Isosorbide

Isosorbide

Generic Name

Isosorbide

Mechanism

Isosorbide is a *vasodilator* that works by releasing nitric‑oxide (NO) from the endothelium.
NO-mediated: NO activates guanylate cyclase → ↑cyclic‑GMP → smooth‑muscle relaxation.
• Results in decreased systemic vascular resistance and reduced preload/afterload.
• Does not inhibit cyclooxygenase, thereby sparing platelet function and reducing GI irritation.

Pharmacokinetics

ParameterDetails
AbsorptionOral forms: ~ 90 % bioavailability; oral dissolution in acidic pH is well tolerated.
DistributionWidely distributed; crosses the blood‑brain barrier (low‑dose effect).
MetabolismHydrolyzed by plasma esterases to isosorbide mononitrate or inactive metabolites. No major CYP involvement.
ExcretionRenal (major route). Elimination half‑life: 3 – 4 h for isosorbide dinitrate; ~10 h for controlled‑release isosorbide mononitrate.
Special PopulationsRenal impairment: no significant accumulation; adjust dose if creatinine clearance < 30 mL/min for prolonged regimens.

Indications

  • Stable angina pectoris (short‑term and long‑term prevention).
  • Pre‑operative prophylaxis in coronary artery disease patients.
  • Chronic heart failure adjunct (usually in combination with nitrates).
  • Pre‑operative prophylaxis for coronary artery bypass graft (CABG) surgery when NO donors are indicated.

Contraindications

  • Contraindications
  • Hypersensitivity to isosorbide, nitrate, or any excipient.
  • Severe hypotension (SBP  24 h continuous exposure; recommended “nitrate‑free interval” (at least 10–14 h daily).
  • Concurrent use with phosphodiesterase‑5 inhibitors (sildenafil, tadalafil) → risk of severe hypotension.
  • Pregnancy – category B; use only if benefit outweighs risk.
  • Concomitant antihypertensives – add‑on therapy may cause additive hypotension; start dose titration.

Dosing

FormTypical DoseFrequencyTitration Notes
Isosorbide dinitrate (tablet)5 mg PO q6‑8 h → titrate ↑ every 1–2 days to pain control OR ≤ 50 mg/dayTaper as needed; avoid > 50 mg/day unless supervisedStart low; increase by 5–10 mg increments until response or side‑effects.
Isosorbide mononitrate (tablet, XR)5 mg PO q24 h → titrate ↑ 2.5–5 mg every 3–5 days to 20–30 mg q24 hDay‑dose.Use at bedtime; adjust for breakthrough angina.
Isosorbide dinitrate (IV)0.3 mg/kg over 5 min → repeat every 10 min if neededOnly in acute settings (e.g., hypertensive crisis)Monitor BP closely; stop if < 90 mm Hg SBP.

Adverse Effects

Common (≥ 5 %)Serious (rare)
Headache, flushed skin, dizziness, nausea, postural hypotensionSevere hypotension, syncope, myocardial infarction (unlikely but watch for ischemic changes), anaphylaxis (rare)
Methemoglobinemia (rare, after prolonged high doses)Tolerance with continuous use; risk of organ ischemia if untreated
Hypotension (especially with oral dinitrate)Severe GI bleed if combined with antithrombotics (monitor hemoglobin)

Monitoring

  • Blood pressure: baseline, daily during titration, at 2–4 h post‑dose.
  • Heart rate: watch for reflex tachycardia.
  • Serum creatinine / eGFR: baseline; every 1–3 months if CKD.
  • Methemoglobin level: in patients with 5‑ASA, sulfa drugs, or prolonged therapy.
  • Symptoms of nitrate tolerance: evaluate every 4–6 weeks during chronic use.

Clinical Pearls

  • “Nitrate‑free interval” is key: ensure at least 10–14 h of no nitrate use to prevent tolerance—especially critical for oral dinitrate users.
  • Isosorbide mononitrate is preferable for once‑daily dosing in stable angina and reduces the risk of hypotension compared to dinitrate.
  • Avoid concurrent use with phosphodiesterase‑5 inhibitors or high‑dose antihypertensives; the NO‑mediated vasodilation can lead to precipitous drops in blood pressure.
  • In patients with renal insufficiency, isosorbide is safe but monitor renal function; there is no dose adjustment for moderate CKD.
  • Pre‑operative “Nitrate stress test”: administer 10–20 mg IV isosorbide dinitrate to detect silent ischemia; positive test predicts peri‑operative cardiac events.
  • When prescribing in pregnancy, stay within maximum recommended daily doses and counsel on possible fetal effects; isotopic evidence is limited but considered relatively safe (category B).

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References

1. Katzung BG. *Basic & Clinical Pharmacology*. 15th ed. McGraw‑Hill; 2022.

2. Mayo Clinic Proceedings. “Nitrate therapy in angina: dosing and monitoring.” 2023.

3. UpToDate. “Isosorbide dinitrate and mononitrate (drug, dosing, side effects, interactions).” 2025.

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