Isosorbide dinitrate
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Nitroglycerin (nye" troe glis' er in) is a propanetriol trinitrate, a nitric oxide prodrug that has been in common use as a treatment for acute angina pectoris for more than 100 years.
Indications (use) - Isosorbide dinitrate
Current indications include treatment and prevention of angina attacks and management of acute coronary syndromes. Nitroglycerin is highly volatile and is formulated in a matrix that stabilizes the molecule. However, it is still susceptible to inactivation and is generally provided in a light-proof bottle with a short shelf life (6 months). Nitroglycerin is well absorbed orally but has a high first pass clearance by the liver, for which reason it is typically given sublingually or by transdermal routes. However, nitroglycerin is available generically in many forms, sublingual tablets, topical ointments, transdermal patches, transmucosal ointments, aerosolized sprays, extended release oral tablets and liquid solutions for intravenous use.
Dosage and administration for Isosorbide dinitrate
The typical sublingual dose is 0.3 to 0.6 mg at the onset of angina pain or in anticipation of angina. The dose can be repeated every 5 minutes for 15 to 30 minutes for a maximum of 3 doses. The onset of action is within 2 to 5 minutes. The oral and transdermal forms are used largely for prevention of angina and long term therapy.
Side effects of Isosorbide dinitrate
Side effects of nitroglycerin include headache, dizziness, weakness, flushing, syncope, tachycardia, palpitations and postural hypotension. Dermal forms can cause local rash and irritation.
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Contributors: Prab R. Tumpati, MD