Isolong | Isonit | Maycor | Nitrosorbid;
(EG) Egypt: Cardiket | Cardioguard | Coronit | Dinitra | Iso Mack | Isomak | Isorbid | Isorbide | Isordil | Isosorbide;
(ES) Spain: Iso lacer;
(ET) Ethiopia: Isosorbide;
(FI) Finland: Dinit | Isonit | Nitrosid;
(FR) France: Dinitrate D Isosorbide Merck | Langoran lp | Risordan | Sorbitrate;
(GB) United Kingdom: Cedocard | Isoket | Isordil | Isosorb dinit | Isosorb dinit cox | Isosorb dinitrate | Isosorbid dinitrate | Isosorbid dinitrate kent pharm | Jeridin | Slomon xl | Soni Slo | Sorbid sa | Sorbitrate | Vascardin;
(GR) Greece: Isotrate | Pensordil | Risordan;
(HK) Hong Kong: Apo isdn | Iso Mack | Isobid | Isoket | Isordil | Isorem | Nitorol;
(HR) Croatia: Tinidil;
(HU) Hungary: Cardonit | Huma-sorbide | Isdn al | Isdn q | Iso Mack | Isoket | Isordil | Nitrosorbid | Nitrosorbon | Rigedal | Sorbonit;
(ID) Indonesia: Cedocard | Farsorbid | Gasorbid | Hapisor | Isoket | Isomack | Isonat | Isorbid | Isordil | Isosorbide | Nosorbid | Sorbidin | Vascardin;
(IE) Ireland: Cedocard | Isoket | Isordil;
(IL) Israel: Cordil | Isocardide | Isolong | Isotard;
(IN) India: Anzidin | Cardicap | Cardicap tr | Iso Mack | Isonit | Isordil | Sorbicap | Sorbitrate;
(IQ) Iraq: Isordin awa | Vasordil;
(IT) Italy: Carvasin | Diniket | Nitrosorbide;
(JO) Jordan: Cardipine | Iso Mack | Isobide | Isocard | Isoket | Isordil | Isorem;
(JP) Japan: Carvanil | Circres | Conspit | Conspit taiyo | Cycobelan r | Diasera l | Frandol | Helpinin r | Hoxnol l | Isocoronal r | Isocoronal r amel | Isocoronal r nichiiko | Isosorbi Dinit | Isosorbide Dinitrate Tsuruhara | Kalliant | Kalliant merck hoei | Kalliant zensei | L ohnesgen mita | L-ohnesgen | Lubnol r amel | Lubnol r mg pharma | Nichirate | Nitorol | Nitrobide | Nitroslow | Nytosorbide | Rifatac | Sawadol | Sornilart | Sornitron | Storo | Sulendmin | Sulendmin choseido;
(KE) Kenya: Anginal;
(KR) Korea, Republic of: Angibid | Angibid sr | Bukwang isomack retard | Carso | Carsodil | Iso Mack | Isobin | Isodil | Isoket | Isoket retard | Isomide | Isosorbide | Solbid;
(KW) Kuwait: Isoket | Isomack | Isordil;
(LB) Lebanon: Apo isdn | Apo isosorbide | Iso Mack | Isoket | Isordil | Novo Sorbide | Risordan;
(LT) Lithuania: Apo isdn | Cardiket | Cardonit | I s d n | Isdn | Isodinit | Isoket | Isolong | Isomack | Isosorb | Isosorbide dinitra | Maycor | Nitrosorbid | Nitrosorbide;
(LU) Luxembourg: Cedocard | Isdn | Isodinit | Isoket | Isomack | Isordil | Sorbitrate;
(LV) Latvia: Cardiket | Cardonit | Dinitreks | Isdn | Isodinit | Isoket | Isomack | Isosorb | Isosorbide | Maycor | Nitrosorbid | Nitrosorbide | Sorbidin;
(MA) Morocco: Apo isdn | Disorlon | Langoran | Risordan | Risordan l.p.;
(MX) Mexico: Biderit | Biordyn | Debisor | Dinorbide | Insucar | Isoket | Isorbid | Isorbid ap | Isosorbida | Isosorbida arlex | Isosorbida carbel | Isosorbida kendall;
(MY) Malaysia: Angsobide | Apo isdn | Iso Mack | Isobid | Isoket | Isordil | Nitorol | Solbid | Sorbidin;
(NL) Netherlands: Cedocard | Isordil | Isosorbide dinitraat cf | Isosorbide Dinitraat Katwijk | Isosorbidedinitraat | Isosorbidedinitraat A | Isosorbidedinitraat actavis | Isosorbidedinitraat alpharma | Isosorbidedinitraat cf | Isosorbidedinitraat flx | Isosorbidedinitraat Merck | Isosorbidedinitraat pch | Isosorbidedinitraat Ratiopharm | Isosorbidedinitraat Sandoz;
(NO) Norway: Sorbangil;
(NZ) New Zealand: Coronex;
