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Active Ingredient: Isosorbide Dinitrate
Brans Name: Isordil

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What is Isordil

Isordil is used to prevent angina (chest pain) caused by coronary artery disease. It does not work fast enough to relieve the pain of an angina attack that has already started. Isordil belongs to the group of medicines called nitrates. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart while reducing its work load. When used regularly on a long-term basis, this helps prevent angina attacks from occurring.

Isordil Drug Recommendation

With > 2 assaults of secure angina pectoris (AP) per week, upkeep therapy with a selective, lipophilic β-blocker or dihydropyridine calcium antagonist is indicated. Select relying on affected person traits and desire. Swap to the opposite drug or give a long-acting nitrate if there are uncomfortable side effects or contra-indications. If the impact is inadequate, improve the dose or add the choice. Take into account including a 3rd agent (β-blocker, dihydropyridine or long-acting nitrate) beneath sure circumstances.

Isordil or nitroglycerin might be administered oromucosally to interrupt an assault of secure angina. As well as, life-style recommendation needs to be given for the secondary prevention of heart problems (HVZ).

Isordil Indications


  • prophylaxis and upkeep therapy of angina pectoris;
  • symptomatic therapy of reasonable to extreme coronary heart failure that doesn’t reply adequately to diuretics and cardiac glycosides.


  • acute angina pectoris assaults;
  • short-term prophylaxis of angina pectoris assaults throughout greater than regular train.

What Should You Discuss To Your Doctor Before Using This Medicine

  • Being pregnant
    • Teratogenesis: In people, inadequate knowledge. In animals, no proof of harmfulness.
    • Suggestion: Use solely on very strict indication, attributable to lack of information.

  • Lactation
    • Transition in breast milk: Unknown.
    • Pharmacological results: With short-term sublingual use, antagonistic results within the toddler are unlikely because of the brief half-life of nitrates. With persistent use, hypotension and methaemoglobinaemia might happen. Infants as much as 6 months of age are notably delicate to nitrates.
    • Suggestion: Can in all probability be used safely with a single dose; for security causes, pump the primary meals after dosing and don’t use. Persistent use shouldn’t be really useful.

Isordil Contraindications

  • elevated intracranial stress, e.g. from head trauma or cerebral haemorrhage;
  • extreme anaemia;
  • extreme hypotension (systolic blood stress < 90 mmHg);
  • acute circulatory disturbances
    • shock
    • collapses except adequate end-diastolic stress is maintained by applicable measures
  • extreme hypovolaemia;
  • coronary heart failure attributable to obstruction:
    • constrictive pericarditis
    • hypertrophic obstructive cardiomyopathy
    • cardiac tamponade
    • aortic and/or mitral stenosis
  • hypersensitivity to nitrates.

Isordil Drug Interactions

  • On account of an additive blood stress reducing impact, concomitant use with riociguat is contraindicated.
  • Concomitant use with phosphodiesterase-5 inhibitors (avanafil, sildenafil, tadalafil and vardenafil) is contraindicated because it potentiates the vasodilatory impact and in prone sufferers might result in life-threatening cardiovascular issues; sufferers on nitrates as upkeep remedy needs to be knowledgeable that nitrate remedy shouldn’t be interrupted briefly to manage the phosphodiesterase-5 inhibitor.
  • Concomitant use of alcohol
  • antihypertensive medicine
  • tricyclic antidepressants
  • sapropterin or antipsychotics

Isordil Dosage

  1. Upkeep therapy angina pectoris
    • Adults (incl. aged)
      • Oral, ‘titradose’: 30 mg 2-4×/day; in particular person instances larger doses could also be required.
      • Retard pill: beginning dose 20 mg 1-2×/day with an interval of as much as 6 hours, due to doable preliminary uncomfortable side effects an intermediate dose of 10 mg 1-2×/day could also be fascinating; max. 80 mg 1-2×/day.

  2. Acute angina pectoris assault
    • Adults (incl. aged)
      • Sublingually: soften 5 mg beneath the tongue, repeat after a number of minutes if obligatory.

  3. Prophylaxis angina pectoris assault
    • Adults (incl. aged)
      • Sublingually: let 5 mg soften beneath the tongue a couple of minutes earlier than train.

