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Isosorbide dinitrate

Isosorbide dinitrate
Isosorbide dinitrate structure.svg
Isosorbide dinitrate ball-and-stick.png
Clinical data
Trade names Isordil, others
AHFS/Drugs.com Monograph
Pregnancy
category
  • US: C (Risk not ruled out)
Routes of
administration
by mouth
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability 10–90%, average 25%
Metabolism Liver
Biological half-life 1 hour
Excretion Kidney
Identifiers
Synonyms (3R,3aS,6S,6aS)-hexahydrofuro[3,2-b]furan-3,6-diyl dinitrate
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
ECHA InfoCard 100.001.583
Chemical and physical data
Formula C6H8N2O8
Molar mass 236.136 g/mol
3D model (Jmol)
 NYesY (what is this?)  

Isosorbide dinitrate (ISDN) is a medication used for heart failure, esophageal spasms, and to treat and prevent chest pain from not enough blood flow to the heart. It has been found to be particularly useful in heart failure due to systolic dysfunction together with hydralazine in black people. It is taken by mouth or under the tongue.

Common side effects include headache, lightheadedness with standing, and blurred vision. Severe side effects include low blood pressure. It is unclear if use in pregnancy is safe for the baby. It should not be used together with medications within the sildenafil family. ISDN is in the nitrate family of medications and works by dilating blood vessels.

Isosorbide dinitrate was first written about in 1939. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. ISDN is available as a generic medication. The wholesale cost in the developing world is about 6.36 USD a month. In the United States it costs less than 25 USD per month. A long acting form exists.

It is used for angina, in addition to other medications for congestive heart failure, and for esophageal spasms.

Long-acting nitrates can be more useful as they are generally more effective and stable in the short term.

After long-term use for treating chronic conditions, tolerance may develop in patients, reducing its effectiveness. The mechanisms of nitrate tolerance have been thoroughly investigated in the last 30 years and several hypotheses have been proposed. These include:


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Wikipedia

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