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Generic Name: isosorbide dinitrate (eye soe SOR bide dye NYE trate)
Brand Names: Dilatrate-SR, Isochron, Isordil Titradose

What is ISDN (isosorbide dinitrate)?

Isosorbide dinitrate is in a group of drugs called nitrates. Isosorbide dinitrate dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.

Isosorbide dinitrate is used to treat or prevent attacks of chest pain (angina).

Isosorbide dinitrate may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about ISDN (isosorbide dinitrate)?

Do not use isosorbide dinitrate if you are taking sildenafil (Viagra). Serious, life-threatening side effects can occur if you take isosorbide dinitrate while you are using sildenafil.

Isosorbide dinitrate can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use the medication. Do not stop taking isosorbide dinitrate. Ask your doctor before using any headache pain medication.

What should I discuss with my healthcare provider before taking ISDN (isosorbide dinitrate)?

Do not use isosorbide dinitrate if you are taking sildenafil (Viagra). Serious, life-threatening side effects can occur if you take isosorbide dinitrate while you are using sildenafil. Do not use this medication if you are allergic to isosorbide dinitrate, isosorbide mononitrate (Imdur), or nitroglycerin.

Before taking this isosorbide dinitrate, tell your doctor if you are allergic to any drugs, or if you have:

  • early signs of a heart attack (chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling);

  • congestive heart failure;

  • severe anemia (a lack of red blood cells); or

  • low blood pressure; or

  • kidney disease.

If you have any of these conditions, you may not be able to use isosorbide dinitrate, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether isosorbide dinitrate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Isosorbide dinitrate can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use isosorbide dinitrate. Do not stop taking the medication. Ask your doctor before using any headache pain medication.

How should I take ISDN (isosorbide dinitrate)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

If possible, try to rest or stay seated when you use this medication. Isosorbide dinitrate can cause dizziness or fainting.

If you use isosorbide dinitrate to treat an angina attack: Use the medicine at the first sign of chest pain. Place the sublingual tablet under your tongue and allow it to dissolve slowly. Do not chew or swallow it. The chewable tablet should be chewed and then held in the mouth for about 2 minutes before swallowing.

You may use additional tablets every 5 minutes, but not more than 3 tablets in 15 minutes.

Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. Seek emergency medical attention if your chest pain gets worse or lasts more than 5 minutes, especially if you have trouble breathing or feel weak, dizzy, or nauseated, or lightheaded.

It is important to keep this medicine on hand at all times in case of an angina attack. Get your prescription refilled before you run out of medicine completely.

If you take isosorbide dinitrate on a regular schedule to prevent angina, do not stop taking it suddenly or you could have a severe attack of angina.

Do not change brands of isosorbide dinitrate without the approval of your doctor.

Store isosorbide dinitrate at room temperature, away from moisture, heat, and light. Keep the medicine in its original container.

Throw away any leftover isosorbide dinitrate on the expiration date. Expired isosorbide will not treat your condition.

What happens if I miss a dose?

Since isosorbide dinitrate is often used only as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If your next dose is less than 2 hours away, skip the missed dose and use the medicine at your next regularly scheduled time.

If you are using the extended-release tablet and your next dose is less than 6 hours away, skip the missed dose and use the medicine at your next regularly scheduled time.

Do not use extra medicine to make up a missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of isosorbide dinitrate can be fatal.

Overdose symptoms may include a severe throbbing headache, confusion, fever, fast or pounding heartbeats, dizziness, vision problems, nausea, vomiting, bloody diarrhea, trouble breathing, cold or clammy skin, feeling light-headed, fainting, and seizures.

What should I avoid while taking ISDN (isosorbide dinitrate)?

Isosorbide dinitrate can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol. It can increase some of the side effects of isosorbide dinitrate, such as dizziness, drowsiness, feeling light-headed, or fainting.

ISDN (isosorbide dinitrate) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
  • fast, slow, pounding, or uneven heart rate;

  • blurred vision or dry mouth; or

  • nausea, vomiting, sweating, pale skin, feeling like you might pass out.

Less serious side effects may be more likely to occur, such as:

  • warmth, redness, or tingly feeling under your skin; or

  • feeling weak or dizzy.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

See also: Side effects (in more detail)

What other drugs will affect ISDN (isosorbide dinitrate)?

Before taking isosorbide dinitrate, tell your doctor if you are using any of the following drugs:

  • blood pressure medication;

  • dihydroergotamine (D.H.E. 45, Migranal) or ergotamine (Ergomar, Cafergot, and others);

  • an erectile dysfunction medication such as tadalafil (Cialis) or vardenafil (Levitra);

  • a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and others; or

  • a calcium channel blocker such as diltiazem (Tiazac, Cardizem), nifedipine (Procardia), nimodipine (Nimotop), verapamil (Calan, Covera, Verelan), and others.

If you are using any of these drugs, you may not be able to use isosorbide dinitrate, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect isosorbide dinitrate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about isosorbide dinitrate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 5.06. Revision Date: 02/09/2008 8:30:22 PM.
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