📌 Medicine Name:
Isosorbide Dinitrate Tablet 10 mg
(A long-acting nitrate vasodilator)
📋 Description / Prescription:
Isosorbide dinitrate 10 mg is a prescription-only oral medication used for the prevention and long-term management of angina pectoris, and sometimes as part of treatment for congestive heart failure (especially when used with hydralazine).
- Each tablet contains 10 mg of isosorbide dinitrate
- Taken orally, not for acute angina relief
🔬 Nature / Mechanism of Action:
Isosorbide dinitrate works by:
- Converting to nitric oxide (NO) in the body
- NO activates guanylate cyclase, increasing cyclic GMP
- This leads to vascular smooth muscle relaxation (vasodilation)
Key effects:
- Venodilation → reduces preload (less blood returning to the heart)
- Arterial dilation at higher doses → reduces afterload
- Lowers myocardial oxygen demand, easing cardiac workload
✅ Advantages / Therapeutic Benefits:
- ✅ Prevents angina attacks when taken regularly
- ✅ Improves exercise tolerance in coronary artery disease patients
- ✅ Can be used in chronic heart failure (especially in Black patients, with hydralazine)
- ✅ Has a longer duration of action than short-acting nitrates (e.g., glyceryl trinitrate)
- ✅ Useful in stable angina, variant angina, or post-MI support
📦 Packaging:
- Usually small, round or oval tablets, may be scored
- Commonly packed in blister strips or HDPE bottles
- Typical pack sizes: 10, 30, 50, or 100 tablets
🌡️ Storage:
- Store at 15–25°C (59–77°F)
- Keep in a dry, cool place, away from moisture and heat
- Protect from light
- Keep out of reach of children
⚠️ Precautions:
Use cautiously in:
- Hypotension or volume depletion
- Severe anemia
- Increased intracranial pressure
- Closed-angle glaucoma (rare association)
🚫 Do NOT use with:
- PDE-5 inhibitors (e.g., sildenafil/Viagra, tadalafil/Cialis) – causes severe hypotension
- Alcohol – can intensify blood pressure-lowering effects
Nitrate Tolerance:
- May develop with continuous use
- Recommend nitrate-free interval of at least 10–14 hours/day (often scheduled as morning and early afternoon doses)
👩⚕️ Patient Advice / Counseling Points:
- 💊 Do not use for acute chest pain—this is a preventive medication
- 🕒 Take at the same times each day; maintain a nitrate-free period
- 🪑 Sit or lie down if feeling dizzy or light-headed
- 🚫 Avoid alcohol and PDE-5 inhibitors (e.g., sildenafil)
- ⚠️ Report:
- Severe headaches (common but may improve with continued use)
- Fainting, palpitations, or worsening angina
- 🔁 Do not suddenly stop the medication—tapering may be needed under supervision