• Dosage of I.S.D. in details
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Dosage of I.S.D. in details

I.S.D. Dosage

Generic name: I.S.D. 40mg

Dosage form: tablet, extended release

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

As noted under “CLINICAL PHARMACOLOGY”, multiple-dose studies with I.S.D. and other nitrates have shown that maintenance of continuous 24-hour plasma levels results in refractory tolerance. Every dosing regimen for I.S.D. ER tablets must provide a daily dose-free interval to minimize the development of this tolerance. With immediate-release I.S.D., it appears that one daily dose-free interval must be at least 14 hours long. The necessary dose-free interval for I.S.D. ER tablets has not been clearly identified, but is presumably somewhat longer.

As also noted under “CLINICAL PHARMACOLOGY”, only one trial has ever studied the use of controlled-release I.S.D. for more than one dose. In that trial, 40 mg of a different formulation of controlled-release I.S.D. was administered twice daily in doses given 6 hours apart. After 4 weeks, active treatment could not be distinguished from placebo.

Large controlled studies with other nitrates suggest that no dosing regimen with I.S.D. ER tablets should be expected to provide more than about 12 hours of continuous anti-anginal efficacy per day.

In clinical trials, immediate-release oral I.S.D. has been administered in a variety of regimens, with total daily doses ranging from 30 mg to 480 mg.

More about I.S.D. (I.S.D.)

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• I.S.D. (Advanced Reading)

• Other brands: Isordil, Isordil Titradose, Dilatrate-SR, Isochron

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• I.S.D. (FDA)

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What other drugs will affect I.S.D.?

Before taking I.S.D., tell your doctor if you are using any of the following drugs:

• blood pressure medication;

• dihydroergotamine (D.H.E. 45, Migranal) or ergotamine (Ergomar, Cafergot, and others);

• an erectile dysfunction medication such as tadalafil (Cialis) or vardenafil (Levitra);

• a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and others; or

• a calcium channel blocker such as diltiazem (Tiazac, Cardizem), nifedipine (Procardia), nimodipine (Nimotop), verapamil (Calan, Covera, Verelan), and others.

If you are using any of these drugs, you may not be able to use I.S.D., or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect I.S.D.. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

I.S.D. interactions

Blood Pressure Lowering Agents: The concomitant use of drugs with blood pressure lowering properties, e.g. vasodilators, beta-blockers, calcium channel antagonists, ACE inhibitors, neuroleptics or tricyclic antidepressants and alcohol may potentiate the antihypertensive effect of I.S.D..

Phosphodiesterase Inhibitors: A blood pressure lowering effect of I.S.D. will be increased, if used together with phosphodiesterase inhibitors (e.g. sildenafil, tadalafil, vardenafil). This might lead to life-threatening cardiovascular complications. Patients who are on I.S.D. therapy therefore must not use phosphodiesterase inhibitors (e.g. sildenafil, tadalafil, vardenafil).

Patients who have recently taken phosphodiesterase inhibitors (e.g. sildenafil, vardenafil, tadalafil) therefore must not receive acute I.S.D. therapy.

Dihydroergotamine: I.S.D. used in combination with dihydroergotamine may lead to higher blood concentration of dihydroergotamine and thus increase the effect of this medicinal product.

Sapropterine: Sapropterine contains the API Tetrahydrobiopterine (BH4). BH4 is a cofactor for nitric oxide synthetase. Caution is recommended during concomitant use of sapropterine-containing medicine with all agents that cause vasodilation by affecting nitric oxide (NO) metabolism or action, including classical NO donors [e.g. glyceryl trinitrate (GTN), I.S.D. (ISDN), isosorbide mononitrate and others].

References

1. DailyMed. "ISOSORBIDE DINITRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
2. FDA/SPL Indexing Data. "IA7306519N: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
3. MeSH. "Nitric Oxide Donors". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology