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Isosorbide dinitrate is in the nitrate family of medications and works by dilating blood vessels. [1] Isosorbide dinitrate was first written about in 1939. [3] It is on the World Health Organization's List of Essential Medicines. [4] Isosorbide dinitrate is available as a generic medication. [1] [5] A long-acting form exists. [1]
Nitrates mainly differ in speed and duration of their action. Glyceryl trinitrate acts fast and short (10 to 30 minutes), while most other nitrates have a slower onset of action, but are effective for up to six hours. Molsidomine, as has been mentioned, not only acts slowly but also differs from the nitrates in exhibiting no tolerance. [2]
By nitration of isosorbide with concentrated nitric acid, 2,5-isosorbide dinitrate (ISDN) can be obtained. 2,5-isosorbide dinitrate is suitable (just like its major metabolite 5-isosorbide mononitrate, ISMN [6]) for the treatment of angina pectoris due to its vasodilator effect. [7]
The most common adverse effects are headache, which occurs in 10–25% of patients, and low blood pressure. Side effects occurring in fewer than 1% of patients include dizziness, nausea , reflex tachycardia (fast heartbeat), hypersensitivity reactions, as well as thrombocytopenia (low blood platelet count) in rare cases.
Isosorbide mononitrate, sold under many brand names, is a medication used for heart-related chest pain , heart failure and esophageal spasms. [2] It can be used both to treat and to prevent heart-related chest pain; however, it is generally less preferred than beta blockers or calcium channel blockers . [ 2 ]
In the medical field, nitrate-derived organic esters, such as glyceryl trinitrate, isosorbide dinitrate, and isosorbide mononitrate, are used in the prophylaxis and management of acute coronary syndrome, myocardial infarction, acute pulmonary oedema. [10] This class of drug, to which amyl nitrite also belongs, is known as nitrovasodilators.
[4] [10] [11] In 2006, the Heart Failure Society of America included the use of the fixed dose combination of isosorbide dinitrate/hydralazine as the standard of care in the treatment of heart failure in Black patients. [12]: e44
Nicorandil is an anti-angina medication that has the dual properties of a nitrate and ATP-sensitive K + channel opener. [7] In humans, the nitrate action of nicorandil dilates the large coronary arteries at low plasma concentrations. [7]
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