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Isosorbide is used to prevent or treat chest pain (angina). It works by relaxing the blood vessels to the heart, so the blood and oxygen supply to the heart is increased.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Usage directions

Isosorbide comes as a regular, sublingual, chewable, and extended-release (long-acting) tablet and extended-release (long-acting) capsule to be taken by mouth. The tablet usually is taken every 6 hours. The extended-release tablet usually is taken one or two times a day. The extended-release capsule usually is taken every 8 to 12 hours. Do not crush, chew, or divide the extended-release tablets or capsules. The sublingual or chewable tablet is used as needed to relieve chest pain that has already started or to prevent pain before activities known to provoke attacks (e.g., climbing stairs, sexual activity, heavy exercise, or being outside in cold weather). The chewable tablet also may be used every 2 to 3 hours to prevent chest pain. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take isosorbide exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Isosorbide controls chest pain but does not cure it. Continue to take isosorbide even if you feel well. Do not stop taking isosorbide without talking to your doctor. Stopping the drug abruptly may cause chest pain.

Isosorbide can lose its effectiveness when used for a long time. This effect is called tolerance. If your angina attacks happen more often, last longer, or are more severe, call your doctor.

If you are using isosorbide sublingual or chewable tablets for acute chest pain, you should carry the tablets with you at all times. If you are taking isosorbide and your chest pain is not relieved within 5 to 10 minutes, take another dose. Call for emergency assistance or go to a hospital emergency department if pain persists after you have taken three tablets (at 5 to 10-minute intervals) and 15 to 30 minutes have passed.

When an attack occurs, sit down. If you use chewable tablets, chew a tablet thoroughly and swallow it. To use the sublingual tablets, place a tablet under your tongue or between your cheek and gum and allow it to dissolve. Do not swallow the tablet. Try not to swallow saliva too often until the tablet dissolves.

Other uses

Isosorbide tablets are also used with other drugs to treat congestive heart failure. Talk to your doctor about the possible risks of using this drug for your condition.

Special precautions

Before taking isosorbide,

• tell your doctor and pharmacist if you are allergic to isosorbide; nitroglycerin tablets, patches, or ointment; or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially aspirin; beta blockers such as atenolol (Tenormin), carteolol (Cartrol), labetalol (Trandate, Normodyne), metoprolol (Lopressor), nadolol (Corgard), propranolol (Inderal), sotalol (Betapace), and timolol (Blocadren); calcium channel blockers such as amlodipine (Norvasc), diltiazem (Cardizem), felodipine (Plendil), isradipine (DynaCirc), nifedipine (Procardia), and verapamil (Calan, Isoptin); dihydroergotamine (D.H.E. 45); sildenafil (Viagra); tadalafil (Cialis); vardenafil (Levitra); and vitamins.
• tell your doctor if you have or have ever had low red blood cell counts (anemia), glaucoma, or recent head trauma.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking isosorbide, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking isosorbide.
• you should know that this drug may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how it affects you.
• tell your doctor if you consume large amounts of alcohol regularly and ask about the safe use of alcoholic beverages while you are taking isosorbide. Alcohol can make the side effects from isosorbide worse.

Food limitations and special diet when taking Isosorbide

Take isosorbide tablets on an empty stomach (at least 1 hour before or 2 hours after meals) with a full glass of water.

Missed dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Possible side effects

Side effects from isosorbide are common. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• rash
• dizziness
• upset stomach
• headache
• flushing (feeling of warmth)

If you experience any of the following symptoms, call your doctor immediately:

• blurred vision
• dry mouth
• chest pain
• fainting

Storage and disposal of Isosorbide

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Keep sublingual and chewable tablets in the original container. Do not open a container of sublingual or chewable isosorbide until you need a dose. Do not use tablets that are more than 12 months old. Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Emergency/overdose

In case of overdose, call your local poison control center. If the victim has collapsed or is not breathing, call local emergency services.

Other important information

Keep all appointments with your doctor and the laboratory.

Isosorbide regular and extended-release tablets or capsules should not be used for acute angina attacks. Continue to use isosorbide sublingual or chewable tablets to relieve chest pain that has already started.

If headache continues, ask your doctor if you may take acetaminophen. Your isosorbide dose may need to be adjusted. Do not take aspirin or any other medication for headache while using isosorbide unless you doctor tells you to.

The tablets may cause a sweet, tingling sensation when placed under your tongue. This sensation is not an accurate indicator of drug strength; the absence of a tingling sensation does not mean that the drug is not working.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Disclaimer

We provide only general information about Imdur which does not cover all possible drug integrations, directions or precautions. Information at our website cannot be used for self-treatment and self-diagnosis. Any specific instructions for a particular patient should be agreed with his health care adviser or doctor in charge of the case. We disclaim reliability of this information and mistakes it could contain. We are not responsible for any direct, indirect, special or other indirect damage as a result of any use of the information on this site and also for consequences of self-treatment.

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