Those with coronary artery disease can control their angina (chest pain) using isosorbide immediate-release pills (narrowing of the blood vessels that supply blood to the heart). When a person has coronary artery disease, isosorbide extended-release (long-acting) tablets and extended-release capsules are used to treat chest pain. Only angina can be treated with isosorbide; once an episode has started, it cannot be stopped. Isosorbide belongs to the group of drugs known as vasodilators. By allowing the blood arteries to relax, it makes the heart work less hard and so consumes less oxygen.

To be swallowed whole, isosorbide is available as a tablet, an extended-release (long-acting) tablet, and an extended-release capsule. Often, two or three times a day are used to take the tablet. The extended-release tablet is often taken in the morning, once daily. Typically, one daily dose of the extended-release capsule is required.

Do not crush, chew, or divide the extended-release tablets or capsules; instead, swallow them whole. Ask your doctor or chemist to explain any instructions on your prescription label that you are unsure about following. Just as prescribed, use isosorbide. Never take it in larger or less amounts or more frequently than directed by your doctor.

Although it can reduce chest pain, isosorbide does not treat coronary artery disease. Even if you feel good, keep taking isosorbide. Without consulting your doctor, do not stop taking isosorbide.

After using isosorbide for a while or taking multiple doses, it could not work as well. Your doctor will plan your doses so that you are not exposed to isosorbide for a certain amount of time each day. Call your doctor if your chest pain attacks increase in frequency, duration, or severity at any point while you are receiving therapy.

To treat heart failure, isosorbide tablets are frequently taken in combination with other drugs. Discuss the potential dangers of using this medicine for your illness with your doctor.

Ask your doctor or chemist for more details if you’re interested in using this medication for any other conditions.

Before taking isosorbide,

• If you have any allergies, including to isosorbide, nitroglycerin pills, patches, or ointment, other medicines, or any of the substances in isosorbide tablets, extended-release tablets, or extended-release capsules, let your doctor and chemist know right away. Get a list of the ingredients from your chemist.
• Inform your physician if you take or recently took riociguat (Adempas) or a PDE-5 inhibitor, such as avanafil (Stendra), sildenafil (Revatio, Viagra), tadalafil (Adcirca, Cialis), or vardenafil (Levitra, Staxyn). If you are currently on one of these drugs, your doctor probably won’t recommend that you take isosorbide.
• Inform your physician and pharmacist of all prescription and over-the-counter drugs, vitamins, dietary supplements, and herbal products you are currently taking or intend to take. Incorporate any of the following: Beta-blockers like atenolol and aspirin (Tenormin, Tenoretic), metoprolol, betametal (Trandate), and carteolol (Lopressor, Toprol-XL, in Dutoprol, in Lopressor HCT), timolol, sotalol (Betapace, Sorine, Sotylize), and propranolol (Hemangeol, Inderal, Innopran), as well as nadolol (Corgard, in Corzide); calcium channel blockers like diltiazem and amlodipine (Norvasc, Amturnide, and Tekamlo) (Cardizem, Cartia, Dilt-CD, others), nifedipine (Adalat CC, Afeditab, Procardia), verapamil (Calan, Covera, Verelan), felodipine (Plendil), isradipine; ergot-type drugs such cabergoline, dihydroergotamine (D.H.E. 45, Migranal), bromocriptine (Cycloset, Parlodel), and ergoloid mesylates (Hydergine), methysergide (Sansert; no longer available in the U.S.), pergolide (Permax; no longer available in the U.S.), ergotamine (in Cafergot and Migergot), methylergonovine (Methergine), and ergotamine (in Cafergot and Migergot); drugs for heart failure, excessive blood pressure, or irregular pulse. Your physician might need to adjust the dosage of your drugs or keep a close eye on you for side effects.
• Inform your physician if you believe you may be dehydrated, have recently experienced a heart attack, have heart failure, low blood pressure, or hypertrophic cardiomyopathy (thickening of the heart muscles).
• Inform your doctor if you are expecting, intend to get pregnant, or are nursing a baby. Call your doctor if you conceive while taking isosorbide.
• Inform your doctor or dentist that you are taking isosorbide if you are having surgery, including dental surgery.
• See your doctor about whether drinking alcohol is safe while taking isosorbide. The negative effects of isosorbide can be exacerbated by alcohol.
• You should be aware that isosorbide can make you feel queasy, lightheaded, and faint if you stand up too rapidly from a reclining position or at any other time, particularly if you have had alcohol. Get up gradually and leave your feet on the floor for a few minutes before rising up to avoid this issue. Take additional care to prevent falling when receiving isosorbide therapy.
• You should be aware that when using isosorbide, headaches could happen every day. These headaches can be an indication that the medicine is doing what it should be doing. To prevent headaches, do not try to alter how or when you take isosorbide because doing so could make the drug less effective. To treat your headaches, your doctor can advise you to take a painkiller.

Keep eating normally unless your doctor instructs you otherwise.

If you miss a dosage, take it as soon as you recall. If the next dose is soon due, skip the missed one and carry on with your regular dosing plan. To make up for a missing dose, do not take a second one.

There may be adverse effects from isosorbide. If any of these symptoms, or any of the ones detailed in the SPECIAL PRECAUTIONS section, are severe or do not go away, consult your doctor:

• Nausea

Certain adverse effects can be very harmful. Call your doctor right away if you encounter any of these symptoms, or seek emergency care:

• Deteriorating chest ache
• Rash
• Hives
• Itching
• Breathing or swallowing challenges

Other negative effects of isosorbide may occur. If you have any strange side effects while taking this medicine, contact your doctor right once.

You or your doctor can submit a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting programme online or by phone if you have a serious side event (1-800-332-1088).

Keep this medication tightly closed in the original container and out of the reach of children. Keep it away from excessive heat and moisture at room temperature (not in the bathroom).

Although many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Always lock safety caps and promptly stash medication up and away from young children where it is out of their sight and reach to prevent poisoning. http://www.upandaway.org

Unused prescriptions must be disposed of carefully to prevent pets, kids, and other people from ingesting them. You should not, however, dispose of this medication in the toilet. Instead, utilising a medicine take-back programme is the easiest approach to get rid of your medication. To find out about take-back programmes in your area, speak with your chemist or the garbage/recycling agency in your city. If you do not have access to a take-back programme, see the FDA’s Safe Disposal of Medications website at http://goo.gl/c4Rm4p for additional information.

Call the poison control hotline at 1-800-222-1222 in the event of an overdose. Moreover, information can be found online at https://www.poisonhelp.org/help. Call 911 right once if the person has collapsed, experienced a seizure, is having difficulty breathing, or cannot be roused.

Overdose symptoms could include:

• Headache
• Confusion
• Fever
• Dizziness
• Sluggish or rapid heartbeat
• Nausea
• Vomiting
• Bloody stools
• Fainting
• Breathing difficulty
• Sweating
• Flushing
• Clammy, frigid skin
• Loss of body movement ability
• Coma (loss of consciousness for a period of time)
• Seizures