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Isordil (Isosorbide dinitrate) 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 decreases chest pain.

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Uses

Isosorbide dinitrate (eye-soe-SOR-bide dye-NYE-trate) is prescribed to relieve or prevent angina pectoris (suffocating chest pain).

How to take

In swallowed capsules or tablets, Isosorbide dinitrate helps to increase the amount of exercise you can do before chest pain begins. In chewable or sublingual (held under the tongue) tablets, Isosorbide dinitrate can help relieve chest pain that has already started or prevent pain expected from a strenuous activity such as walking up a hill or climbing stairs. Swallowed capsules or tablets should be taken on an empty stomach. While regular tablets may be crushed for easier use, sustained- or prolonged-release products should not be chewed, crushed or altered. Chewable tablets should be chewed thoroughly and held in the mouth for a couple of minutes. Do not eat, drink, smoke, or use chewing tobacco while a sublingual tablet is dissolving. This drug's effectiveness is closely linked to the dose, so follow your doctor's instructions carefully.

Side effects

Headache is the most common side effect; usually, standard headache treatments with over-the-counter pain products will relieve the pain. The headaches associated with Isosorbide dinitrate usually subside within 2 weeks after treatment with the drug begins. Do not change your dose to avoid the headache. At a dose that eliminates headaches, the drug may not be as effective against angina. Other common side effects may include: Dizziness, light-headedness, low blood pressure, weakness. Less common or rare side effects may include: Collapse, fainting, flushed skin, high blood pressure, nausea, pallor, perspiration, rash, restlessness, skin inflammation and flaking, vomiting.

Precaution

Isosorbide dinitrate may cause severe low blood pressure (possibly marked by dizziness or fainting), especially when you stand or sit up quickly. People taking diuretic medication or those who have low blood pressure should use Isosorbide dinitrate with caution. You should use Isosorbide dinitrate with caution if you have anemia, glaucoma, a previous head injury or heart attack, heart disease, low blood pressure, or thyroid disease. If you stop using Isosorbide dinitrate, you should follow your doctor's plan for a gradual withdrawal schedule. Abruptly stopping this medication could result in additional chest pain. Alcohol may interact with Isosorbide dinitrate and produce a swift decrease in blood pressure, possibly causing dizziness and fainting. Some people who use Isosorbide dinitrate for a long time without a break may develop a physical need to continue taking it. If you take Isosorbide dinitrate without a break and then suddenly stop taking it, you may get withdrawal symptoms. These may include chest pain, heart attack, or possibly sudden death. Be sure to have a "nitrate-free" period of time each day; this may help prevent dependence and withdrawal problems. Do not take more than prescribed.

Drug interactions

You should not take Isosorbide dinitrate if you have had a previous allergic reaction to it or to other nitrates or nitrites. Extreme low blood pressure (marked by dizziness, fainting, and numbness) may occur if you take Isosorbide dinitrate with certain other high blood pressure drugs such as Cardizem and Procardia, as well as the impotence remedy Viagra.

Missed dose

If you are taking this drug regularly, take the forgotten dose as soon as you remember. If your next dose is within 2 hours--or 6 hours for controlled-release tablets and capsules--skip the one you missed and go back to your regular schedule. Do not take 2 doses at once.

Storage

Store Isosorbide dinitrate at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Isosorbide dinitrate out of the reach of children and away from pets.