Isordil Side Effects
Generic name: isosorbide dinitrate
Note: This document contains side effect information about isosorbide dinitrate. Some of the dosage forms listed on this page may not apply to the brand name Isordil.
Some side effects of Isordil may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to isosorbide dinitrate: capsule extended release, tablet, tablet chewable, tablet extended release
Along with its needed effects, isosorbide dinitrate (the active ingredient contained in Isordil) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking isosorbide dinitrate:Rare
- Bluish-colored lips, fingernails, or palms
- dark urine
- difficulty with breathing
- dizziness or lightheadedness
- pale skin
- rapid heart rate
- shortness of breath
- sore throat
- unusual bleeding or bruising
- unusual tiredness or weakness
- Arm, back, or jaw pain
- blurred vision
- chest pain or discomfort
- chest tightness or heaviness
- dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
- fast or irregular heartbeat
Get emergency help immediately if any of the following symptoms of overdose occur while taking isosorbide dinitrate:Symptoms of overdose
- Blurred or loss of vision
- bulging soft spot on the head of an infant
- change in consciousness
- change in the ability to see colors, especially blue or yellow
- cold, clammy skin
- disturbed color perception
- double vision
- fast, irregular, pounding, or racing heartbeat or pulse
- feeling of constant movement of self or surroundings
- halos around lights
- headache, severe and throbbing
- increased sweating
- loss of appetite
- loss of consciousness
- night blindness
- overbright appearance of lights
- sensation of spinning
- slow heartbeat
- tunnel vision
For Healthcare Professionals
Applies to isosorbide dinitrate: oral capsule extended release, oral tablet, oral tablet chewable, oral tablet extended release, sublingual tablet
Headache is probably due to vasodilation and may respond to acetaminophen analgesia.
A case of isosorbide dinitrate-associated transient ischemic attack has been reported, supposedly due to an arterial "steal phenomenon" secondary to drug-induced vasodilation.
A case of visual hallucinations, suicidal ideation, and depression associated with isosorbide dinitrate (the active ingredient contained in Isordil) has been reported, even upon blind rechallenge of the drug.
Nervous system side effects have included headache and dizziness.
Organic nitrates may induce a sudden drop in systemic blood pressure and enhanced vagal tone, resulting in possible inhibition of reflex tachycardia and syncope.
Cardiovascular side effects include flushing, hypotension, diaphoresis, weakness, sinus bradycardia, and unusual case reports of AV heart block. Unusual cases of edema have also been reported. Frequent dosing, high dosages, and long-acting preparations giving constant 24-hour nitroglycerin levels can result in tolerance to the drug. The risk of tolerance is significantly decreased by withholding the drug, so called "nitrate-free" intervals. Rebound symptoms may occur during this time.
Gastrointestinal side effects include mild nausea and constipation.
Hypersensitivity reactions including rare cases of pruritus and drug rash have been reported.
In vitro data show decreased platelet aggregation when exposed to isosorbide dinitrate (the active ingredient contained in Isordil)
Nitrates, after conversion to nitrites, may accelerate the oxidation of hemoglobin, resulting in abnormally high plasma concentrations of methemoglobin. While most cases of methemoglobinemia are asymptomatic, methemoglobin levels greater than 60% usually induce symptoms (dyspnea, chest pain), particularly in the presence of underlying coronary artery disease. Treatment in symptomatic persons is methylene blue 1% solution 2 mg/kg intravenously over 10 minutes. It is recommended that affected patients be screened for NADP-methemoglobin reductase deficiency.
Hematologic side effects are rare and include methemoglobinemia and a case of isosorbide dinitrate-induced hemolytic anemia in a patient with underlying glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Renal side effects of isosorbide dinitrate (the active ingredient contained in Isordil) (ISDN) are described in nonazotemic patients with liver cirrhosis. ISDN can cause a reduction of glomerular filtration rate and free water clearance associated with significant increases in plasma renin and aldosterone in patients with liver cirrhosis. The changes are most remarkable in patients with ascites.
More Isordil resources
- Isordil Prescribing Information (FDA)
- Isordil Advanced Consumer (Micromedex) - Includes Dosage Information
- Isosorbide Dinitrate Professional Patient Advice (Wolters Kluwer)
- Isosorbide Dinitrate Prescribing Information (FDA)
- Dilatrate-SR Prescribing Information (FDA)
- Dilatrate-SR Concise Consumer Information (Cerner Multum)
- Dilatrate-SR MedFacts Consumer Leaflet (Wolters Kluwer)
- Isordil Titradose Prescribing Information (FDA)
- Isordil Titradose MedFacts Consumer Leaflet (Wolters Kluwer)
- Isosorbide Dinitrate/Mononitrate Monograph (AHFS DI)
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