Isosorbide
Dinitrate (Isordil, Dilitrate-SR, Sorbitrate, Timecelles)
Category:
Description:
Indications:
-
Prevention
of angina pectoris
-
Relief
of acute anginal episodes and prophylaxis prior to events likely to
provoke an attack
-
CHF
(non-FDA approved)
-
Hypertension
(acute) (non-FDA approved)
Contraindications:
Precautions:
-
Pregnancy
category C; use caution in nursing mothers
-
Acute
MI, hypertrophic cardiomyopathy, glaucoma
-
Volume
depletion, hypotension, abrupt withdrawal
-
Continuous
delivery without nitrate-free interval (tolerance develops)
Adverse
Reactions (Side Effects):
-
CNS:
agitation, anxiety, apprehension, confusion, dizziness,
dyscoordination, headache, hypoesthesia, hypokinesia, insomnia,
nervousness, nightmares, restlessness, vertigo, weakness
-
CV:
atrial fibrillation, cardiovascular collapse, crescendo angina,
dysrhythmias, edema, hypotension, PVC’s, rebound hypertension,
retrosternal discomfort, syncope, tachycardia
-
EENT:
blurred vision, diplopia
-
GI:
abdominal pain, diarrhea, dyspepsia, involuntary passing of feces,
nausea, tenesmus, vomiting
-
GU:
dysuria, impotence, involuntary passing of urine, urinary frequency
-
HEME:
hemolytic anemia, methemoglobinemia
-
MS:
arthralgia, muscle twitching
-
SKIN:
cold sweat, crusty skin lesions, exfoliative dermatitis, flushing,
pallor, perspiration, pruritis, rash
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Dosage:
Administered
orally: Asymmetric dosing regimens provide a daily nitrate-free interval
to minimize the development of tolerance.
-
Adult:
-
SL
2.5-5mg initially, titrate upward until angina is relieved or side
effects limit the dose;
-
chewable
tablets 5mg initially, titrate upward until angina is relieved or
side effects limit the dose;
-
PO
5-20mg 2-3 times daily initially (last dose no later than 1900),
maintenance 10-40mg 2-3 times daily (last dose no later than
1900);
-
PO
SUS REL 40mg 1-2 times daily initially (last dose no later than
1400), maintenance 40-80mg 1-2 times daily (last dose no later
than 1400)
Special
considerations:
-
Headache
may be a marker for drug activity; do not try to avoid by altering
treatment schedule; aspirin or acetaminophen may be used for relief
-
Dissolve
SL tablets under tongue; do not crush, chew, or swallow
-
Do
not crush chewable tablets before administering
-
Avoid
alcohol
-
Make
changes in position slowly to prevent fainting
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Distribution is unlimited. The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks.
Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300.
Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300 |
Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
United States Special Operations
Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323 |
*This web version is provided by The Brookside Associates, LLC. It contains
original contents from the official US Navy NAVMED P-5139, but has been
reformatted for web access and includes advertising and links that were not
present in the original version. The medical information presented was reviewed and felt to be accurate in 2001. Medical knowledge and practice methods may have changed since that time. Some links may no longer be active. This web version has not been approved by the
Department of the Navy or the Department of Defense. The presence of any
advertising on these pages does not constitute an endorsement of that product or
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Brookside Associates is a private organization, not affiliated with the United
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