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Isosorbide dinitrate is mainly used for the long-term treatment of coronary heart disease and the prevention of vasospasmodic and mixed angina, and is also suitable for the treatment of myocardial infarction and the long-term treatment of chronic heart failure.
The basic pharmacological effect of isosorbide dinitrate is to directly relax smooth muscle, especially vascular smooth muscle, expand peripheral arteries and veins, reduce the amount of blood returning to the heart, reduce the pre- and post-cardiac load, reduce myocardial oxygen consumption, and have the effect of expanding coronary arteries, which can improve local coronary blood flow and myocardial blood supply in ischemic areas to achieve the purpose of anti-angina.
| Items | Specifications | Results |
| Appearance | White crystalline powder (Undiluted) | Conforms |
| Impurity A | ≤0.5% | 0.09% |
| Impurity B | ≤0.5% | 0.13% |
| Impurity C | ≤0.5% | 0.21% |
| Assay | 36%~44% | 41.2% |
| 95%~105%, stated on the label | 99.97% |
| Product parameters | |
| Cas number: | 87-33-2 |
| Appearance: | Isosorbide dinitrate |
| Purity: | 40% (diluted) |
| Package details: | 1kg/foil bag; 25kg/fiber drum |
| Brand: | Fortunachem |
It belongs to the nitrate class of drugs, a group known for relaxing blood vessels.
It works by converting to nitric oxide in the body, which dilates (widens) coronary arteries, improving blood flow to the heart muscle. It also dilates peripheral blood vessels, reducing the heart’s workload (preload and afterload) and oxygen demand.
Prevention of Angina: Long-acting formulations (tablets, capsules, patches) are used to reduce the frequency and severity of angina episodes in patients with coronary artery disease.
Acute Relief of Angina: Sublingual tablets or sprays act quickly (within minutes) to relieve sudden chest pain by rapidly dilating blood vessels.
Heart Failure Management: Sometimes used as an adjunct therapy in severe heart failure to improve blood flow and reduce symptoms like shortness of breath.
Contraindications: Not for use in patients with hypersensitivity to nitrates, severe anemia, hypotension (low blood pressure), or those taking phosphodiesterase type 5 (PDE5) inhibitors (e.g., sildenafil, tadalafil)—this combination can cause life-threatening low blood pressure.
Common Side Effects: Headache (often temporary, most common with initial use), flushing of the face/neck, dizziness, and lightheadedness. These typically diminish with continued use.
Precautions: Avoid sudden position changes (e.g., standing up quickly) to prevent dizziness from low blood pressure. Use cautiously in patients with kidney or liver impairment, or a history of syncope (fainting).
Tolerance Risk: Prolonged continuous use can lead to nitrate tolerance (reduced effectiveness). To avoid this, healthcare providers may recommend a "nitrate-free interval" (e.g., 10–12 hours daily) with long-acting formulations.
Sublingual Tablets/Sprays: Fast-acting (1–3 minutes onset), used for acute angina relief.
Oral Tablets/Capsules (Immediate/Extended-Release): For long-term angina prevention, dosed 2–4 times daily (immediate-release) or once daily (extended-release).
Transdermal Patches: Applied once daily, provide continuous nitrate delivery for angina prevention.
It is available by prescription only, requiring medical supervision to adjust dosage and monitor for side effects.
Patients should carry sublingual formulations at all times for emergency angina relief.
If chest pain persists despite use, or is accompanied by sweating, shortness of breath, or radiation to the jaw/arm, seek emergency medical care (may indicate a heart attack).
Used as an antianginal.
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