Isotab

Isosorbide 20mg tablets contain the active ingredient Isosorbide, a nitrate vasodilator that relaxes smooth muscle cells in blood vessels. It works by inhibiting phosphodiesterase type 3 (PDE3), increasing intracellular cyclic adenosine monophosphate (cAMP) levels, which activates protein kinase A (PKA). This leads to vasodilation, reduced vascular resistance, and improved blood flow—essential for managing angina pectoris and other conditions requiring enhanced circulation.

Key Benefits:

• Prevents and relieves angina (heart pain) episodes
• Improves exercise tolerance in heart failure patients
• Reduces post-heart attack mortality risk
• Lowers blood pressure in hypertension
• Alternative for patients intolerant to other angina therapies
• Long-term vascular health maintenance through vasodilation

How to Use

• Administration: Swallow the tablet whole with a full glass of water.
• Timing: Take as directed, typically 2-3 times daily at consistent intervals; follow your healthcare provider’s schedule.
• With/Without Food: Can be taken with or without food, but avoid high-fat meals which may affect absorption.
• Consistency: Maintain regular dosing for optimal therapeutic effects.
• Do Not: Crush, chew, or break the tablet.

Expert Tips from CureCart Direct:

• Rise slowly from sitting or lying positions to prevent dizziness.
• Monitor blood pressure regularly, especially if hypotensive.
• Avoid alcohol and grapefruit juice to minimize side effects.
• Stay hydrated and limit caffeine/sodium intake.
• Report persistent headaches or vision changes immediately.
• Do not abruptly stop; consult your doctor for tapering if needed.

Missed Dose: Take as soon as remembered unless near next dose—skip and resume schedule. Do not double dose. Contact provider if multiple doses missed.

Overdose: Seek emergency help for severe headache, dizziness, blurred vision, or irregular heartbeat. Treatment includes monitoring and supportive care.

Primary Uses

• Prevention and treatment of angina pectoris.
• Enhancing exercise capacity in heart failure.
• Reducing mortality risk post-myocardial infarction.
• Hypertension management.
• Chest pain relief in nitrate-intolerant patients.
• Long-term vasodilatory therapy for heart health.

Indications

Indicated for angina prevention/treatment, heart failure symptom relief, post-heart attack risk reduction, and hypertension control where vasodilation improves cardiac workload and blood flow.

Side Effects

Common:

• Headache (often initial; may lessen over time)
• Dizziness or lightheadedness
• Flushing (skin warmth/redness)
• Nausea, vomiting, stomach discomfort

Less Common:

• Fatigue or weakness
• Blurred vision
• Increased heart rate

Serious/Rare:

• Severe hypotension
• Irregular heartbeat
• Persistent severe headache

Headaches may require medical advice if severe; tolerance often develops with continued use.

Warnings and Precautions

• Pregnancy/Lactation: Consult physician; use only if benefits outweigh risks.
• Driving: May cause dizziness—avoid until effects known.
• Blood Pressure: Monitor closely; risk of significant drops, especially in hypotensive patients.
• Heart Conditions: Caution in arrhythmias; may exacerbate.
• Orthostatic Hypotension: Rise slowly to prevent falls.
• Alcohol: Avoid; potentiates side effects.
• Liver/Kidney Disease: Dose adjustments may be needed; inform doctor.
• Elderly/Children: Lower doses for elderly; not recommended for children.
• Headaches: Seek advice if severe/persistent.

Contraindications

Do not use in:

• Known allergy to Isosorbide or nitrates.
• Severe hypotension.
• Head trauma or increased intracranial pressure.
• Acute myocardial infarction.
• Cardiac tamponade or constrictive pericarditis.
• Aortic stenosis or hypertrophic obstructive cardiomyopathy.
• Severe anemia.
• Recent stroke.

Drug Interactions

• Alcohol: Increases dizziness and hypotension.
• Antihypertensives (e.g., beta-blockers, ACE inhibitors): Additive blood pressure effects; monitor closely.
• Liver-Metabolized Drugs (e.g., erythromycin, antifungals): May alter Isosorbide metabolism.
• Nitrates/PDE5 Inhibitors (e.g., sildenafil): Severe vasodilation and hypotension risk—contraindicated.
• Tricyclic Antidepressants/Sympathomimetics: May counteract effects.
• NSAIDs: Reduce hypotensive efficacy.
• Antacids: Decrease absorption.

Inform your doctor of all medications.

Food Interactions

• Avoid grapefruit/juice: Increases drug levels.
• Limit alcohol: Enhances hypotension.
• Reduce sodium: Counteracts blood pressure lowering.
• Monitor potassium-rich foods (bananas, oranges): Potential elevation.
• Limit caffeine: Possible interaction.
• Take with low-fat meals: High-fat may impair absorption.
• Avoid St. John’s Wort: Reduces effectiveness.
• Stay hydrated: Supports action.

Storage/Disposal

Store in a cool, dry place at room temperature, protected from light and moisture. Keep in original tightly sealed container. Avoid extreme heat (e.g., near stoves/vehicles). Check expiration dates. Do not flush; consult pharmacist for safe disposal. Keep away from children.

Doctor Review

Dr. Ahmed Khan, MBBS, FCPS – Consultant Cardiologist “Isosorbide 20mg tablets function as nitrate vasodilators primarily through PDE3 inhibition, which elevates cAMP levels and promotes vascular smooth muscle relaxation. This mechanism effectively reduces preload and afterload, making it relevant for angina management where coronary vasodilation decreases myocardial oxygen demand. Clinical observations show initial headaches are common due to systemic vasodilation, with many patients developing tolerance over 1-2 weeks. The drug’s profile includes risks of hypotension, particularly in combination with antihypertensives or PDE5 inhibitors, which can lead to severe interactions. Monitoring is essential in elderly patients or those with comorbidities.”

FAQs

How does Isosorbide work? Inhibits PDE3 to boost cAMP, relaxing vessels via PKA activation for better blood flow.

Why headaches? Common from vasodilation; often improves with time or dose adjustment.

Safe with blood pressure meds? Additive effects; requires monitoring and possible adjustments.

Can I drink alcohol? No; increases dizziness and low blood pressure risk.

Missed doses? Take promptly but skip if near next; contact doctor for multiples.

Overdose symptoms? Severe headache, rapid heartbeat, vision issues—seek emergency care.

Related Tests: Blood pressure, ECG, liver/kidney function.

Quick Tips:

• Consistent dosing schedule.
• Whole tablet with water.
• No sharing; doctor history disclosure.
• Cool, dry storage.

Disclaimer: This information is for educational purposes only and not a substitute for professional medical advice. Always consult a qualified physician before use. CureCart Direct ensures accurate details but cannot cover all interactions or precautions. Prices and availability subject to change.