Dilator
Generic Name
Isosorbide Dinitrate
Manufacturer
Beacon Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dilator 10 mg tablet | ৳ 3.00 | ৳ 30.00 |
Description
Overview of the medicine
Dilator 10 mg Tablet contains Isosorbide Dinitrate, an organic nitrate used to prevent and treat angina pectoris and for the management of chronic heart failure. It works by relaxing blood vessels.
Uses & Indications
Dosage
Adults
Oral: 5-30 mg, 2-3 times daily, with a nitrate-free interval (typically 14 hours) to prevent tolerance. Doses up to 120 mg/day may be used.
Elderly
No specific dosage adjustment required, but start with lower doses and titrate carefully due to increased sensitivity.
Renal_impairment
No specific dosage adjustment required; use with caution in severe impairment.
How to Take
Tablets should be swallowed whole with water, with or without food. To prevent tolerance, maintain a daily nitrate-free interval.
Mechanism of Action
Isosorbide Dinitrate is metabolized to nitric oxide, which activates guanylate cyclase, increasing cyclic GMP (cGMP). cGMP causes relaxation of vascular smooth muscle, leading to vasodilation, particularly of veins, reducing preload and myocardial oxygen demand.
Pharmacokinetics
Onset
Oral tablet: 20-60 minutes; Sublingual: 2-5 minutes
Excretion
Excreted primarily via the kidneys as metabolites.
Half life
Parent drug: approximately 1 hour; active metabolites (isosorbide-2-mononitrate and isosorbide-5-mononitrate): 2 and 5 hours respectively.
Absorption
Rapidly and completely absorbed orally. Subject to significant first-pass metabolism.
Metabolism
Extensively metabolized in the liver to active metabolites, isosorbide-2-mononitrate and isosorbide-5-mononitrate.
Side Effects
Contraindications
- Hypersensitivity to isosorbide dinitrate or other nitrates
- Severe hypotension or cardiogenic shock
- Concurrent use with phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil)
- Severe anemia
- Constrictive pericarditis, cardiac tamponade
- Increased intracranial pressure
Drug Interactions
Alcohol
May enhance hypotensive effects.
PDE5 Inhibitors (sildenafil, tadalafil)
Potentiation of hypotensive effects, leading to severe hypotension, syncope, or myocardial infarction. Concomitant use is absolutely contraindicated.
Other vasodilators, calcium channel blockers, beta-blockers, diuretics, antihypertensives
Additive hypotensive effects.
Storage
Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension, persistent throbbing headache, dizziness, palpitation, visual disturbances, flushing, sweating, nausea, vomiting, syncope. Management involves symptomatic and supportive care, maintaining blood pressure and correcting methemoglobinemia if present.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Excretion into breast milk is unknown; use with caution in nursing mothers. Consult a doctor.
Side Effects
Contraindications
- Hypersensitivity to isosorbide dinitrate or other nitrates
- Severe hypotension or cardiogenic shock
- Concurrent use with phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil)
- Severe anemia
- Constrictive pericarditis, cardiac tamponade
- Increased intracranial pressure
Drug Interactions
Alcohol
May enhance hypotensive effects.
PDE5 Inhibitors (sildenafil, tadalafil)
Potentiation of hypotensive effects, leading to severe hypotension, syncope, or myocardial infarction. Concomitant use is absolutely contraindicated.
Other vasodilators, calcium channel blockers, beta-blockers, diuretics, antihypertensives
Additive hypotensive effects.
Storage
Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension, persistent throbbing headache, dizziness, palpitation, visual disturbances, flushing, sweating, nausea, vomiting, syncope. Management involves symptomatic and supportive care, maintaining blood pressure and correcting methemoglobinemia if present.
Pregnancy & Lactation
Use during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Excretion into breast milk is unknown; use with caution in nursing mothers. Consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date
Availability
Available in pharmacies, hospitals, and clinics
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensively studied in numerous clinical trials demonstrating efficacy in angina and heart failure. Further trials may explore new indications or formulations.
Lab Monitoring
- Blood pressure monitoring, heart rate monitoring. No specific routine lab tests required.
Doctor Notes
- Advise patients about the importance of nitrate-free intervals to prevent tolerance.
- Educate on the absolute contraindication with PDE5 inhibitors.
- Monitor for orthostatic hypotension, especially in elderly patients and those on other hypotensive agents.
Patient Guidelines
- Take exactly as prescribed.
- Do not stop taking abruptly without consulting your doctor.
- Avoid sudden changes in posture to prevent dizziness.
- Report any severe headaches or dizziness to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or after dose adjustments. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Adopt a heart-healthy diet low in saturated fats and sodium.
- Engage in regular physical activity as advised by your doctor.
- Quit smoking.
- Limit alcohol intake.
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