Components:
Method of action:
Treatment option:
Medically reviewed by Kovalenko Svetlana Olegovna, PharmD. Last updated on 14.03.2022
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Dinit
Isosorbide Dinitrate
Tablets 20 mg: round tablets of white color, on one side flat, with a chamfer and a risk and engraving: above the risk — "IR", under the risk — "20", on the other side — convex, with the engraving "SCHWARZ PHARMA".
Tablets 40 mg: round tablets of white color, on one side flat, with a chamfer and a risk and engraving: above the risk — "IR", under the risk — "40", on the other side — convex, with the engraving "SCHWARZ PHARMA".
Tablets 60 mg: round tablets of white color, on one side flat, with a chamfer and a risk and engraving: above the risk — "IR", under the risk — "60", on the other side — convex, with the engraving "SCHWARZ PHARMA".
Angina pectoris, heart failure.
relief of angina attacks,
prevention of angina attacks (incl. before physical or emotional stress),
acute myocardial infarction,
acute left ventricular failure.
relief of angina attacks,
prevention of angina attacks (incl. before physical or emotional stress),
acute myocardial infarction,
acute left ventricular failure.
long-term treatment of coronary heart disease: prevention of angina attacks,
secondary prevention of myocardial infarction and treatment of persistent angina (as part of combination therapy),
chronic heart failure (as part of combination therapy with cardiac glycosides, ACE inhibitors and/or diuretics).
Angina pectoris (relief and prevention of seizures), acute myocardial infarction and acute left ventricular failure, as an emergency means (in the prehospital stage), spasm of the coronary arteries (prevention and treatment when using a cardiac catheter), transdermal intravascular coronary angioplasty.
Angina pectoris (prevention of seizures), postinfarction period, chronic heart failure (as part of combination therapy), pulmonary hypertension (some forms).
Angina pectoris (prevention of seizures), coronary circulation disorders, heart failure (vasodilator therapy), postinfarction period.
Angina pectoris, heart failure.
Inside, after eating, without crushing, chewing and drinking plenty of liquid-20 mg 2 times a day (morning and evening) or 40-60 mg 1 time a day (at the same time).
Hypersensitivity, acute myocardial infarction, acute left ventricular failure of the heart, hypotension, collapse, shock, increased intracranial pressure.
Isosorbide Dinitrate 0.05% should be used with caution in patients who are predisposed to closed angle glaucoma, and in patients suffering from hypothyroidism, malnutrition, severe liver or renal disease or hypothermia.
None stated.
Headache, anxiety, fever, facial hyperemia, tachy - or bradycardia, hypotension, orthostatic disorders, nausea, vomiting, cyanosis, respiratory disorders, ataxia. A few days after the start of treatment, side effects usually do not manifest themselves.
Sign: marked decrease in blood pressure, collapse, fainting, headache, dizziness, feeling of heartbeat, visual disturbances, skin hyperemia, perspiration, nausea, vomiting, diarrhea, methemoglobinemia (cyanosis, anoxia), hyperpnea, dyspnea, bradycardia, cerebral hypertension, paralysis, coma.
Treatment: gastric lavage, with methemoglobinemia-in / in a 1% solution of methylene blue, 1-2 mg / kg. symptomatic therapy (epinephrine and its related compounds are ineffective).
Cyanosis, anxiety, methemoglobinemia, possible fatal outcome due to circulatory and respiratory failure.
Treatment: symptomatic.
Isosorbide dinitrate causes relaxation of the smooth muscle wall of the vessels, thereby inducing vasodilation. Isosorbide dinitrate acts as a peripheral vasodilator, affecting both arteries and veins. These effects contribute to the deposition of venous blood and the reduction of venous return to the heart, thereby reducing the final DBP and left ventricular volume (reducing preload).
Dinit® prolonged action is characterized by the combination of the rapid onset of the effect with the duration of action.
