Isosorbide dinitrate/mononitrate

Isosorbide is rapidly absorbed and undergoes rapid first-pass metaboHsm by the Hver. The bioavaUabUity of the subHngual and chewable tablets is 59% and 22%, respectively, for the regular tablet. Isosorbide is metabolized to isosorbide-2-mononitrate and isosorbide-5-mononitrate, both of which have pharmacologic activity. The elimination half-Hves of subHngual and po isosorbide dinitrate ate 1 and 4 h, respectively. Those of the 2- and 5-mononitrate metaboHtes are 1.5—3.1 h and 4—5.6 h, respectively. The two metaboHtes prolong the elimination half-life of the dinitrate. Adverse effects with isosorbide are similar to those described for nitroglycerin (99). 

The frequent dosing of isosorbide dinitrate (e.g. 3-4 times daily) is not conducive to patient adherence therefore, a once-daily isosorbide mononitrate is commonly substituted for isosorbide dinitrate to simplify the dosing regimen. A nitrate-free interval is still required when using nitrates for HE... 

Isosorbide dinitrate slow-release capsules Isosorbide mononitrate tablets Isosorbide mononitrate 40 mg 1-2 times daily, with a daily nitrate-free interval of at least 18 hours 20 mg 2 times daily, with doses 7 hours apart 30-120 mg once daily... 

Isosorbide Dinitrate (ISDN) and Isosorbide Mononitrate (ISMN)... 

Isosorbide Dinitrate 42 Isosorbide Mononitrate 42 Isotretinoin 43 Isradpine 43 IsuprS 42 Itraconazole 43... 

Isoprenaline (= Isoproterenol) Isosorbide dinitrate 5-lsosorbide mononitrate Isotretinoin... 

Isosorbide dinitrate Allergic reactions to isosorbide dinitrate or any of its ingredients. Isosorbide mononitrate Hypersensitivity or idiosyncratic reactions to other nitrates or nitrites. 

Pregnancy Category C (nitroglycerin, isosorbide dinitrate, isosorbide mononitrate [ie, ISMO], amyl nitrite) Category B (isosorbide mononitrate ER [ie, Imdut], isosorbide mononitrate [ie, Monoket]). 

Isosorbide Dinitrate (Isordil, Sorbitrate, Dilatrate-SR) Isosorbide Mononitrate (Ismo, Imdur) Minoxidil (Loniten, Rogaine)... 

Angina PO (isosorbide dinitrate) 5-40 mg 4 times a day. Sustained-Release 40 mg q8-12h. PO (isosorbide mononitrate) 5-10 mg twice a day given 7 hr apart. Sustained-Release Initially, 30-60 mg/day in morning as a single dose. May increase dose at 3-day intervals. Maximum 240 mg/day. 

Coronary vasodilators, nitrates isosorbide dinitrate isosorbide-5-mononitrate nitroglycerin... 

Isosorbide is available in two forms, isosorbide dinitrate (ISDN) and isosorbide mononitrate (ISDN). ISDN is rapidly metabolised in the liver to the active mononitrate. ISDN is only available in oral form. An intravenous formulation of ISDN is available, but is only used for the treatment of acute heart failure. 

A high-performance, liquid chromatography (h.p.l.c.) assay (reversed phase, C lg column, methanol - water- acetate buffer) for isosorbide dinitrate along with the two mononitrates in pharmaceutical formulations has been described.45 A similar method can be found in Ref. 44. 

Differential scanning calorimetry can be used to detect isosorbide dinitrate in the presence of various proportions of other isohexide mononitrates in pharmaceutical formulations81 and for testing its hazardous characteristics.82 A complete analytical profile for isosorbide dinitrate, detailing spectroscopic and other physical properties, as well as useful analytical methods, has been reported.83... 

Optimum conditions for the preparation, purification, and crystallization of isosorbide dinitrate have been elaborated.140-163 The bioconversion of isosorbide dinitrate into the mononitrates by various micro-organisms has been investigated.164 164 165 Stable inclusion complexes of isosorbide 5-mononitrate using cyclomaltoheptaose166 166 have been prepared. 

The continuous worldwide application of isosorbide dinitrate and, since the early eighties, of isosorbide 5-mononitrate also, has given rise to a very great number of publications on different aspects of these drugs. It would be beyond the scope of this report to include all of the work on these two important compounds. The present synopsis is therefore restricted to other novel isohexide derivatives and to some new pharmaceutical applications of known compounds. 

Isosorbide Mononitrate This drug is another long-acting nitrate that is similar in structure and function to isosorbide dinitrate. It is typically given orally for prevention of anginal attacks. 

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