Isordil: Effective Angina Relief and Prevention
Isordil
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | 1.17 $ | 70.20 $ (0%) | 🛒 Add to cart |
| 90 | 0.87 $ | 105.30 $ 78.39 $ (26%) | 🛒 Add to cart |
| 120 | 0.70 $ | 140.40 $ 84.24 $ (40%) | 🛒 Add to cart |
| 180 | 0.58 $ | 210.60 $ 105.30 $ (50%) | 🛒 Add to cart |
| 270 | 0.52 $ | 315.90 $ 141.57 $ (55%) | 🛒 Add to cart |
| 360 | 0.49 $
Best per pill | 421.20 $ 176.67 $ (58%) | 🛒 Add to cart |
| Product dosage: 5mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 60 | 0.99 $ | 59.67 $ (0%) | 🛒 Add to cart |
| 90 | 0.82 $ | 89.50 $ 73.71 $ (18%) | 🛒 Add to cart |
| 120 | 0.65 $ | 119.34 $ 78.39 $ (34%) | 🛒 Add to cart |
| 180 | 0.49 $ | 179.01 $ 87.75 $ (51%) | 🛒 Add to cart |
| 270 | 0.44 $ | 268.51 $ 119.34 $ (56%) | 🛒 Add to cart |
| 360 | 0.41 $
Best per pill | 358.02 $ 147.42 $ (59%) | 🛒 Add to cart |
Isordil (isosorbide dinitrate) is a well-established nitrate vasodilator prescribed for the prevention and treatment of angina pectoris, a condition characterized by chest pain due to heart disease. It works by relaxing and widening blood vessels, allowing blood to flow more easily and reducing the heart’s workload. This action helps to decrease the frequency and severity of angina attacks, improving exercise tolerance and quality of life for patients with coronary artery disease. Available in various formulations, including sublingual tablets for rapid relief and oral extended-release tablets for prolonged prophylaxis, Isordil remains a cornerstone in the management of chronic stable angina.
Features
- Active ingredient: Isosorbide dinitrate
- Available in sublingual, chewable, and oral extended-release tablet formulations
- Rapid onset of action for sublingual tablets (2-5 minutes)
- Prolonged effect with extended-release formulations (up to 12 hours)
- Well-documented pharmacokinetic profile with extensive clinical use history
- Multiple strength options to allow for individualized dosing regimens
Benefits
- Significantly reduces the frequency and intensity of angina pectoris episodes
- Enhances exercise capacity and tolerance in patients with chronic stable angina
- Provides rapid symptomatic relief during acute angina attacks when used sublingually
- Offers convenient, long-lasting prophylaxis with once or twice-daily dosing of extended-release formulations
- Helps decrease myocardial oxygen demand through balanced vasodilation
- Contributes to improved quality of life by enabling greater physical activity with reduced chest pain
Common use
Isordil is primarily indicated for the prophylactic management of angina pectoris in patients with documented coronary artery disease. The sublingual formulation is particularly useful for acute relief of angina attacks, providing rapid symptom resolution. Healthcare providers may also prescribe Isordil as part of a comprehensive management strategy for patients with heart failure, though this represents an off-label use that requires careful medical supervision. The medication is typically incorporated into long-term treatment plans alongside other antianginal agents, lifestyle modifications, and risk factor management.
Dosage and direction
Dosage must be individualized based on patient response, formulation, and clinical circumstances. For sublingual administration: 2.5-5 mg at the onset of an angina attack, repeated every 5-10 minutes if needed, not to exceed 3 doses within 15-30 minutes. For prophylaxis using regular tablets: 5-40 mg orally 2-3 times daily. Extended-release tablets: 40 mg once or twice daily, with doses approximately 7 hours apart to minimize tolerance development. Tablets should be swallowed whole without crushing or chewing, except for specifically formulated chewable tablets. Administration on an empty stomach is recommended to enhance bioavailability. A nitrate-free interval of 10-14 hours daily is advised to prevent tolerance.
Precautions
Patients should be advised that Isordil may cause dizziness or lightheadedness, especially upon standing quickly from a sitting or lying position. Alcohol consumption should be avoided as it may potentiate these effects. Headache is common initially but often diminishes with continued therapy; analgesics may be used for relief. Patients should not suddenly discontinue therapy as rebound angina may occur. Caution is warranted in patients with hypovolemia, hypotension, or hypertrophic cardiomyopathy. Regular blood pressure monitoring is recommended, particularly during dose titration. Patients should inform all healthcare providers about their Isordil use before any surgical procedures.
Contraindications
Isordil is contraindicated in patients with known hypersensitivity to nitrates or any component of the formulation. It must not be used concurrently with phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil) due to the risk of profound hypotension. Additional contraindications include severe anemia, increased intracranial pressure, and circulatory failure associated with low filling pressures. The medication is not recommended in cases of cardiogenic shock unless adequate filling pressures are maintained. Patients with closed-angle glaucoma should use Isordil with extreme caution and only under specialist supervision.
Possible side effect
Common side effects include headache (often dose-related), dizziness, lightheadedness, and orthostatic hypotension. Flushing, nausea, and vomiting may occur initially but typically subside with continued therapy. Less frequently, patients may experience tachycardia, palpitations, or paradoxical angina. Dermatological reactions including rash and pruritus have been reported. Rare but serious adverse effects include methemoglobinemia, particularly with high doses or in patients with glucose-6-phosphate dehydrogenase deficiency. Syncope and severe hypotension requiring medical intervention may occur, especially with initial doses or dose increases.
Drug interaction
Concomitant use with phosphodiesterase-5 inhibitors is absolutely contraindicated due to life-threatening hypotension risk. Additive hypotensive effects may occur with other vasodilators, antihypertensives, calcium channel blockers, beta-blockers, and alcohol. Concurrent use with riociguat may result in symptomatic hypotension. Tricyclic antidepressants and antipsychotics may potentiate orthostatic hypotension. Aspirin may increase nitrate bioavailability, while ergot alkaloids may diminish the antianginal efficacy. Heparin’s anticoagulant effect may be reduced when administered with Isordil. Healthcare providers should conduct thorough medication reviews before initiation.
Missed dose
If a scheduled prophylactic dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Patients should never double the dose to make up for a missed one. For sublingual tablets used for acute angina relief, there is no scheduled dosing, so the “missed dose” concept does not apply. Patients should be educated to take their medication at consistent times daily to maintain stable blood levels and maximize therapeutic benefit while minimizing tolerance development.
Overdose
Isordil overdose manifests primarily as vasodilation leading to severe hypotension, syncope, tachycardia, flushing, headache, dizziness, and nausea. Methemoglobinemia may occur with massive overdoses, presenting as cyanosis, fatigue, and dyspnea that is unresponsive to oxygen therapy. Treatment involves immediate discontinuation of the medication, elevation of legs to improve venous return, and administration of intravenous fluids. Severe hypotension may require vasopressors such as phenylephrine or norepinephrine. Methemoglobinemia exceeding 30% may necessitate methylene blue administration (1-2 mg/kg IV over 5 minutes). Supportive care and continuous hemodynamic monitoring are essential.
Storage
Store at controlled room temperature (20-25°C or 68-77°F) in the original container with the lid tightly closed. Protect from moisture, light, and heat. Do not store in bathroom cabinets where humidity levels fluctuate. Keep sublingual tablets in their original glass container with cotton removed to prevent moisture absorption. Do not transfer tablets to other containers. Keep all medications out of reach of children and pets. Properly discard any medication that has expired or shows signs of deterioration (discoloration, unusual odor, or crumbling).
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Isordil is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual response to therapy may vary, and proper medical evaluation is necessary before initiation or discontinuation of treatment. Patients should not make changes to their medication regimen without consulting their physician. The manufacturer’s prescribing information should be consulted for complete details regarding use, warnings, and precautions.
Reviews
Clinical studies and decades of therapeutic use demonstrate Isordil’s efficacy in angina management. In randomized controlled trials, isosorbide dinitrate has shown significant improvement in exercise tolerance and reduction in angina frequency compared to placebo. Many patients report substantial improvement in quality of life and functional capacity. Some users note the initial headache as bothersome but find it diminishes with continued use. Healthcare providers appreciate the flexible dosing options and rapid action of the sublingual formulation for acute episodes. The development of tolerance with continuous dosing remains a consideration that requires careful management through nitrate-free intervals.