(PE) Peru: Cardosor | Dilangin | Dinitrato de isosorbida | Isob | Isoket | Isorbide | Isosorbida dinitrato | Isotrate;
(PH) Philippines: Bideren | Isobar | Isobenil | Isoket | Isordil | Nitorol | Nitrosorbon | Novisor | Socorro | Sorbance 5 | Sornitrat | Trindil;
(PK) Pakistan: Isdin | Isobid | Isocord-d10 | Isocord-d5 | Isoday | Isoket | Isonit | Isoprime | Isordil | Isornit | Mayadil | Sorbid | Tinidil;
(PL) Poland: Apo isdn | Cardiosorbid | Cardonit | Cornilat | Iso puren | Isodinit | Isoket | Isomack | Maycor | Risordan | Sorbonit;
(PR) Puerto Rico: Dilatrate | Isoditrate | Isordil | Sorbitrate;
(PT) Portugal: Dinitrato de isossorbida | Flindix | Isoket | Isopront;
(PY) Paraguay: Cardil | Isomack retard | Isordil | Terdil;
(QA) Qatar: ISDN AL Retard | ISDN Stada | ISDN-Ratiopharm | Isoket | Isoket Retard | Isordil | Isorem | Wesorbide;
(RO) Romania: Dinicord retard | Diniter sr | Isolong | Isosorbid dinitrat arena | Izosorbid dinitrat | Maycor;
(RU) Russian Federation: Cardiket | Cardix | Dinisorb | Dinorb | Isacardin | Isodinit | Isoket | Isomack | Isosorb | Isosorbid | Isosorbide dinitrat | Kardonit | Nitrosorbid | Sorbidin;
(SA) Saudi Arabia: Apo isosorbide dinitrate | Iso Mack | Isobide | Isoket | Isordil;
(SE) Sweden: Sorbangil;
(SG) Singapore: Angsobide | Apo isdn | Isoket | Isomack | Isordil;
(SI) Slovenia: Iso Mack | Tinidil;
(SK) Slovakia: Cardiket | Dinisan | Isoket | Isomack | Isopelet | Maycor;
(SR) Suriname: Apo isdn | Cedocard | Cedocard retard | Isordil | Isosorbide dinitraat apotex retard | Isosorbide dinitraat cf | Isosorbidedinitraat | Isosorbidedinitraat actavis | Isosorbidedinitraat aurobindo retard | Isosorbidedinitraat cf;
(TH) Thailand: Angitrit | Apo isdn | Cedocard | Corodil | Hartsorb | Iso | Iso Mack | Isobide | Isobinate | Isoket | Isorbide | Isordil | Isorem | Isosorb | Isosorbide | Isotrate | Izo | Nitorol | Soni Slo | Sorbidin | Sorbitrate | Sornil | Tinidil;
(TN) Tunisia: Apo isdin | Isodil | Langoran | Pensordil | Risordan;
(TR) Turkey: Cardioket | Isonit | Isordil ayerst | Nitrofix | Sorbid;
(TW) Taiwan: Angidil | Cedocard | Iso Mack | Isobide | Isocin | Isoket | Isordil | Isosorbide | Nitorol | Sorbangil | Sorbitrate | Sorcilin | U-Sorbide;
(UA) Ukraine: Cardiket | Cardiket retard | Dicor long | Iso Mack | Iso mick | Iso mik | Isodinitrat | Isoket | Isosorb | Izosorbit | Nitrosorbid | Nitrosorbit;
(UY) Uruguay: Cardionit | Conducil | Isoket | Nitransur;
(VE) Venezuela, Bolivarian Republic of: Dinitrato de isosorbida | Dinitrato de isosorbide | Isoket | Isomack | Isordil;
(VN) Viet Nam: Biresort | Nadecin;
(ZA) South Africa: Cedocard | Isoket | Isordil | Rolab-isosorbide dinitrate;
(ZW) Zimbabwe: Apo isdn

Abu-Zaid A, Alshahrani MS, Al-Matary A, et al. Isosorbide mononitrate for cervical ripening during labour induction: a systematic review and meta-analysis of 23 randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2022;276:38-46. doi:10.1016/j.ejogrb.2022.06.028 [PubMed 35803111]
American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 107: induction of labor. Obstet Gynecol. 2009;114(2 Pt 1):386-397. doi:10.1097/AOG.0b013e3181b48ef5 [PubMed 19623003]
Amsterdam EA, Wenger NK, Brindis RG, et al; ACC/AHA task force members. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;130(25):e344-e426. doi:10.1161/CIR.0000000000000134 [PubMed 25249585]
