II. General
- Need 10-12 hours Nitroglycerin free interval per day
- Not proven to reduce Incidence of future events
III. Indications
- Chronic Angina Pectoris
- Not indicated for acute Myocardial Ischemia
IV. Preparations: Long acting
- Isosorbide Dinitrate (Isordil)
- Reg: 10 to 40 mg PO tid (7am, 12 noon, 5pm)
- SR: 40-80 mg PO bid (8am, 3pm)
- Isosorbide Mononitrate
- Nitroglycerin sustained release (Nitro-Bid)
V. Preparations: Transdermal
-
Nitroglycerin 2% ointment (15 mg per inch)
- Start: 0.5 inch q8 hours
- Maintenance: 1-2 inches q8 hours
- Maximum: 4-5 inches q4 hours
- Poor absorption, with dosing at 1 inch equivalent to 10 mcg/min IV infusion
- Other preparations are preferred
- Transdermal Nitroglycerin
- Apply 1 patch for 12-14 hours per day
- Doses range from 0.1 to 0.8 mg per hour
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Related Studies
| Isosorbide Mononitrate (on 6/18/2017 at Walmart.com) | ||
| Isosorbide Mononitrate 30mg ER | #30 tablets for $4.00 | $0.13 each |
| Isosorbide Mononitrate 30mg ER | #90 tablets for $10.00 | $0.11 each |
| Isosorbide Mononitrate 60mg ER | #30 tablets for $4.00 | $0.13 each |
| Isosorbide Mononitrate 60mg ER | #90 tablets for $10.00 | $0.11 each |
| isosorbide (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ISOSORBIDE DN 10 MG TABLET | Generic | $0.58 each |
| ISOSORBIDE DN 20 MG TABLET | Generic | $0.64 each |
| ISOSORBIDE DN 30 MG TABLET | Generic | $0.75 each |
| ISOSORBIDE DN 5 MG TABLET | Generic | $0.58 each |
| ISOSORBIDE DN ER 40 MG TABLET | Generic | $1.41 each |
| ISOSORBIDE MN 10 MG TABLET | Generic | $0.17 each |
| ISOSORBIDE MN 20 MG TABLET | Generic | $0.15 each |
| ISOSORBIDE MN ER 120 MG TAB | Generic | $0.42 each |
| ISOSORBIDE MN ER 30 MG TABLET | Generic | $0.16 each |
| ISOSORBIDE MN ER 60 MG TABLET | Generic | $0.20 each |
Ontology: Isosorbide (C0022251)
| Definition (CHV) | a drug used to prevent or treat chest pain (angina). |
| Definition (NCI) | An organic nitrate with vasodilator activity. Isosorbide relaxes vascular smooth muscle by formation of the free radical nitric oxide (NO), which is identical to the endothelium-derived relaxing factor (EDRF). NO activates guanylyl cyclase, thereby increasing the synthesis of cGMP within smooth muscle. Elevated cGMP levels in smooth muscle activate cGMP-dependent kinase activity that leads to release of sequestered Ca2+. In turn, free Ca+ triggers dephosphorylation of light chain myosin and relaxation of peripheral arteries and veins. In addition isosorbide relaxes coronary arteries, thereby increasing the blood circulation through the ischemic area. |
| Definition (MSH) | 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma. |
| Concepts | Pharmacologic Substance (T121) , Carbohydrate (T118) |
| MSH | D007547 |
| SnomedCT | 108478001, 386853004 |
| LNC | LP171613-5 |
| English | Isosorbide, D-Glucitol, 1,4:3,6-dianhydro-, isosorbide, Isosorbide [Chemical/Ingredient], ISOSORBIDE, Isosorbide (product), Isosorbide (substance) |
| Swedish | Isosorbid |
| Czech | isosorbid |
| Finnish | Isosorbidi |
| Russian | IZOSORBID, ИЗОСОРБИД |
| Japanese | イソソルビド |
| Croatian | IZOSORBID |
| Spanish | Isosorbida, isosorbida (producto), isosorbida (sustancia), isosorbida |
| Polish | Izosorbid |
| Portuguese | Isossorbido, Isossorbida |
| French | Isosorbide |
| German | Isosorbid |
| Italian | Isosorbide |
Ontology: Isosorbide Dinitrate (C0022252)
| Definition (NCI) | The dinitrate salt form of isosorbide, an organic nitrate with vasodilator activity. Isosorbide dinitrate relaxes vascular smooth muscle by formation of the free radical nitric oxide (NO), which is identical to the endothelium-derived relaxing factor (EDRF). NO activates guanylyl cyclase, thereby increasing the synthesis of cGMP within smooth muscle, resulting in dephosphorylation of light chain myosin and relaxation of peripheral arteries and veins. In addition, isosorbide dinitrate relaxes coronary arteries, thereby increasing the blood circulation through the ischemic area. (NCI05) |
| Definition (MSH) | A vasodilator used in the treatment of ANGINA PECTORIS. Its actions are similar to NITROGLYCERIN but with a slower onset of action. |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | D007548 |
| SnomedCT | 387332007, 5924003 |
