Isosorbide dinitrate - Oral

Isosorbide dinitrate is used to prevent and treat angina (chest pain which occurs when the heart does not receive enough blood supply).

This medicine is also used to treat certain types of heart failure (weakness and inability of the heart to pump blood).

Take Isosorbide dinitrate exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.

Try to take it at the same time each day.

The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition and your response to the medication.

Isosorbide dinitrate must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it suddenly as this may worsen your condition.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.

DO NOT double a dose under any circumstances.

If you often forget to take your medicine, let your doctor or pharmacist know.

Alert your doctor if you have the following conditions:

• other heart problems e.g. hypertrophic obstructive cardiomyopathy (abnormally thick heart muscle that results in blockage of blood flow), narrowing of the heart valves
• very low blood pressure
• cardiogenic shock (a serious sudden condition when the heart cannot supply enough oxygen-rich blood to the brain and vital organs of the body)
• conditions that can increase the pressure in the brain e.g. head injury, bleeding in the brain
• severe anaemia (low red blood cell count in the body)
• low blood volume circulating in the body

as Isosorbide dinitrate may not be suitable for you.

Do not take Isosorbide dinitrate with medicines used to treat impotence and a certain medicine used to manage high blood pressure in the blood vessels leading to the lungs. Please see the section “Can I take this with other medicines?” below for more information.

Inform your doctor if you have the following conditions:

• hypothyroidism (underactive thyroid gland)
• low body temperature
• glaucoma (increased pressure in the eye)
• nutrient imbalance due to insufficient or excessive dietary intake
• low level of oxygen in the blood
• severe kidney disease
• severe liver disease

Let your doctor know if you are pregnant or breastfeeding.

Be sure to check with your doctor or pharmacist before giving Isosorbide dinitrate to the elderly. Elderly people may be more sensitive to the side effects.

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.

Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure and heart rate regularly.

Isosorbide dinitrate may cause dizziness and tiredness. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: headache, nausea, vomiting, diarrhoea, flushing, and weakness.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience slow or fast heartbeat, severe dizziness, or passing out.

Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.

Do not take Isosorbide dinitrate with the following medicines:

• medicines used to treat impotence e.g. sildenafil, tadalafil, vardenafil
• riociguat (medicine used to treat high blood pressure in the blood vessels leading to the lungs)

Inform your doctor and pharmacist if you are taking any of these medicines:

• medicines for high blood pressure e.g. atenolol, nifedipine, losartan, captopril
• certain medicines to treat depression e.g. isocarboxazid, amitriptyline
• medicines for mood disorders e.g. chlorpromazine

This list does not include all medicines that may interact with Isosorbide dinitrate.

Always notify your doctor or pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicine, supplements, and medicines that you buy without a prescription.

Avoid alcohol.

Store in a cool, dry place away from the reach of children.

Medicines must not be used past the expiry date.