- Need 10-12 hours Nitroglycerin free interval per day
- Not proven to reduce Incidence of future events
- Chronic Angina Pectoris prophylaxis
- Not indicated for acute Myocardial Ischemia
-
Congestive Heart Failure (not FDA approved)
- Combine with Hydralazine
- Nitrate free period of 10-14 hours per day prevents the development of nitrate tolerance
- Swallow whole and do not crush or chew
- Isosorbide Dinitrate (Isordil)
- Regular
- Start 5 to 20 mg orally three times daily (7am, 12 noon, 5pm)
- Maximum: 40 mg orally three times daily
- Sustained Release
- Start 40 mg orally twice daily (8 am, 3 pm)
- Maximum: 80 mg orally twice daily
- Regular
- Isosorbide Mononitrate (Imdur)
- Regular
- Start 20 mg orally twice daily (8 am, 3 pm)
- Extended Release
- Start 30 mg orally daily
- May advance to 60 mg orally daily
- Maximum: 240 mg/day (maximum dose is rarely indicated)
- Regular
- Isosorbide Dinitrate (Isordil) Regular Sublingual
- Onset: 5 minutes
- Duration: 1 to 4 hours
- Isosorbide Dinitrate (Isordil) Regular Oral
- Onset: 30 minutes
- Duration: 4 to 6 hours
- Isosorbide Dinitrate (Isordil) Sustained Release Oral
- Onset: 30 minutes
- Duration: 8 hours
- See Nitroglycerin
- See Nitroglycerin
- Pregnancy Category C
- Unknown safety in Lactation
- Isosorbide Mononitrate (DailyMed)
- Isosorbide Dinitrate (DailyMed)
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 70-1
- Hamilton (2020) Tarascon Pocket Pharmacopoeia