  4. Coronary heart failure
    • Adults (incl. aged)
      • Oral, ‘titradose’: beginning dose 30 mg 2-4×/day. On the premise of the therapeutic impact, improve as essential to 120-240 mg day by day in 2-4 doses .
      • Retard pill: based on the CBO Guideline Coronary heart Failure 2010 together with hydralazine initially 20 mg 3×/day, then step by step improve to focus on dose 40 mg 3×/day or to the utmost tolerated dose, dose improve ideally each 2-4 weeks.
      • Decreased renal or hepatic operate: No dose adjustment required.

  5. Administration: Swallow the Retard tablets complete with some water.

Signs of Overdose

  • extreme hypotension
  • pallor
  • sweating
  • weak pulse
  • headache
  • weak point
  • dizziness
  • nausea
  • vomiting
  • diarrhoea
  • shock
  • coma
  • convulsions.

In case of extreme overdose, particularly in younger youngsters, test for methaemoglobinaemia manifested by:

  • cyanosis
  • dyspnoea
  • respiratory insufficiency

Isordil Precautions

Use with warning after a latest myocardial infarction, in extreme coronary atherosclerosis, extreme cerebral sclerosis and in ailments related to an obstruction of the cardiac outflow pathway, equivalent to orthostatic dysfunction. Angina pectoris brought on by hypertrophic cardiomyopathy might worsen.

Additionally watch out in sufferers with hypoxemia and ventilation-perfusion mismatch attributable to:

  • pulmonary illness
  • ischaemic coronary heart failure
  • angina pectoris
  • myocardial infarction
  • cerebral ischaemia.

Small-airway abnormalities are sometimes current in these sufferers. In alveolar hypoventilation, native vasoconstriction might shift perfusion to higher ventilated areas of the lungs. Extreme vasodilation can negate this protecting vasoconstriction and trigger additional ventilation-perfusion mismatch and reduce in partial arterial oxygen stress, probably resulting in myocardial hypoxia.

Isordil Side Effects

  • Headache
  • Dizziness
  • Drowsiness
  • Tachycardia
  • Hypotension
  • Sensation of weak point
  • Extreme sweating
  • Pallor
  • Worsening of angina pectoris
  • Nausea
  • Vomiting
  • Allergic pores and skin reactions
  • Flushing
  • Circulatory collapse
  • Restlessness
  • Acid burn
  • Angioedema
  • Stevens-Johnson syndrome
  • Exfoliative dermatitis
  • Transient hypoxaemia
  • Palpitations


Information concerning psychotic disorders, included within the review of Isordil, is used for the informative features exclusively as well as should not be thought-about to alternative to licensed healthcare or referral of the well being treatment distributor.


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Frequently asked questions

  1. What is Isordil?

    Isordil is used for the treatment and prevention of angina caused by coronary artery disease because angina occurs when the heart muscle does not get enough blood. This medication is used before physical activities (exercise, sexual activity). Isordil belongs to a class of drugs called nitrates.

  2. What to do if you miss a dose?

    If you miss a dose of Isordil, take it as quickly as potential. However, whether it is virtually time to your subsequent dose, skip the missed dose and return to your common dosing schedule. Do not double doses.

  3. What if u take too much Isordil?

    If an overdose happens, name your physician or call your nearest hospital. You might have pressing medical care. You might also contact the poison management at your local hospital.

  4. How to store Isordil?

    Store at room temperature, approximately 25° C (77° F). Protect from moisture, light. 

  5. What Should I Avoid While Taking Isordil?

    Avoid consuming alcohol or utilizing unlawful medicine when you are taking Isordil. They might lower the advantages (e.g. worsen your confusion) and improve hostile results (e.g. sedation) of the remedy.

  6. What are the side effects of Isordil?

    Severe headache is the most known side effect that can be caused by high doses. Also, it can be lightheadedness, occasionally related to blood pressure changes. 

  7. What are the Contraindication?

    Isordil is contraindicated in patients who have an allergy to Isordil or any of its other ingredients although allergic reactions to organic nitrates are extremely rare, they do occur sometimes.

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