Buy Isordil Online

Isosorbide Dinitrate (isosorbide dinitrate)

OTHER BRAND NAMES

Isordil Titradose

THERAPEUTIC CLASS

Nitrate vasodilator

DEA CLASS

RX

INDICATIONS

Prevention of angina pectoris due to coronary artery disease (CAD). (Tab, SL) Treatment of angina pectoris due to CAD.

ADULT DOSAGE

Angina Pectoris

Due to Coronary Artery Disease:

Prevention:
Tab/Isordil Titradose:
Initial: 5-20mg bid-tid
Maint: 10-40mg bid-tid
Allow a dose-free interval of ≥14 hrs

Tab, Extended Release:
Refer to PI for dosing based on clinical trials

Tab, SL:
Prevention: 1 tab (2.5mg-5mg) 15 min before activity
Treatment: Use to abort acute angina episode recommended only in patients who fail to respond to SL nitroglycerin
Must provide a daily dose-free interval; 1 of the daily dose-free intervals must be somewhat >14 hrs

DOSING CONSIDERATIONS

Elderly
Start at lower end of dosing range

ADMINISTRATION

Oral/SL route

HOW SUPPLIED

Tab, Extended Release (ER): 40mg*; Tab, SL: 2.5mg, 5mg; Tab: 10mg*, 20mg*, 30mg*, (Isordil Titradose) 5mg*, 40mg* *scored

CONTRAINDICATIONS

Concomitant use w/ certain drugs for erectile dysfunction (eg, sildenafil, tadalafil, vardenafil) and soluble guanylate cyclase stimulator riociguat.

WARNINGS/PRECAUTIONS

Severe hypotension, particularly w/ upright posture, may occur. Perform careful clinical or hemodynamic monitoring if used in patients w/ acute MI or CHF to avoid the hazards of hypotension and tachycardia. Hypotension may be accompanied by paradoxical bradycardia and increased angina pectoris. May aggravate angina caused by hypertrophic cardiomyopathy. Caution w/ volume depletion and hypotension. May develop tolerance. Chest pain, acute MI, and sudden death reported during temporary withdrawal in patients w/ long term exposure to therapy. (Tab, SL) Not the 1st drug of choice for abortion of acute anginal episode.

ADVERSE REACTIONS

Headache, lightheadedness, hypotension, syncope, crescendo angina, rebound HTN.

DRUG INTERACTIONS

See Contraindications. Additive vasodilation w/ other vasodilators (eg, alcohol).

PREGNANCY AND LACTATION

Category C, caution in nursing.

MECHANISM OF ACTION

Nitrate vasodilator; relaxes vascular smooth muscle and dilates peripheral arteries and veins; venous dilatation reduces left ventricular end diastolic pressure and pulmonary capillary wedge pressure (preload); arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload); dilates the coronary artery.

PHARMACOKINETICS

Absorption: (Tab) Nearly complete; bioavailability (10-90%); Tmax=1 hr. (Tab, SL) Bioavailability (40-50%); Tmax=10-15 min. Distribution: Vd=2-4L/kg. Metabolism: Liver (extensive 1st-pass) (tab); 2-mononitrate, 5-mononitrate (active metabolites). Elimination: T1/2=1 hr, 5 hrs (5-mononitrate), 2 hrs (2-mononitrate).

ASSESSMENT

Assess for drug hypersensitivity, hypotension, acute MI, CHF, volume depletion, hypertrophic cardiomyopathy, alcohol intake, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for paradoxical bradycardia, increased angina pectoris, hypotension, hemodynamic rebound, decreased exercise tolerance, chest pain, acute MI, and other adverse reactions. In patients w/ MI or CHF, perform careful clinical or hemodynamic monitoring.

PATIENT COUNSELING

Counsel to carefully follow prescribed dosing regimen. Inform that headaches sometimes accompany therapy and are markers of drug activity; instruct not to alter schedule of therapy since loss of headache may be associated w/ simultaneous loss of antianginal efficacy. Inform that lightheadedness on standing may occur, which may be more frequent w/ alcohol consumption.

STORAGE

(Tab) 25°C (77°F); (Isordil Titradose) excursions permitted to 15-30°C (59-86°F). Protect from light. (Tab, SL/Tab, ER) 20-25°C (68-77°F). (Tab, SL) Protect from light and moisture.

TAGS

isordil 10 mg nedir, isordil hydralazine, isordil tablet 5mg, isordil tablet fiyat, isordil hydralazine heart failure, isordil 300 mg, isordil 10 mg.คือ, isordil 10 mg, isordil titradose 40 mg, isordil tablet indication, isordil 10 mg ฃิไฃ, isordil 30 mg, what is isordil tablet used for, isordil 20 mg, buy isordil, isordil tablet, isordil tablet nedir, isordil 40 mg, isordil tabletten, isordil 10 mg 50 tablet, isordil tembids 40 mg, isordil 10 mg tds, isosorbide dinitrate 10 mg, isordil sublingual 10 mg, isosorbide dinitrate 20 mg, isordil 20 mg คือ, isordil 60 mg, isordil ap 40 mg, buy isosorbide dinitrate