預防心絞痛 Angina pectoris, prevention
Treatment (immediate-release only) and prevention of angina pectoris caused by coronary artery disease

Vasodilator
The major active metabolite of isosorbide dinitrate, is an organic nitrate used to prevent angina. It exerts its effect by relaxing vascular smooth muscles resulting in dilatation of peripheral arteries and veins.

Absorption:
1. Tmax: 30-60 minutes
2. Bioavailability: Nearly 100%
3. Effect of food: No significant effect.
Distribution:
1. Vd: Approximately 0.6-0.7 L/k
2. Protein binding: Approximately 5%.
Metabolism:
Hepatic; denitration, glucuronidation, hydration
Excretion:
1. Fecal: About 1%; Renal: 93-96%, 2% unchanged
2. Dialyzable: Yes (hemodialysis); No (peritoneal dialysis)
Elimination Half Life: 5 hours

Concomitant use of phosphodiesterase inhibitors, concomitant riociguat use

B (FDA), B2 (AUS)

Infant risk cannot be ruled out

>10%:
CNS: Headache (13-35%)
1% to 10%:
CV: Angina pectoris, flushing
CNS: Dizziness, fatigue, pain, emotional lability
Dermatologic: Pruritus,skin rash
GI: Nausea, abdominal pain, diarrhea
Hypersensitivity: Hypersensitivity reaction
Respiratory: Upper respiratory infection, increased cough

1. Initial 20 mg ORALLY every morning, then 20 mg 7 hours later
2. May initiate at 5 mg in patients with small stature then increase to at least 10 mg by day 2 or 3

Safety and efficacy not established

Adjustment not necessary.

Do not store above 25 °C