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Isosorbide dinitrate

  • Isosorbide dinitrate is to prevent chest pain associated with angina.
  • Side-effects include flushing, headache and light-headedness.

About isosorbide dinitrate

Type of medicineNitrate
Used forAngina
Heart failure (a condition where the pumping action of the heart is reduced)
Also calledIsoket® Retard, Isoket®
Available asTablets, modified-release tablets (isosorbide dinitrate is slowly released to give an even effect) and injection

Isosorbide dinitrate is known as a nitrate and is used to prevent the symptoms of angina (chest pain) and other heart conditions including heart failure.

Angina is pain or tightness of the chest caused by a lack of oxygen reaching the heart muscle. Nitrates work in two different ways. They widen the arteries that carry blood to the heart muscle and they relax the veins that return blood from the body to the heart. Together these actions allow more oxygen to reach the heart muscle and reduce the work of the heart. This lowers the overall strain on the heart reducing the risk of angina and relieving the pain associated with an acute angina attack.

Isosorbide dinitrate is taken on a regular basis to prevent angina attacks.

Before taking isosorbide dinitrate

Before taking isosorbide dinitrate make sure your doctor or pharmacist knows:

  • If you are pregnant, trying for a baby or breast-feeding.
  • If you suffer from a heart condition, liver or kidney problems.
  • If you suffer from hypotension (low blood pressure).
  • If you have recently suffered a head injury or brain haemorrhage.
  • If you have recently suffered a heart attack.
  • If you suffer from anaemia (low levels of iron in the blood) or hypoxaemia (low levels of oxygen in the blood).
  • If you suffer from thyroid problems.
  • If you suffer from glaucoma (increased pressure in the eye).
  • If you are taking any products to help treat erectile dysfunction (such as Viagra®).
  • If you suffer from hypothermia (low body temperature).
  • If you suffer from poor nutrition.
  • If you are taking other medicines, including those available to buy without a prescription, herbal or complementary medicines.
  • If you have ever had an allergic reaction to this or any other medicine.

How to take isosorbide dinitrate

  • Before beginning treatment, read the manufacturer's printed information leaflet.
  • Your doctor will tell you when and how often you should take isosorbide dinitrate. Take it exactly as you have been directed.
  • Try to take isosorbide dinitrate at the same times each day to avoid missing any doses. Your last dose should usually be taken no later than 6pm. This is to stop your body from becoming tolerant to the isosorbide dinitrate which would make it less effective.
  • If you have been given the modified-release tablets, swallow them whole with a drink of water. Do not chew or crush them.
  • If you forget to take a dose, take one as soon as you remember unless it is nearly time for your next dose. Do not take two doses at the same time to make up. If in doubt, speak to your pharmacist or doctor.

Getting the most from your treatment

  • If you are having any treatment like an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
  • Keep your regular doctor's appointment so your progress can be monitored.
  • Do not stop taking this medicine without speaking to your doctor first.
  • If you buy any medicines, check with a pharmacist that they are safe to take with your other medicines.
  • It is best not to drink alcohol while you are taking isosorbide dinitrate. Alcohol can make any dizziness you feel worse. If you do drink alcohol, drink only a little and be aware of its effect on you.
  • Your doctor may advise you to use a quick acting nitrate (such as glyceryl trinitrate) if you have chest pain. Important: If at any time you experience severe chest pain which is not relieved, go to your local accident and emergency department straight away.

Can isosorbide dinitrate cause problems?

Along with their useful effects all medicines can cause unwanted side effects which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.

Common side-effects - these affect less than 1 in 10 people who take this medicineWhat can I do if I experience this
Light-headedness or dizziness especially when getting up from a sitting or lying positionGetting up slowly should help. If you begin to feel dizzy, lie down so that you do not faint, then sit for a few moments before standing
HeadacheAsk your pharmacist to recommend a suitable pain-killer
DizzinessMake sure your reactions are normal before driving, operating machinery or doing other jobs, which could be dangerous, if you were not fully alert
Fast or fluttering heartbeat, feeling sick, and flushingIf troublesome, speak with your doctor

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store isosorbide dinitrate

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines


  • Never take more than the prescribed dose. If you suspect that you or someone else has taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.
  • This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
  • Never keep out of date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
  • If you have any questions about this medicine ask your pharmacist.

References

  • Manufacturer's PIL, Isoket Retard®, UCB Pharma Limited, electronic Medicines Compendium. Dated November 2007, accessed March 2009.
  • British National Formulary; 57th Edition (March 2009) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF).
Comprehensive patient resources are available at www.patient.co.uk
© EMIS 2009DocID: 3855DocRef: dils3884Last Reviewed: 12 May 2009Version: 22
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