The benefits of the drug are determined by the fact that the active substance contained in the Dinit tablet® prolonged action, quickly enters the bloodstream. As a result, the drug provides a rapid onset of effect in the treatment of angina pectoris and retains its protective effect for a long time.
Reduces the oxygen requirement of the heart (decrease in pre - and post-load), improves blood supply to the subendocardial layer, reduces the filling pressure of the left ventricle, causes the opening of coronary collaterals, increases coronary blood flow (dilates coronary arteries and eliminates vascular spasms). It has a relaxing effect on the smooth muscles of internal organs (bronchi, gastrointestinal tract, urinary tract).
Reduces the final diastolic volume of the left ventricle and reduces the systolic voltage of its walls, reduces the pre - and postload on the heart, OPSS, the need for myocardial oxygen. Causes coronarodilation, reduces pressure in the small circle of blood circulation, increases tolerance to physical exercise.
When taken orally, isosorbide dinitrate is rapidly absorbed. Bioavailability at ingestion-22% (effect of the "first pass" through the liver). The beginning of the action-after 15-30 minutes, Cmax substances in the blood plasma are reached by 15 min-1 - 2 H.as a result of the passage through the liver, isosorbide dinitrate is metabolized to form isosorbide-2-mononitrate and isosorbide-5-mononitrate, which have the same effect.1/2 1.5 - 2 and 4-6 h respectively. Both metabolites are pharmacologically active. It is excreted by the kidneys (almost entirely in the form of metabolites). Binding to plasma proteins-30%.
Quickly absorbed by the mouth, Cmax approximately 30% of the circulating isosorbide dinitrate binds to plasma proteins. Metabolized in the liver to 2 active metabolites (5-isosorbide mononitrate and 2-isosorbide mononitrate), T1/2 - about 60 minutes.
Quickly and completely absorbed when ingested. After absorption, the gastrointestinal tract undergoes intensive metabolism due to the effect of the "first pass". The active metabolite of isosorbide dinitrate is isosorbide-5-mononitrate. Microgranules provide a prolonged release of the active substance, which leads to a uniform concentration of the drug in the plasma.
Rapidly absorbed after oral administration, it is converted to active metabolites (isosorbide-2-mononitrate and isosorbide-5-mononitrate), having a longer half-life, which ensures the prolongation of the effect.
There are no preclinical data of relevance to the prescriber which are additional to that already included in other sections of the Summary of Product Characteristics.
Sodium Chloride
Water for Injections
It is possible to increase the hypotensive effect of the drug Isacardin® spray when concomitant with other сосудорасширяющими means (peripheral antihypertensive), hypotensive means (beta-blockers, diuretics, slow calcium channel blockers, ACE inhibitors), antipsychotic means (neuroleptics) and tricyclic antidepressants, in combination with ethanol andттанолсодержащими funds, as well as only when applying PDE-5 inhibitors (including sildenafil, vardenafil, tadalafil, уденафила).
With the simultaneous use of procainamide, quinidine can also increase the hypotensive effect.
With the simultaneous use of sapropterin and isosorbide dinitrate, there is an increased risk of arterial hypotension (since sapropterin, being a coenzyme of nitric oxide synthetase, potentiates the synthesis of an additional amount of nitric oxide).
When combined with amiodarone, propranolol, BCC (including verapamil, nifedipine, etc.), it is possible to enhance the antianginal effect.
Under the influence of sympathomimetics, alpha-blockers (dihydroergotamine, etc.), a decrease in the severity of the antianginal effect is possible (excessive decrease in blood pressure and, accordingly, coronary perfusion).
With the simultaneous use of m-holinoblokatorami (atropine, etc.) increases the likelihood of increased IOP.
Nitrate compounds can reduce the therapeutic effect of norepinephrine (norepinephrine).
Barbiturates accelerate metabolism and reduce the concentration of nitrate compounds in the blood plasma.
With the simultaneous use of a soluble stimulant guanylate cyclase riociguatom-risk of arterial hypotension.