Anderson JL, Adams CD, Antman EM, et al, "2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines," Circulation, 2011, 123(18):e426-579. [PubMed 21444888]
Antman EM, Anbe SC, Alpert JS, et al, “ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction - Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction),” Circulation, 2004, 110(5):588-636. Available at http://www.circulationaha.org/cgi/content/full/110/5/588 [PubMed 15289388]
Bauer H, Laufen H, Franz HE. Isosorbide dinitrate in plasma and dialysate during haemodialysis. Eur J Clin Pharmacol. 1986;30(2):187-190. doi:10.1007/BF00614300 [PubMed 3709643]
Bogaert MG, Rosseel MT, Boelaert J, Daneels R. Fate of isosorbide dinitrate and mononitrates in patients with renal failure. Eur J Clin Pharmacol. 1981;21(1):73-76. doi:10.1007/BF00609591 [PubMed 7333349]
Cheitlin MD, Hutter AM Jr, Brindis RG, et al, “ACC/AHA Expert Consensus Document. Use of Sildenafil (Viagra) in Patients With Cardiovascular Disease. American College of Cardiology/American Heart Association,” J Am Coll Cardiol, 1999, 33(1):273-82. [PubMed 9935041]
Cohn JN, Archibald DG, Ziesche S, et al, "Effect of Vasodilator Therapy on Mortality in Chronic Congestive Heart Failure. Results of a Veterans Administration Cooperative Study," N Engl J Med, 1986, 314(24):1547-52. [PubMed 3520315]
Cohn JN, Johnson G, Ziesche S, et al, "A Comparison of Enalapril With Hydralazine-Isosorbide Dinitrate in the Treatment of Chronic Congestive Heart Failure," N Engl J Med, 1991, 325(5):303-10. [PubMed 2057035]
Colucci WS. Secondary pharmacologic therapy in heart failure with reduced ejection fraction. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed November 2, 2021.
Dilatrate-SR (isosorbide dinitrate sustained-release capsules) [prescribing information]. Malvern, PA: Endo Pharmaceuticals; January 2019.
Duckitt K, Thornton S, O'Donovan OP, Dowswell T. Nitric oxide donors for treating preterm labour. Cochrane Database Syst Rev. 2014;2014(5):CD002860. doi:10.1002/14651858.CD002860.pub2 [PubMed 24809331]
Dvořáčková E, Pilková A, Matoulek M, Slanař O, Hartinger JM. Bioavailability of orally administered drugs after bariatric surgery. Curr Obes Rep. 2024;13(1):141-153. doi:10.1007/s13679-023-00548-7 [PubMed 38172482]
Evers J, Bonn R, Boertz A, Cawello W, Dickmans HA, Weiss M. Pharmacokinetics of isosorbide dinitrate, isosorbide-2-nitrate and isosorbide-5-nitrate in renal insufficiency after repeated oral dosage. Klin Wochenschr. 1989;67(6):342-348. doi:10.1007/BF01741389 [PubMed 2709744]
Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
Ghosh A, Lattey KR, Kelly AJ. Nitric oxide donors for cervical ripening and induction of labour. Cochrane Database Syst Rev. 2016;12(12):CD006901. doi:10.1002/14651858.CD006901.pub3 [PubMed 27918616]
Gogia H, Mehra A, Parikh S, et al, “Prevention of Tolerance to Hemodynamic Effects of Nitrates With Concomitant Use of Hydralazine in Patients With Chronic Heart Failure,” J Am Coll Cardiol, 1995, 26(7):1575-80. [PubMed 7594088]
Hawkins DN, Faler BJ, Choi YU, Prasad BM. Time course of blood pressure decrease after bariatric surgery in normotensive and hypertensive patients. Obes Surg. 2018;28(7):1845-1851. doi:10.1007/s11695-017-3091-x [PubMed 29725978]
Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2022;145(18):e895-e1032. doi:10.1161/CIR.0000000000001063 [PubMed 35363499]
ISDN (isosorbide dinitrate) [product monograph]. Vaughan, Ontario, Canada: AA Pharma Inc; June 2010.
