Cochin Cardiac Club

Health Blog by Dr.Uday Nair

SORBITRATE/NITRATES


What is Sorbitrate (isosorbide dinitrate)?


Isosorbide dinitrate is in a group of drugs called nitrates. Isosorbide dinitrate dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.Isosorbide dinitrate is used to treat or prevent attacks of chest pain(angina)

Why is Sorbitrate prescribed?
 
Angina pectoris occurs when the arteries and veins become constricted and sufficient oxygen does not reach the heart. Sorbitrate dilates the blood vessels by relaxing the muscles in their walls. Oxygen flow improves as the vessels relax, and chest pain subsides. In swallowed capsules or tablets, Sorbitrate helps to increase the amount of exercise you can do before chest pain begins. In chewable or sublingual tablets, Sorbitrate can help relieve chest pain that has already started or prevent pain expected from a strenuous activity such as walking up a hill or climbing stairs. Sorbitrate may cause severe low blood pressure, especially when you stand or sit up quickly. People taking diuretic medication or those who have low blood pressure should use Sorbitrate with caution.






How should I take Sorbitrate (isosorbide dinitrate)?


Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.
If possible, try to rest or stay seated when you use this medication. Isosorbide dinitrate can cause dizziness or fainting.
If you use isosorbide dinitrate to treat an angina attack: Use the medicine at the first sign of chest pain. Place the sublingual tablet under your tongue and allow it to dissolve slowly. Do not chew or swallow it. The chewable tablet should be chewed and then held in the mouth for about 2 minutes before swallowing.
You may use additional tablets every 5 minutes, but not more than 3 tablets in 15 minutes.
Do not crush, chew, break, or open an extended-release tablet or capsule. Swallow the pill whole. It is specially made to release medicine slowly in the body. Breaking or opening the pill would cause too much of the drug to be released at one time. Seek emergency medical attention if your chest pain gets worse or lasts more than 5 minutes, especially if you have trouble breathing or feel weak, dizzy, or nauseated, or lightheaded.
It is important to keep this medicine on hand at all times in case of an angina attack. Get your prescription refilled before you run out of medicine completely.
If you take isosorbide dinitrate on a regular schedule to prevent angina, do not stop taking it suddenly or you could have a severe attack of angina.
Do not change brands of isosorbide dinitrate without the approval of your doctor.
Store isosorbide dinitrate at room temperature, away from moisture, heat, and light. Keep the medicine in its original container.


Recommended Dosage of Sorbitrate

The dosage of Sorbitrate prescribed to each patient will vary. Always follow your physician’s instructions and/or the directions on the prescription drug label.

Missed Dose of Sorbitrate


If your physician has instructed or directed you to take Sorbitrate medication in a regular schedule and you have missed a dose of this medicine, take it as soon as you remember. However, if it is almost time for your next dose, then skip the missed dose and go back to your regular dosing schedule. Do not double the doses unless otherwise directed.

Overdose of Sorbitrate

Any medication taken in excess can have serious consequences. If you suspect an overdose of Sorbitrate, seek medical attention immediately.

What should I discuss with my doctor before taking Sorbitrate (isosorbide dinitrate)?






Do not use isosorbide dinitrate if you are taking sildenafil (Viagra). Serious, life-threatening side effects can occur if you take isosorbide dinitrate while you are using sildenafil.
Isosorbide dinitrate can cause severe headaches, especially when you first start using it. These headaches may gradually become less severe as you continue to use the medication. Do not stop taking isosorbide dinitrate. Ask your doctor before using any headache pain medication. Do not use this medication if you are allergic to isosorbide dinitrate, isosorbide mononitrate (Imdur), or nitroglycerin.



Before taking this isosorbide dinitrate, tell your doctor if you are allergic to any drugs, or if you have:
  • early signs of a heart attack (chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling);
  • congestive heart failure;
  • severe anemia (a lack of red blood cells); or
  • low blood pressure; or
  • kidney disease.
If you have any of these conditions, you may not be able to use isosorbide dinitrate, or you may need a dosage adjustment or special tests during treatment.
FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether isosorbide dinitrate passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.


Use caution engaging in activities that require alertness or in operating machinery if this medication makes you dizzy or drowsy. Alcoholic beverages may increase the risk of fainting or of experiencing dizziness. 

What other drugs will affect Sorbitrate (isosorbide dinitrate)?



Before taking isosorbide dinitrate, tell your doctor if you are using any of the following drugs:
  • blood pressure medication;
  • dihydroergotamine (D.H.E. 45, Migranal) or ergotamine (Ergomar, Cafergot, and others);
  • an erectile dysfunction medication such as tadalafil (Cialis) or vardenafil (Levitra);
  • a beta-blocker such as atenolol (Tenormin), carvedilol (Coreg), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and others; or
  • a calcium channel blocker such as diltiazem (Tiazac, Cardizem), nifedipine (Procardia), nimodipine (Nimotop), verapamil (Calan, Covera, Verelan), and others.
If you are using any of these drugs, you may not be able to use isosorbide dinitrate, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect isosorbide dinitrate. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Sorbitrate (isosorbide dinitrate) side effects





Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

  • fast, slow, pounding, or uneven heart rate;
  • blurred vision or dry mouth; or
  • nausea, vomiting, sweating, pale skin, feeling like you might pass out.
Less serious side effects may be more likely to occur, such as:
  • warmth, redness, or tingly feeling under your skin; or
  • feeling weak or dizzy.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.





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