[vc_row][vc_column][vc_tta_tabs color=”black” spacing=”10″ gap=”10″ alignment=”center” active_section=”1″ css_animation=”rollIn”][vc_tta_section title=”Description” tab_id=”1500389328687-b3b21899-eef0″][vc_column_text]Isordil is used to treat or prevent attacks of chest pain (angina).
Only the sublingual tablet should be used to treat an angina attack that has already begun.
Isordil regular and extended-release tablets are used to prevent angina attacks but will not treat an angina attack.
Isordil may also be used for purposes other than those listed in this medication guide.[/vc_column_text][/vc_tta_section][vc_tta_section title=”Use” tab_id=”1500389328750-d09ab9ad-1d93″][vc_column_text]It is used for angina, in addition to other medications for congestive heart failure, and for esophageal spasms.[/vc_column_text][/vc_tta_section][vc_tta_section title=”How to Take” tab_id=”1500389387696-bdbeacb1-9ee0″][vc_column_text]
As with all titratable drugs, it is important to administer the minimum dose which produces the desired clinical effect. The usual starting dose of Isordil Titradose is 5 mg to 20 mg, two or three times daily. For maintenance therapy, 10 mg to 40 mg, two or three times daily is recommended. Some patients may require higher doses. A daily dose-free interval of at least 14 hours is advisable to minimize tolerance. The optimal interval will vary with the individual patient, dose and regimen.
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Side Effects” tab_id=”1500389412853-d02a327a-b319″][vc_column_text]
Adverse reactions to Isordil are generally dose-related, and almost all of these reactions are the result of Isordil activity as a vasodilator. Headache, which may be severe, is the most commonly reported side effect. Headache may be recurrent with each daily dose, especially at higher doses. Transient episodes of lightheadedness, occasionally related to blood pressure changes, may also occur. Hypotension occurs infrequently, but in some patients it may be severe enough to warrant discontinuation of therapy. Syncope, crescendo angina, and rebound hypertension have been reported but are uncommon. Extremely rarely, ordinary doses of organic nitrates have caused methemoglobinemia in normal-seeming patients. Methemoglobinemia is so infrequent at these doses that further discussion of its diagnosis and treatment is deferred. Data are not available to allow estimation of the frequency of adverse reactions during treatment with Isordil Titradose tablets.
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Precautions” tab_id=”1500389436547-e45a2b4c-4cda”][vc_column_text]
Severe hypotension, particularly with upright posture, may occur with even small doses of isosorbide dinitrate. This drug should therefore be used with caution in patients who may be volume depleted or who, for whatever reason, are already hypotensive. Hypotension induced by isosorbide dinitrate may be accompanied by paradoxical bradycardia and increased angina pectoris. Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy. As tolerance to isosorbide dinitrate develops, the effect of sublingual nitroglycerin on exercise tolerance, although still observable, is somewhat blunted. Some clinical trials in angina patients have provided nitroglycerin for about 12 continuous hours of every 24-hour day. During the daily dose-free interval in some of these trials, anginal attacks have been more easily provoked than before treatment, and patients have demonstrated hemodynamic rebound and decreased exercise tolerance. The importance of these observations to the routine, clinical use of immediate-release oral isosorbide dinitrate is not known. In industrial workers who have had long-term exposure to unknown (presumably high) doses of organic nitrates, tolerance clearly occurs. Chest pain, acute myocardial infarction, and even sudden death have occurred during temporary withdrawal of nitrates from these workers, demonstrating the existence of true physical dependence.
[/vc_column_text][/vc_tta_section][vc_tta_section title=”Drug Interactions” tab_id=”1500389457813-0dc3e294-95e1″][vc_column_text]
The vasodilating effects of Isordil may be additive with those of other vasodilators. Alcohol, in particular, has been found to exhibit additive effects of this variety. Concomitant use of Isordil Titradose with phosphodiesterase inhibitors in any form is contraindicated. Concomitant use of Isordil Titradose with riociguat, a soluble guanylate cyclase stimulator, iscontraindicated. This monograph has been modified to include the generic and brand name in many instances.