What is Isd?
Preventing symptoms of angina (chest pain) caused by heart disease. Isd extended-release capsules is used alone or with other medicines. Isd extended-release capsules is NOT intended for the immediate relief of acute attacks of angina. It may also be used for other conditions as determined by your doctor.
Isd extended-release capsules is a nitrate. It works by relaxing the blood vessels in the body, allowing them to widen. This lets more blood flow through the blood vessels, which reduces the work the heart has to do to pump blood. This reduces the oxygen needs of the heart and makes chest pain go away.
Isd indications
Angina Pectoris:Oral Tablet:
Prophylaxis of ischemic heart pain associated with coronary insufficiency. Isd may reduce the frequency, duration and severity of anginal attacks. Exercise tolerance may be improved and the need for nitroglycerin may be reduced. The oral tablets are not indicated for the treatment of an anginal attack.
Sublingual Tablet: Treatment of angina pectoris and prophylaxis in situations likely to provoke an anginal attack ie, physical or emotional stress.
Congestive Heart Failure: Acute and chronic congestive heart failure (including that associated with myocardial infarction). Based on current knowledge, Isd should be considered only as an adjunct to the more conventional modes of therapy (cardiac glycosides and diuretics); however, in refractory cases, it may be used alone or concomitantly with other vasodilators. Isd is particularly effective in patients with increased left ventricular end diastolic pressure (LVEDP), "backward failure" and normal or approximately normal cardiac output in whom pulmonary congestion or edema is the primary problem. Isd is especially recommended when coronary artery disease is the cause of congestive heart failure, in which case its antianginal effect is of additional value.
How should I use Isd?
Use Isd extended-release capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take Isd extended-release capsules by mouth on an empty stomach with a full glass of water (8 oz [240 mL]).
- Swallow Isd extended-release capsules whole. Do not break, crush, or chew before swallowing.
- If you miss a dose of Isd extended-release capsules, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Isd extended-release capsules.
Uses of Isd in details
Use: Labeled Indications
Angina pectoris, prevention: Prevention of angina pectoris due to coronary artery disease.
Note: Due to slower onset of action, Isd is not the drug of choice to abort an acute anginal episode.
Off Label Uses
Achalasia
Based on the American College of Gastroenterology (ACG) guidelines on the diagnosis and management of achalasia, Isd may be considered for patients with achalasia who cannot use or refuse more definitive therapies (pneumatic dilation or surgical myotomy) and patients who have failed botulinum toxin injections.
Heart failure with reduced ejection fraction
Data from a randomized, double-blind trial comparing enalapril and hydralazine plus Isd in patients with chronic heart failure support the use of Isd (in combination with hydralazine) in patients with intolerance to ACE inhibitor therapy.
Isd description
Each tablet of Isd 5 mg contains 5 mg of Isd.
Each tablet of Isd 10 mg contains 10 mg of Isd.
Each sustained-release tablet of Isd 20 mg contains 20 mg of Isd.
Each sustained-release tablet of Isd 40 mg contains 40 mg of Isd.
Isd dosage
As noted under "CLINICAL PHARMACOLOGY," multiple-dose studies with Isd and other nitrates have shown that maintenance of continuous 24-hour plasma levels results in refractory tolerance. Every dosing regimen for Isd tablets must provide a daily dose-free interval to minimize the development of this tolerance. With immediate-release Isd, it appears that one daily dose-free interval must be at least 14 hours long.
As also noted under "CLINICAL PHARMACOLOGY," the effects of the second and later doses have been smaller and shorter-lasting than the effects of the first.
Large controlled studies with other nitrates suggest that no dosing regimen with Isd tablets should be expected to provide more than about 12 hours of continuous anti-anginal efficacy per day.
As with all titratable drugs, it is important to administer the minimum dose which produces the desired clinical effect. The usual starting dose of Isd 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.
Isd interactions
See also:
What other drugs will affect Isd?
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 Isd.
Phosphodiesterase Inhibitors: A blood pressure lowering effect of Isd 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 Isd 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 Isd therapy.
Dihydroergotamine: Isd 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), Isd (ISDN), Isd mononitrate and others].
Isd side effects
See also:
What are the possible side effects of Isd?
Adverse reactions to Isd are generally dose-related, and almost all of these reactions are the result of Isd's 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 Isd tablets.
To report SUSPECTED ADVERSE REACTIONS contact AvKARE, Inc. at 1-855-361-3993; email drugsafety@avkare.com; or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Isd contraindications
See also:
What is the most important information I should know about Isd?
