What is Isosorbidedinitraat retard A?
Preventing symptoms of angina (chest pain) caused by heart disease. Isosorbidedinitraat retard A extended-release capsules is used alone or with other medicines. Isosorbidedinitraat retard A 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.
Isosorbidedinitraat retard A 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.
Isosorbidedinitraat retard A indications
Angina Pectoris:Oral Tablet:
Prophylaxis of ischemic heart pain associated with coronary insufficiency. Isosorbidedinitraat retard A 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, Isosorbidedinitraat retard A 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. Isosorbidedinitraat retard A 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. Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A?
Use Isosorbidedinitraat retard A extended-release capsules as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Take Isosorbidedinitraat retard A extended-release capsules by mouth on an empty stomach with a full glass of water (8 oz [240 mL]).
- Swallow Isosorbidedinitraat retard A extended-release capsules whole. Do not break, crush, or chew before swallowing.
- If you miss a dose of Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A extended-release capsules.
Uses of Isosorbidedinitraat retard A in details
Use: Labeled Indications
Angina pectoris, prevention: Prevention of angina pectoris due to coronary artery disease.
Note: Due to slower onset of action, Isosorbidedinitraat retard A 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, Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A in patients with chronic heart failure support the use of Isosorbidedinitraat retard A (in combination with hydralazine) in patients with intolerance to ACE inhibitor therapy.
Isosorbidedinitraat retard A description
Each tablet of Isosorbidedinitraat retard A 5 mg contains 5 mg of Isosorbidedinitraat retard A.
Each tablet of Isosorbidedinitraat retard A 10 mg contains 10 mg of Isosorbidedinitraat retard A.
Each sustained-release tablet of Isosorbidedinitraat retard A 20 mg contains 20 mg of Isosorbidedinitraat retard A.
Each sustained-release tablet of Isosorbidedinitraat retard A 40 mg contains 40 mg of Isosorbidedinitraat retard A.
Isosorbidedinitraat retard A dosage
As noted under "CLINICAL PHARMACOLOGY," multiple-dose studies with Isosorbidedinitraat retard A and other nitrates have shown that maintenance of continuous 24-hour plasma levels results in refractory tolerance. Every dosing regimen for Isosorbidedinitraat retard A tablets must provide a daily dose-free interval to minimize the development of this tolerance. With immediate-release Isosorbidedinitraat retard A, 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 Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A 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.
Isosorbidedinitraat retard A interactions
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What other drugs will affect Isosorbidedinitraat retard A?
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 Isosorbidedinitraat retard A.
Phosphodiesterase Inhibitors: A blood pressure lowering effect of Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A therapy.
Dihydroergotamine: Isosorbidedinitraat retard A 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), Isosorbidedinitraat retard A (ISDN), Isosorbidedinitraat retard A mononitrate and others].
Isosorbidedinitraat retard A side effects
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What are the possible side effects of Isosorbidedinitraat retard A?
Adverse reactions to Isosorbidedinitraat retard A are generally dose-related, and almost all of these reactions are the result of Isosorbidedinitraat retard A'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 Isosorbidedinitraat retard A 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.
Isosorbidedinitraat retard A contraindications
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What is the most important information I should know about Isosorbidedinitraat retard A?
Do not use Isosorbidedinitraat retard A if you are taking sildenafil (Viagra). Serious, life-threatening side effects can occur if you take Isosorbidedinitraat retard A while you are using sildenafil.
You should not use this medication if you are allergic to Isosorbidedinitraat retard A, Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A, tell your doctor if you have congestive heart failure, low blood pressure, or kidney disease.
Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A. 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.
Isosorbidedinitraat retard A 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 Isosorbidedinitraat retard A suddenly. Stopping suddenly could cause a severe angina attack.
Active ingredient matches for Isosorbidedinitraat retard A:
Isosorbide Dinitrate in Netherlands.
List of Isosorbidedinitraat retard A substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Isosorbidedinitraat Tiofarma (Netherlands) | |
| Isosorbidemononitraat Aurobindo (Netherlands) | |
| Isostad (Austria) | |
| Isostad Retard | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 20 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 40 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 60 mg | |
| Isostat | |
| Isostenase (Germany) | |
| Tablet; Oral; Isosorbide Dinitrate 10 mg (Azupharma) | |
| Isostenase 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 | |
| Isotard (Israel, United Kingdom) | |
| Isotrate (Thailand) | |
| Isotrate 10 mg x 50 x 10's (Berlin Pharm) | |
| Isotrate 10 mg x 100's (Berlin Pharm) | |
| Isotrate 10 mg x 500's (Berlin Pharm) | |
| Isotrate 20 mg x 100's (Berlin Pharm) | |
| ISOTRATE 10MG TABLET 1 strip / 10 tablets each (Berlin Pharm) | $ 1.37 |
| ISOTRATE 20MG TABLET 1 strip / 10 tablets each (Berlin Pharm) | $ 2.09 |
| Isotrate tab 10 mg 50 x 10's (Berlin Pharm) | |
| Isotrate 10mg Tablet (Berlin Pharm) | $ 0.14 |
| Isotrate 20mg Tablet (Berlin Pharm) | $ 0.21 |
| Izo (Thailand) | |
| Jenacard (Germany) | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 20 mg (Jenapharm) | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 40 mg (Jenapharm) | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 60 mg (Jenapharm) | |
| Jenacard Retard (Germany) | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 20 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 40 mg | |
| Capsule, Retard; Oral; Isosorbide Dinitrate 60 mg | |
| Jeridin (United Kingdom) | |
| Kai Wei Xin (China) | |
| Kalliant (Japan) | |
| Kalliant SR (Japan) | |
| Kalliant TP (Japan) | |
| Kardiket (Bulgaria, Russian Federation) | |
| Capsule, Prolonged Release; Oral; Isosorbide Dinitrate 120 mg (Schwarz) | |
| Tablet, Prolonged Release; Oral; Isosorbide Dinitrate 20 mg (Schwarz) | |
| Tablet, Prolonged Release; Oral; Isosorbide Dinitrate 40 mg (Schwarz) | |
| Tablet, Prolonged Release; Oral; Isosorbide Dinitrate 60 mg (Schwarz) | |
| Kardiket 20mg - 50 Tablets (Schwarz) | $ 10.40 |
| Kardiket Retard (Bulgaria) | |
| Korodil | |
| L-Ohnesgen (Japan) | |
See 751 substitutes for Isosorbidedinitraat retard A | |
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).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
