Isosorbide dinitrate

When ATH:
C01DA08

Characteristic.

The white crystalline powder odorless. Practically insoluble in water, soluble in acetone, alcohol, ether. Molecular weight 236,14.

Pharmacological action.
Antianginalnoe, vasodilator.

Application.

Angina (relief and prevention of attacks), incl. Unstable, acute myocardial infarction, post-myocardial infarction (rehabilitation treatment), acute left ventricular failure, arterial hypertension, congestive heart failure, pulmonary hypertension, chronic pulmonary heart, prevention and treatment of coronary spasm during coronary angiography.

Contraindications.

Hypersensitivity, anemia, bleeding in the brain or recent head injury, hemorrhagic stroke, intracranial hypertension, zakrыtougolynaya glaucoma, hyperthyroidism, shock, collapse, gipotenziya (Sad below 100 mmHg.), myocardial infarction or congestive heart failure with low pressure filling of the left ventricle, stenosis of the aortic or mitral valves, hypertrophic cardiomyopathy with obstruction of the left ventricular outflow tract, toxic pulmonary edema, deficiency of glucose-6-fosfatdegidrogenazы, pregnancy (I trimester), lactation, childhood.

Restrictions apply.

The tendency to orthostatic hypotension, pregnancy (II and III trimester).

Pregnancy and breast-feeding.

Contraindicated for use in the I trimester of pregnancy. Appointment of II-III trimester of pregnancy is possible only under strict conditions and under constant medical supervision.

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

At the time of treatment should stop breastfeeding.

Side effects.

Rush of blood to the face and neck, headache, dizziness, nausea, vomiting, burning sensation on the tongue, orthostatic hypotension, collapse, restlessness, constraint, impaired attention, tachycardia, withdrawal.

Cooperation.

Adsorbents, knitting and enveloping means reduce the absorption from the gastrointestinal tract. Antihypertensive agents (beta-blockers, calcium antagonists, others. vasodilators), digidroergotamin, prokaynamyd, quinidine, tricyclic antidepressants, neuroleptics, Sildenafil citrate and alcohol increase hypotension, sympathomimetic reduced antianginal effect, combination with atropine increases the likelihood of elevated intraocular pressure.

Overdose.

Symptoms: metgemoglobinemiâ (cyanosis of the lips and nails, anoksija), severe dizziness or fainting, collapse, feeling of pressure in the head, weakness, breathlessness, weak and rapid heartbeat, bradycardia, fever, cranial hypertension, convulsions, nausea, vomiting, diarrhea, dyspnoea, visual disturbances.

Treatment: gastric lavage, symptomatic treatment, when methemoglobinemia - appointment methylthioninium chloride (Methylene blue) at a dose of 1-2 mg/kg, I /.

Dosing and Administration.

Inside, sublingually, I /, inhalation, fur gloves. Angina: Capsules and tablets - by every 5-20 mg 6 no (optionally up to 20-40 mg 4 once a day); dosage forms with prolonged action - by 40-80 mg every 8-12 hours (swallow whole).

By 2.5-5 mg sublingually, if necessary, every 2-3 hours.

In acute myocardial infarction, acute left ventricular failure in /: initial dose - 1.2 mg / hr, maximum dose - 8.10 mg / hr.

Inhalation for the relief of angina attacks: 1-3 Dose is sprayed onto the oral mucosa intervals 30 with on the background of breath.

on skin - 1 g cream / 2 dose applied on the skin surface.

Precautions.

Caution should be exercised when administered to patients with a tendency to orthostatic hypotension. When used in patients with baseline blood pressure reduction should be combined with the introduction of drugs, having positive inotropic action. It is recommended to monitor blood pressure and heart rate, especially at the beginning of treatment. At the beginning of treatment should be particularly careful to persons, whose work requires quick mental and motor reactions. Attention is drawn to the patient, that the side effects are amplified in patients receiving alcohol. For the prevention of addiction after 3-6 weeks of regular intake it is recommended to make a break for 3-5 days.

Cooperation