Do not use Isd if you are taking sildenafil (Viagra). Serious, life-threatening side effects can occur if you take Isd while you are using sildenafil.
You should not use this medication if you are allergic to Isd, Isd mononitrate (Imdur, ISMO, Monoket), or nitroglycerin, or if you have early signs of a heart attack (chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling).
Before taking Isd, tell your doctor if you have congestive heart failure, low blood pressure, or kidney disease.
Isd can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use the medication. Do not stop taking Isd. Ask your doctor before using any headache pain medication.
Only the sublingual tablet should be used to treat an angina attack that has already begun.
Isd regular and extended-release tablets are used to prevent angina attacks but will not treat an angina attack.
It is important to keep taking this medicine as directed to prevent an angina attack. Get your prescription refilled before you run out of medicine completely.
Do not stop taking Isd suddenly. Stopping suddenly could cause a severe angina attack.
Active ingredient matches for Isd:
List of Isd substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Isacardin (Russian Federation) | |
| Isdin (Pakistan) | |
| ISDN | |
| Tablet; Oral; Isosorbide Dinitrate 20 mg | |
| Tablet; Oral; Isosorbide Dinitrate 5 mg | |
| Tablet; Oral; Isosorbide Dinitrate 10 mg | |
| Tablet; Oral; Isosorbide Dinitrate 40 mg | |
| Isdn tablet 5 mg (Aa Pharma Inc (Canada)) | |
| Isdn tablet 10 mg (Aa Pharma Inc (Canada)) | |
| Isdn tablet 30 mg (Aa Pharma Inc (Canada)) | |
| ISDN AA Pharma (Canada) | |
| ISDN AL (Germany) | |
| ISDN AL retard (Germany) | |
| ISDN Heumann (Germany) | |
| ISDN Hexal (Germany) | |
| ISDN Hexal retard (Germany) | |
| ISDN Retard | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 20 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 40 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 60 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 80 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 120 mg | |
| Tablet, Retard; Oral; Isosorbide Dinitrate 20 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 100 mg | |
| ISDN Rth (Latvia) | |
| ISDN Sandoz (Germany) | |
| ISDN Stada (Germany) | |
| ISDN-CT (Germany) | |
| ISDN-Isis (Germany) | |
| ISDN-ratiopharm (Estonia, Germany, Latvia, Lithuania, Luxembourg) | |
| Iso (Spain) | |
| ISO 10mg TAB / 10 (Ascent Remedies Pvt. Ltd.) | $ 0.13 |
| ISO 20mg TAB / 10 (Ascent Remedies Pvt. Ltd.) | $ 0.23 |
| Iso 10 mg Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.01 |
| ISO 10 mg Zee Labs Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.02 |
| ISO 100 mg Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.01 |
| Iso 20 mg Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.02 |
| ISO 300 mg Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.02 |
| ISO 20MG TABLET 1 strip / 10 tablets each (Ascent Remedies Pvt. Ltd.) | $ 0.74 |
| ISO 10mg TAB / 10 (Ascent Remedies Pvt. Ltd.) | $ 0.13 |
| ISO 20mg TAB / 10 (Ascent Remedies Pvt. Ltd.) | $ 0.23 |
| Iso 10mg Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.02 |
| Iso 20mg Tablet (Ascent Remedies Pvt. Ltd.) | $ 0.07 |
| Iso Lacer (Spain) | |
| Iso Mack (Bahrain, Cyprus, Egypt, Jordan, Kuwait, Lebanon, Qatar, Saudi Arabia, United Arab Emirates) | |
| Spray; Subbucal; Isosorbide Dinitrate (Boots healthcare) | |
See 751 substitutes for Isd | |
References
- 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).
- PubChem. "ISOSORBIDE DINITRATE". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
- DrugBank. "ISOSORBIDE DINITRATE". http://www.drugbank.ca/drugs/DB00883 (accessed September 17, 2018).
Reviews
The results of a survey conducted on ndrugs.com for Isd are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Isd. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.User reports
Consumer reported useful
No survey data has been collected yetConsumer reported price estimates
No survey data has been collected yetConsumer reported time for results
No survey data has been collected yet2 consumers reported age
| Users | % | ||
|---|---|---|---|
| 6-15 | 2 | 100.0% | |
Consumer reviews
There are no reviews yet. Be the first to write one! |
Information checked by Dr. Sachin Kumar, MD Pharmacology