| English | Dinitrate, Isosorbide, ISDN, Isosorbide Dinitrate, D-Glucitol, 1,4:3,6-dianhydro-, dinitrate, isosorbide dinitrate, isosorbide dinitrate (medication), vasodilators coronary isosorbide dinitrate, ISOSORBIDE DINITRATE, Isosorbide Dinitrate [Chemical/Ingredient], isd, isdn, Isosorbide dinitrate, ISD, ISDN - isosorbide dinitrate, sorbide nitrate, Isosorbide dinitrate (product), Isosorbide dinitrate (substance) |
| Swedish | Isosorbiddinitrat |
| Czech | isosorbiddinitrát |
| Finnish | Isosorbididinitraatti |
| French | Dinitrate d'isosorbide, Dinitrate isosorbide |
| Russian | IZOSORBIDA DINITRAT, NITROSORBID, ИЗОСОРБИДА ДИНИТРАТ, НИТРОСОРБИД |
| Japanese | 二硝酸イソソルビド, 硝酸イソソルビド, イソソルビドジニトラート, イソソルビド二硝酸 |
| Croatian | IZOSORBID DINITRAT |
| Polish | Diazotan izosorbidu, Dwuazotan izosorbidu |
| Spanish | dinitrato de isosorbida (producto), dinitrato de isosorbida (sustancia), dinitrato de isosorbida, Dinitrato de Isosorbide |
| German | Isosorbiddinitrat |
| Italian | Dinitrato di isosorbide |
| Portuguese | Dinitrato de Isossorbida |
Ontology: Isosorbide Mononitrate (C0064079)
| Definition (NCI) | The mononitrate salt form of isosorbide, an organic nitrate with vasodilator activity. Isosorbide mononitrate relaxes vascular smooth muscle by formation of the free radical nitric oxide (NO), which is identical to the endothelium-derived relaxing factor (EDRF). NO activates guanylyl cyclase, thereby increasing the synthesis of cGMP within smooth muscle, resulting in dephosphorylation of light chain myosin and relaxation of peripheral arteries and veins. In addition, isosorbide mononitrate relaxes coronary arteries, thereby increasing the blood circulation through the ischemic area. (NCI05) |
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| MSH | C030397 |
| SnomedCT | 108484003, 386854005 |
| English | 5-ISMN, isosorbide-5-mononitrate, isosorbide-5-nitrate, 1,4:3,6-Dianhydro-D-glucitol 5-nitrate, isosorbide mononitrate, monocinque, isosorbide mononitrate (medication), Isosorbide Mononitrate, ISOSORBIDE MONONITRATE, isosorbide-5-mononitrate [Chemical/Ingredient], mononitrate isosorbide, isosorbide 5 mononitrate, ISMN - isosorbide mononitrate, ISMO - isosorbide mononitrate, Isosorbide mononitrate, Isosorbide mononitrate product, Isosorbide mononitrate (product), Isosorbide mononitrate (substance) |
| Spanish | mononitrato de isosorbida (producto), mononitrato de isosorbida (sustancia), mononitrato de isosorbida |
Ontology: Nitroglycerin 0.02 MG/MG Topical Ointment (C0782070)
| Concepts | Clinical Drug (T200) |
| SnomedCT | 319407007 |
| English | Glyceryl trinitrate 2% oint, NITROGLYCERIN 2% TRANSDERMAL OINTMENT(GM), NITROGLYCERIN 2% Transdermal ointment, Nitroglycerin 0.02 MG/MG Topical Ointment, NITROGLYCERIN 2 %WW TOPICAL OINTMENT, NITROGLYCERIN 2% OINTMENT(GM), NITROGLYCERIN @ 2% @ OINTMENT(GM), NITROGLYCERIN 2% TRANSDERM. OINTMENT(GM), NITROGLYCERIN@2%@TRANSDERM.@OINTMENT(GM), Nitroglycerin 2% Topical ointment, NITROGLYCERIN@2 %@TRANSDERM.@OINTMENT(GM), NITROGLYCERIN 2 % TRANSDERM. OINTMENT(GM), NITROGLYCERIN 2% OINT, nitroglycerin 2 % Topical Ointment, Nitroglycerin 2% Topical application Ointment, Nitroglycerin Oint 2%, NITROGLYCERIN 2% OINT,TOP [VA Product], NITROGLYCERIN 2 % TRANSDERM OINTMENT(GM), NITROGLYCERIN 2 % TRANSDERM OINTMENT (GRAM), NITROGLYCERIN@2 %@TRANSDERM@OINTMENT (GRAM), NITROGLYCERIN@2 %@TRANSDERM@OINTMENT(GM), nitroglycerin 2% transdermal ointment, Nitroglycerin, 2% transdermal ointment, nitroglycerin 2% topical ointment, Nitroglycerin, 2% topical ointment, Nitroglycerin 2% Transdermal Ointment, NTG 0.02 MG/MG Topical Ointment, TNG 0.02 MG/MG Topical Ointment, Glyceryl trinitrate 2% ointment, Glyceryl trinitrate 2% ointment (product), Glyceryl trinitrate 2% ointment (substance), NITROGLYCERIN 2% OINT,TOP |
| Spanish | trinitrato de glicerilo, 2%, pomada, trinitrato de glicerilo, 2%, ungüento (producto), trinitrato de glicerilo, 2%, ungüento |
Ontology: Transdermal glyceryl trinitrate (C1445777)
| Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
| SnomedCT | 412446007, 346462009 |
| English | Transdermal GTN, transdermal glyceryl trinitrate, Transdermal nitroglycerin (product), Transdermal glyceryl trinitrate, Transdermal glyceryl trinitrate (product), Transdermal glyceryl trinitrate (substance), Transdermal nitroglycerin |
| Spanish | nitroglicerina transdérmica (producto), trinitrato de glicerilo transdérmico (producto), trinitrato de glicerilo transdérmico, nitroglicerina transdérmica |
