Drug Information: Indications, Side Effects, Warnings
Category: Â Cardiovascular Diseases
Generic isordil is used for preventing angina (chest pain) caused by heart disease.
The main ingredient of the drug — isosorbide mononitrate
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Nitrates and similar tools
Nosological classification (ICD-10)
I20 angina [angina pectoris]
I25 Chronic ischemic heart disease
I25.2 Transferred last myocardial infarction
I27 Other forms of cardiopulmonary diseases
I50.0 Congestive heart failure
Characteristics of matter:
The main active metabolite of isosorbide dinitrate. White crystalline solid, is odorless, stable in air and in a solution with a melting point of about 90 Â° C. Easily soluble in water, ethanol, methanol, chloroform, ethyl acetate and dichloromethane.
Pharmacological action — a vasodilator.
How does the drug?
— Generic isordil Increases nitric oxide in the endothelium
— Stimulates guanylate cyclase and cGMP formation
— The preparation in the concentration of calcium decreases smooth muscle cells
— Generic isordil lowers the tone of the vascular wall and causes vasodilation.
— Mainly affects the venous vessels
— Decreases venous return to the heart (due to the expansion of peripheral veins).
— Expanding the arterioles reduces peripheral vascular resistance, systolic and mean arterial pressure.
— Medications reduce myocardial oxygen demand.
— Directly dilates coronary arteries
— And improves coronary blood flow
— Promotes redistribution of blood flow in the ischemic area
— The drug reduces the pressure in the pulmonary arteries
— Reduces end-diastolic volume of the left ventricle
— Generic isordil reduced systolic ventricular wall stress.
— The drug improves exercise tolerance in patients with coronary artery disease
— Reduces the frequency and duration of episodes of silent ischemia
— Generic isordil reduces the pressure in the pulmonary circulation.
The drug improves the quality of life in patients with coronary heart disease, reduces the number of angina attacks. The drug reduces the amount of consumption of nitroglycerin and increases exercise tolerance. The medicine helps unloading infarction, reduces the pressure in the portal vein. The drug used in the treatment of portal hypertension in the prevention of bleeding from esophageal varices. Generic isordil inhibits platelet function.
Generic isordil is well absorbed when taken orally. Bioavailability is 100% (for retardirovannyh forms — up to 84%), isordil not metabolized at «first pass» through the liver. The maximum concentration observed in 30-60 minutes. The volume of distribution is 600 liters, the minimum therapeutic blood concentration — 100 ng / ml. There is a direct relationship between the concentration in the blood, AUC and the dose of drug received. Practically does not bind to plasma proteins (less than 4%). The drug is metabolized in the kidneys. It excreted by the kidneys as metabolites (98%). Renal clearance was 1.8 l / min.
Isordil promotes redistribution of blood flow in the direction of areas with reduced lung ventilation (poorly ventilated alveolar region), so that there may be a transient reduction of oxygen in arterial blood (hypoxemia).
Indications for use:
- Coronary artery disease(long-term care)
- angina and vasospastic(preventing attacks)
- chronic heart failure (combination therapy)
- Pulmonary hypertension.
Hypersensitivity, acute myocardial infarction with reduced left ventricular filling pressure, acute left ventricular failure, cardiogenic shock, circulatory collapse, severe hypotension (Sad less than 90 mm Hg), hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, intracranial hemorrhage, traumatic — hypertension, severe anemia, glaucoma, pregnancy (I term), and breast-feeding.
Restrictions apply to:
Acute myocardial infarction, unstable angina, acute coronary syndrome, children’s age (safety and efficacy in children has not been studied).
From the nervous system and sensory organs: Frequently «nitrate» headache, weakness, agitation.
Cardio-vascular system and blood (blood, hemostasis): Common: transient reddening skin; hypotension, including orthostatic (accompanied by reflex tachycardia, confusion, dizziness, paleness, etc.); Sometimes: in severe hypotension may increase symptoms of angina (paradoxical effect of nitrates) and / or severe paradoxical bradycardia, collapse, syncope; methemoglobinemia (long-term treatment). You should inform your doctor about these symptoms.
From the digestive tract: Common: dry mouth, nausea, vomiting.
Allergic reactions: Common: burning and itching, exfoliative dermatitis.
Other: Sometimes patients complain of: sweating, transient hypoxemia, increased levels of catecholamines and vanillin-succinic acid in the urine.
Overdose Generic isordil:
Symptoms: orthostatic hypotension, sensation of squeezing the head, throbbing headache, severe sweating, cold skin, covered with sticky sweat, or erythematous, palpitations, bradycardia, conduction disturbances (blockade), shortness of breath, Kussmaul breathing, bloody diarrhea, vomiting, dizziness, confusion, syncope, coma, fever, paralysis, visual disturbances.
You should see a doctor as soon as possible.
Treatment: gastric lavage, administration of infusion solutions, monitoring the level of methemoglobin in the blood, a physician may prescribe ascorbic acid at a dose of 1 g orally (by increasing hemoglobin). Used oxygen therapy, hemodialysis, exchange transfusion.
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