Isosorbide Dinitrate
Isosorbide Dinitrate is a nitrate medication used primarily to prevent and treat chest pain (angina) caused by heart disease. It works by relaxing and widening blood vessels, which improves blood flow to the heart and reduces its workload. This medication is typically used in patients with coronary artery disease or certain types of heart failure.
Isosorbide Dinitrate is a nitrate vasodilator used to prevent and treat angina (chest pain) by improving blood flow to the heart.
Key facts at a glance
- ATC
- C01DA08
- RxNorm
- 6058
- Generic
- Isosorbide Dinitrate
- Class
- atc-c01
- Brands
- Isordil, Bidil, Isochron, IsoDitrate
- Availability
- rx
- Pregnancy
- C
- Lactation
- caution
- Routes
- oral, sublingual
- Forms
- tablet, solution, spray, capsule
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
first trimesteravoid if possible
use only if benefits outweigh potential risks to fetus
regular prenatal monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid near delivery
discontinue 24-48 hours before delivery if possible to prevent hypotension in newborn
fetal monitoring, monitor newborn for hypotension
Use with caution and monitor for adverse effects.
lactation
nursing mothersuse lowest effective dose
monitor infant for hypotension and feeding problems; consider alternative feeding method if symptoms occur
monitor infant blood pressure and feeding patterns
Use with caution and monitor for adverse effects.
geriatric
elderly over 65start with lower dose
initiate therapy at low end of dosing range; monitor for excessive hypotension and dizziness
regular blood pressure monitoring, assess for falls
Use with caution and monitor for adverse effects.
pediatric_age
children under 12not recommended
safety and efficacy not established in pediatric population
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
severe renal impairmentdose reduction may be required
use with caution in severe renal impairment; monitor for nitrate accumulation
monitor blood pressure and renal function
Use with caution and monitor for adverse effects.
hepatic_impairment
severe hepatic impairmentdose reduction may be required
use with caution in severe hepatic impairment; may have prolonged effect
monitor blood pressure and liver function tests
Use with caution and monitor for adverse effects.
Statistics and clinical data
Drug class
Cardiovascular drug classification
FDA approved
Original FDA approval year
Primary indication
Therapeutic indication for ischemic chest pain
Mechanism of action
Vasodilatory mechanism through nitric oxide donation
Prevention and treatment of angina pectoris (chest pain) associated with coronary artery disease. May also be used as part of combination therapy for heart failure in some patients.
Isosorbide Dinitrate is converted to nitric oxide (NO) in the body, which activates guanylate cyclase, increasing cyclic GMP in vascular smooth muscle cells. This causes relaxation of vascular smooth muscle, leading to dilation of veins (reducing preload) and, at higher doses, arteries (reducing afterload), thereby decreasing myocardial oxygen demand and improving oxygen supply to the heart.
Tolerance to nitrate effects may develop with continuous use; a nitrate-free interval of at least 12-14 hours daily is recommended. Contraindicated with phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil) due to risk of severe hypotension. Common side effects include headache, flushing, and dizziness. May cause orthostatic hypotension; patients should rise slowly from sitting or lying positions.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy