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Indications

REMS

Unlabeled Uses:

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypotension, tachycardia, paradoxic bradycardia, syncope.

Derm: flushing.

GI: nausea, vomiting.

Neuro: dizziness, headache.
Misc: tolerance.

Interactions

Drug-Drug:

Availability

Isosorbide Dinitrate

(Generic available)

Isosorbide Mononitrate

(Generic available)

Route/Dosage

Isosorbide Dinitrate

Isosorbide Mononitrate

US Brand Names

isosorbide dinitrate: Dilatrate-SR

, Isordil

isosorbide mononitrate: Imdur

, Ismo, Monoket

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: antianginals

Pharmacologic Classification: nitrates

Pharmacokinetics

Absorption: Isosorbide dinitrate undergoes extensive first-pass metabolism by the liver, resulting in 25% bioavailability; isosorbide mononitrate has 100% bioavailability (does not undergo first-pass metabolism).

Distribution: Unknown.

Metabolism/Excretion: Isosorbide dinitrate is metabolized by the liver to 2 active metabolites (5-mononitrate and 2-mononitrate). Isosorbide mononitrate is primarily metabolized by the liver to inactive metabolites; primarily excreted in urine as metabolites.

Half-life: Isosorbide dinitrate: 1 hr; isosorbide mononitrate: 5 hr.

Canadian Brand Names

isosorbide mononitrate: Imdur

Time/Action Profile

(cardiovascular effects)

ROUTEONSETPEAKDURATION
ISDN-PO45–60 minunknown4 hr
ISMN-PO30–60 minunknown7 hr
ISMN-ERunknownunknown12 hr

Patient/Family Teaching

Pronunciation

isosorbide dinitrate: eye-soe-SOR-bide dye-NYE-trate

isosorbide mononitrate: eye-soe-SOR-bide mo-noe-NYE-trate

Pill Image

isosorbidemononitrate_195_8963.jpg