Isosorbide dinitrate

Isosorbide dinitrate
Isosorbide dinitrate
Systematic (IUPAC) name
Clinical data
AHFS/ monograph
Pregnancy cat. C(US)
Legal status Prescription only
Routes Oral
Pharmacokinetic data
Bioavailability 10–90%, average 25%
Metabolism Hepatic
Half-life 1 hour
Excretion Renal
CAS number 87-33-2
ATC code C01DA08 D03AX08
PubChem CID 6883
DrugBank APRD00455
ChemSpider 6619 YesY
UNII IA7306519N YesY
KEGG D00516 YesY
Synonyms (3R,3aS,6S,6aS)-hexahydrofuro[3,2-b]furan-3,6-diyl dinitrate
Chemical data
Formula C6H8N2O8 
Mol. mass 236.136 g/mol
SMILES eMolecules & PubChem
 YesY(what is this?)  dinitrate (verify)

Isosorbide dinitrate (ISDN) (also known as Dilatrate) is a nitrate used pharmacologically as a vasodilator, e.g. in angina pectoris but also for anal fissure, a condition which is known to involve decreased blood supply leading to poor healing. It is also used as a direct vasodilator to treat congestive heart failure.

Isosorbide dinitrate is sold under the brand names Isordil[1] by Biovail, Cedocard, Sorbitrate and Isotrate. In UK, Argentina and Hong Kong, a trade name of it is Isoket. It is also a component of BiDil.



It is more useful in preventing angina attacks than reversing them once they have commenced. It may be given as a tablet for the treatment of an angina attack.


Long acting nitrates can be more useful as they are generally more effective and stable in the short term.


After long term use for treating chronic conditions, tolerance may develop in a patient reducing its effectiveness. The mechanisms of nitrate tolerance have been thoroughly investigated in the last 30 years and several hypotheses have been proposed. these include:

  1. Impaired biotransformation of ISDN to its active principle NO (or a NO-related species)
  2. Neurohormonal activation, causing sympathetic activation and release of vasoconstrictors such as endothelin and angiotensin II which counteract the vasodilation induced by ISDN
  3. Plasma volume expansion
  4. The oxidative stress hypothesis (proposed by Munzel et al. in 1995).

Recent evidence suggests that the latter hypothesis might represent a unifying hypothesis, and an ISDN-induced inappropriate production of oxygen free radicals might induce a number of abnormalities which include the ones described above. Furthermore, studies have shown that nitrate tolerance is associated with vascular abnormalities which have the potential to worsen patients prognosis (Nakamura et al.): these include endothelial and autonomic dysfunction (Gori et al.). In the short run, ISDN can cause severe headaches, necessitating analgesic (very rarely up to morphine) administration for relief of pain as well as severe hypotension, and, in certain cases, bradycardia. This makes some physicians nervous and should prompt caution when starting nitrate administration.


  1. ^ Products

Wikimedia Foundation. 2010.

Игры ⚽ Нужно сделать НИР?

Look at other dictionaries:

  • isosorbide dinitrate — A coronary vasodilator that acts via the formation of nitric oxide. * * * iso·sor·bide di·ni·trate dī nī .trāt n a coronary vasodilator C6H8N2O8 used esp. in the treatment of angina pectoris see ISORDIL * * * a drug used …   Medical dictionary

  • isosorbide dinitrate — a drug used for the prevention and treatment of angina; it acts by relaxing the smooth muscle of both arteries and veins, thus causing dilatation (see vasodilator). It is administered by mouth (as tablets that are swallowed or dissolve under the… …   The new mediacal dictionary

  • Isosorbide dinitrate/hydralazine — is a fixed dose combination drug treatment specifically indicated for black people with congestive heart failure. It is a combination of hydralazine (an antihypertensive) and isosorbide dinitrate (a vasodilator). It is the first race based… …   Wikipedia

  • isosorbide dinitrate — /uy seuh sawr buyd duy nuy trayt, sohr /, Pharm. a coronary vasodilator, C6H8N2O8, used in the prophylaxis and treatment of angina. [ISO + SORB(ITOL) + IDE; DI 1 + NITRATE] * * * …   Universalium

  • isosorbide dinitrate — /uy seuh sawr buyd duy nuy trayt, sohr /, Pharm. a coronary vasodilator, C6H8N2O8, used in the prophylaxis and treatment of angina. [ISO + SORB(ITOL) + IDE; DI 1 + NITRATE] …   Useful english dictionary

  • Isosorbide mononitrate — Systematic (IUPAC) name 8 nitrooxy 2,6 dioxabicyclo[3.3.0]octan 4 ol Clinical data AHFS/ …   Wikipedia

  • Isosorbide — may refer to either of two medications used to treat angina pectoris: isosorbide dinitrate or isosorbide mononitrate.It may also refer to other isosorbide based medicines used as osmotic diuretics.Lowers portal pressure by vasodilation and… …   Wikipedia

  • dinitrate — see ISOSORBIDE DINITRATE * * * di·ni·trate (di niґtrāt) a compound of a base or a metal with two nitrate groups, as in lead dinitrate, Pb(NO3)2 …   Medical dictionary

  • isosorbide — A compound with diuretic properties prepared by acid dehydration of d glucitol. * * * iso·sor·bide .ī sō sȯr .bīd n 1) a diuretic C6H10O4 2) ISOSORBIDE DINITRATE * * * iso·sor·bide (i″so sorґbīd) [USP] a bicyclic ether derivative of… …   Medical dictionary

  • isosorbide mononitrate — an active metabolite of isosorbide dinitrate, having the same actions and uses; administered orally …   Medical dictionary

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”