* Generic Name: isosorbide dinitrate
* Brand Name: Isordil
* What is isosorbide dinitrate?
* What are the possible side effects of isosorbide dinitrate?
* What is the most important information I should know about
isosorbide dinitrate?
* What should I discuss with my healthcare provider before taking
isosorbide dinitrate?
* How should I take isosorbide dinitrate?
* What happens if I miss a dose?
* What happens if I overdose?
* What should I avoid while taking isosorbide dinitrate?
* What other drugs will affect isosorbide dinitrate?
* Where can I get more information?
What is isosorbide dinitrate?
Isosorbide dinitrate is a nitrate that dilates (widens) blood vessels,
making it easier for blood to flow through them and easier for the
heart to pump.
Isosorbide dinitrate is used to treat or prevent attacks of chest pain
(angina).
Only the sublingual tablet should be used to treat an angina attack
that has already begun.
Isosorbide dinitrate regular and extended-release tablets are used to
prevent angina attacks but will not treat an angina attack.
Isosorbide dinitrate may also be used for purposes not listed in this
medication guide.
What are the possible side effects of isosorbide dinitrate?
Get emergency medical help if you have signs of an allergic reaction:
hives; difficulty breathing; swelling of your face, lips, tongue, or
throat.
Call your doctor at once if you have:
* a light-headed feeling, like you might pass out;
* worsening angina pain;
* fast or slow heart rate; or
* pounding heartbeats or fluttering in your chest.
Isosorbide dinitrate can cause severe headaches. These headaches may
gradually become less severe as you continue to use nitroglycerin. Do
not stop taking this medicine to avoid headaches. Ask your doctor
before using any headache pain medication.
Common side effects may be more likely to occur, such as:
* headache; or
* flushing (warmth, redness, or tingly feeling).
This is not a complete list of side effects and others may occur. Call
your doctor for medical advice about side effects. You may report side
effects to FDA at 1-800-FDA-1088.
What is the most important information I should know about isosorbide
dinitrate?
You should not take erectile dysfunction medicine (Viagra,
Cialis, Levitra, Stendra, Staxyn, sildenafil,
avanafil, tadalafil, vardenafil) while you are taking
isosorbide dinitrate. Taking these medicine together can cause a sudden
and serious decrease in blood pressure.
Seek emergency medical attention if you have early symptoms of a heart
attack (chest pain or pressure, pain spreading to your jaw or
shoulder, sweating, general ill feeling).
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What should I discuss with my healthcare provider before taking isosorbide
dinitrate?
You should not use isosorbide dinitrate if:
* you are allergic to isosorbide dinitrate, isosorbide
mononitrate, or nitroglycerin; or
* you have early signs of a heart attack (chest pain or pressure,
pain spreading to your jaw or shoulder, nausea, sweating).
You should not take erectile dysfunction medicine (Viagra, Cialis,
Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil, vardenafil)
while you are taking isosorbide dinitrate. Taking these medicines
together can cause a sudden and serious decrease in blood pressure.
To make sure isosorbide dinitrate is safe for you, tell your doctor if
you have:
* congestive heart failure;
* kidney disease; or
* low blood pressure.
It is not known whether this medicine will harm an unborn baby. Tell
your doctor if you are pregnant or plan to become pregnant.
It is not known whether isosorbide dinitrate passes into breast milk or
if it could affect the nursing baby. Tell your doctor if you are
breast-feeding.
How should I take isosorbide dinitrate?
Before using isosorbide dinitrate to treat a sudden angina attack, your
doctor may want you to first use a nitroglycerin sublingual tablet.
Follow your doctor's instructions about what medications to use during
an attack and how much time to allow between doses.
Follow all directions on your prescription label. Your doctor may
occasionally change your dose. Do not take this medicine in larger or
smaller amounts or for longer than recommended. If you use too much
isosorbide dinitrate, it might stop working as well in controlling your
condition.
Try to rest or stay seated when you take this medicine (may cause
dizziness or fainting).
To prevent angina attacks, isosorbide dinitrate is usually taken at
regular intervals.
To treat an angina attack that has already begun, use the medicine at
the first sign of chest pain. Place the tablet under your tongue and
allow it to dissolve slowly. Do not chew or swallow it.
You may use the sublingual tablet within 15 minutes before an activity
you think might cause chest pain. Follow your doctor's instructions.
Do not crush, chew, break, or open an extended-release capsule or
tablet. Swallow it whole.
Follow your doctor's dosing instructions very carefully. If your doctor
changes your brand, strength, or type of isosorbide dinitrate, your
dosage needs may change. Ask your pharmacist if you have any questions
about the new kind of isosorbide dinitrate you receive at the pharmacy.
Seek emergency medical attention if your chest pain gets worse or lasts
longer than 5 minutes, especially if you have trouble breathing or feel
weak, dizzy, or nauseated, or lightheaded.
You may have very low blood pressure while taking this medicine. Call
your doctor if you are sick with vomiting or diarrhea, or if you
are sweating more than usual. Prolonged illness can lead to a serious
electrolyte imbalance, making it dangerous for you to use
isosorbide dinitrate.
If you take isosorbide dinitrate on a regular schedule to prevent
angina, do not stop taking it suddenly or you could have a severe
attack of angina. Keep this medicine on hand at all times. Get your
prescription refilled before you run out of medicine completely.
Store at room temperature, away from moisture, heat, and light. Keep
the bottle tightly closed when not in use.
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What happens if I miss a dose?
Since isosorbide dinitrate is sometimes used only when needed, you may
not be on a dosing schedule. If you are on a schedule, take the missed
dose as soon as you remember. Skip the missed dose if your next dose is
less than 2 hours away.
If you are using the extended-release capsule or tablet and your next
dose is less than 6 hours away, skip the missed dose and use the
medicine at your next regularly scheduled time.
Do not use extra medicine to make up a missed dose.
What happens if I overdose?
Seek emergency medical attention if you think you have used too much of
this medicine. An overdose of isosorbide dinitrate can be fatal.
Overdose symptoms may include a severe throbbing headache, fever,
confusion, severe dizziness, fast or pounding heartbeats, vision
problems, nausea, vomiting, stomach pain, bloody diarrhea, trouble
breathing, sweating, cold or clammy skin, fainting, and seizure
(convulsions).
What should I avoid while taking isosorbide dinitrate?
This medicine may impair your thinking or reactions. Be careful if you
drive or do anything that requires you to be alert. Avoid getting up
too fast from a sitting or lying position, or you may feel dizzy. Get
up slowly and steady yourself to prevent a fall.
Avoid drinking alcohol. Alcohol may increase certain side effects of
isosorbide dinitrate (dizziness, drowsiness, feeling light-headed, or
fainting).
What other drugs will affect isosorbide dinitrate?
Taking isosorbide dinitrate with certain other medicines can cause
severely low blood pressure. This includes medicine to treat erectile
dysfunction or pulmonary arterial hypertension. Serious,
life-threatening side effects may occur.
Tell your doctor about all your current medicines and any you start or
stop using, especially:
* avanafil (Stendra);
* a diuretic or "water pill";
* nitroglycerin;
* riociguat (Adempas);
* sildenafil (Viagra, Revatio);
* tadalafil (Cialis, Adcirca); or
* vardenafil (Levitra, Staxyn).
This list is not complete. Other drugs may interact with isosorbide
dinitrate, including prescription and over-the-counter medicines,
vitamins, and herbal products. Not all possible interactions are listed
in this medication guide.
Where can I get more information?
Your pharmacist can provide more information about isosorbide
dinitrate.
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