Isordil Titradose (isosorbide dinitrate) tablets [prescribing information]. Bridgewater, NJ: Valeant Pharmaceuticals; August 2019.
Isosorbide Dinitrate (tablets, USP [oral]) [prescribing information]. Memphis, TN: Northstar Rx LLC; April 2020.
Maddox TM, Januzzi JL Jr, Allen LA, et al; Writing Committee. 2021 update to the 2017 ACC Expert Consensus Decision Pathway for optimization of heart failure treatment: answers to 10 pivotal issues about heart failure with reduced ejection fraction: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021;77(6):772-810. doi:10.1016/j.jacc.2020.11.022 [PubMed 33446410]
McDougall ARA, Hastie R, Goldstein M, et al. New medicines for spontaneous preterm birth prevention and preterm labour management: landscape analysis of the medicine development pipeline. BMC Pregnancy Childbirth. 2023;23(1):525. doi:10.1186/s12884-023-05842-9 [PubMed 37464260]
National Institute for Health and Care Excellence. Inducing labour. London: National Institute for Health and Care Excellence (NICE); 2021. https://www.nice.org.uk/guidance/ng207. [PubMed 35438865]
O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2013;61(4):e78-e140. doi:10.1016/j.jacc.2012.11.019 [PubMed 23256914]
Ommen SR, Ho CY, Asif IM, et al. 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR guideline for the management of hypertrophic cardiomyopathy: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(23):e1239-e1311. doi:10.1161/CIR.0000000000001250 [PubMed 38718139]
Parker JO, Fanell B, Lahey KA, et al, “Effect of Intervals Between Doses on the Development to Tolerance to Isosorbide Dinitrate,” N Engl J Med, 1987, 316(23):1440-4. [PubMed 3574424]
Rangel-Castilla L, Gopinath S, Robertson CS. Management of intracranial hypertension. [published correction appears in Neurol Clin. 2008;26(3):xvii]. Neurol Clin. 2008;26(2):521-41, x. [PubMed 18514825]
Taylor AL, Ziesche S, Yancy C, et al, "Combination of Isosorbide Dinitrate and Hydralazine in Blacks With Heart Failure," N Engl J Med, 2004, 351(20):2049-57. [PubMed 15533851]
Trujillo TC and Dobesh PP, “Traditional Management of Chronic Stable Angina,” Pharmacotherapy, 2007, 27(12):1677-92. [PubMed 18041888]
Vaezi MF, Pandolfino JE, Yadlapati RH, Greer KB, Kavitt RT. ACG Clinical Guidelines: Diagnosis and Management of Achalasia. Am J Gastroenterol. 2020;115(9):1393-1411. doi:10.14309/ajg.0000000000000731 [PubMed 32773454]
Wang L, Lin M, Yu J, et al. The impact of bariatric surgery versus non-surgical treatment on blood pressure: systematic review and meta-analysis. Obes Surg. 2021;31(11):4970-4984. doi:10.1007/s11695-021-05671-9 [PubMed 34519991]
Wilson A, Hodgetts-Morton VA, Marson EJ, et al. Tocolytics for delaying preterm birth: a network meta-analysis (0924). Cochrane Database Syst Rev. 2022;8(8):CD014978. doi:10.1002/14651858.CD014978.pub2 [PubMed 35947046]
World Health Organization (WHO). WHO recommendation on tocolytic therapy for improving preterm birth outcomes [Internet]. Geneva: World Health Organization; 2022. https://www.ncbi.nlm.nih.gov/books/NBK585023/. Accessed November 8, 2023.

Topic 8580 Version 451.0

خرید پکیج

Isosorbide dinitrate: Drug information