It is possible to increase the hypotensive effect of the drug Dinit® spray when concomitant with other сосудорасширяющими means (peripheral antihypertensive), hypotensive means (beta-blockers, diuretics, slow calcium channel blockers, ACE inhibitors), antipsychotic means (neuroleptics) and tricyclic antidepressants, in combination with ethanol andттанолсодержащими funds, as well as only when applying PDE-5 inhibitors (including sildenafil, vardenafil, tadalafil, уденафила).
With the simultaneous use of procainamide, quinidine can also increase the hypotensive effect.
With the simultaneous use of sapropterin and isosorbide dinitrate, there is an increased risk of arterial hypotension (since sapropterin, being a coenzyme of nitric oxide synthetase, potentiates the synthesis of an additional amount of nitric oxide).
When combined with amiodarone, propranolol, BCC (including verapamil, nifedipine, etc.), it is possible to enhance the antianginal effect.
Under the influence of sympathomimetics, alpha-blockers (dihydroergotamine, etc.), a decrease in the severity of the antianginal effect is possible (excessive decrease in blood pressure and, accordingly, coronary perfusion).
With the simultaneous use of m-holinoblokatorami (atropine, etc.) increases the likelihood of increased IOP.
Nitrate compounds can reduce the therapeutic effect of norepinephrine (norepinephrine).
Barbiturates accelerate metabolism and reduce the concentration of nitrate compounds in the blood plasma.
With the simultaneous use of a soluble stimulant guanylate cyclase riociguatom-risk of arterial hypotension.
Perhaps an increase in the hypotensive effect of Dinit® prolonged action with simultaneous use with other vasodilators (vasodilators), antihypertensive drugs, beta-blockers, "slow" calcium channel blockers, phosphodiesterase type 5 inhibitors, used for the treatment of erectile dysfunction, tricyclic neuroleptics and antidepressants, novocainamide, quinidine and ethanol.
Simultaneous application of Dinit® prolonged action with dihydroergotamine can lead to an increase in the concentration of dihydroergotamine in the blood and thereby enhance its hypotensive effect. With the simultaneous use of sympathomimetic agents, it is possible to reduce the antianginal effect of the drug Dinit® prolonged action.
Enhances the effect of antihypertensive agents. The probability of deep hypotension significantly increases ethyl alcohol.
Hypotension is enhanced by calcium antagonists, tricyclic antidepressants, ethanol-containing drugs, antihypertensive drugs.
Enhances the effects of phenothiazines, alcohol, antihypertensive drugs, reduces myotic drugs.
Unopened: 24 months.
After first opening: once opened, the product should be used immediately and any unused drug discarded.
When room temperature. Away from heat sources.
Keep out of reach of children.
Shelf life of the drug Aerosonit3 года.Do not use after the expiry date which is stated on the packaging.
1 dose of oral aerosol contains isosorbide dinitrate 1.25 mg, in a box of 12 ml — 300 doses, in a box of 1 cartridge.
The injection is for single dose use only.
The injection should not be used if particles are present.
Isosorbide Dinitrate 0.05% may be administered undiluted. Once opened, the product should be used immediately and any unused drug discarded.
Isosorbide Dinitrate 0.05%is compatible with commonly employed infusion fluids. It is compatible with glass infusion bottles and infusion packs made from polyethylene. A syringe pump with a glass or plastic syringe may also be used for infusion.
Isosorbide Dinitrate solutions diluted with Sodium Chloride Injection BP or Glucose Injection BP have been shown to be chemically and physically stable for 72 hours at 25°C, when stored in polypropylene or glass containers, protected from light.
From a microbiological point of view, the diluted product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2 to 8°C, unless dilution has taken place in controlled and validated aseptic conditions.
Torbay and South Devon NHS Foundation Trust,
Torbay Pharmaceuticals,
Wilkins Drive,
Paignton,
Devon, TQ4 7FG
PL 13079/0002
16 December 1999
05/2017
- Nitrates and nitrates
However, we will provide data for each active ingredient