Isosorbide dinitrate
Isoket Retard
Granskad av Sid DajaniSenast uppdaterad av Michael Stewart, MRPharmSLast updated 21 Oct 2024
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Isosorbide dinitrate helps to prevent angina pain.
The most common side-effect is headache. This should pass after a few days of taking your medication.
At a glance
Isosorbide dinitrate is a medicine mainly used to prevent angina pain.
It works by relaxing and widening blood vessels, reducing strain on the heart.
Tablets are taken either three to four times daily (standard) or twice daily (modified-release).
Modified-release tablets should be swallowed whole and not chewed or crushed.
Common side-effects include headache, dizziness, and a fast heartbeat.
Do not drink alcohol as it can increase side-effects like dizziness.
Tell your doctor or pharmacist if you are taking other medicines.
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About isosorbide dinitrate
Typ av medicin | A nitrate |
Används för | Angina; heart failure |
Även kallad | Isoket Retard® |
Tillgänglig som | Tablets and longer-acting tablets (called modified-release tablets) |
Isosorbide dinitrate is prescribed mainly to prevent angina pain from developing. Angina pain develops if part of your heart muscle does not get as much blood and oxygen as it needs. It is usually caused by narrowing of your coronary arteries due to a build-up of a fatty substance called atheroma. The narrowing makes it more difficult for blood to flow to your heart muscle.
Isosorbide dinitrate works in two ways. It relaxes blood vessels in your body (causing them to widen) and this reduces the strain on your heart, making it easier for your heart to pump blood around your body. It also relaxes and widens blood vessels in your heart (coronary arteries), which increases the flow of blood to your heart muscle.
Some isosorbide dinitrate tablets can also be used to provide quick relief of angina pain when it happens. They are also sometimes prescribed for people with heart failure (where the heart does not beat as efficiently as it should).
Before taking isosorbide dinitrate
Tillbaka till innehållSome medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start isosorbide dinitrate it is important that your doctor knows:
Om du är gravid eller ammar.
If you have any problems with the way your liver works, or any problems with the way your kidneys work.
Om du har lågt blodtryck.
If you have been told by a doctor you have low levels of iron in your blood (anaemia), or low levels of oxygen in your blood (hypoxaemia).
If you have an underactive thyroid gland.
If you have an eye condition called glaucoma.
If you have recently had a head injury or a heart attack.
Om du någonsin har haft en allergisk reaktion mot en medicin.
If you are taking other medicines, including those available to buy without a prescription, as well as herbal or complementary medicines. It is particularly important that you tell your doctor if you are using any medicines to help treat erektil dysfunktion.
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How to take isosorbide dinitrate
Tillbaka till innehållBefore you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about nitrate medicines, and it will also provide you with a full list of side-effects which you could experience from taking isosorbide dinitrate.
Standard tablets (sometimes called immediate-release tablets) are taken three or four times a day, with the last dose usually being taken no later than 6 pm. Longer-acting tablets (called modified-release or 'Retard' tablets) are taken twice daily, the first dose in the morning and the second dose mid-afternoon. Your doctor will tell you which type of tablets you are being supplied with, and your dose will be printed on the label of the pack to remind you about how to take them. You can take isosorbide dinitrate tablets either before or after meals.
If you are taking modified-release tablets, you should swallow the tablet whole - do not chew, break or crush the tablet before you swallow. This is because the tablet is specially made to release the medicine in a controlled way.
Try to take the tablets at the same times of day each day, as this will help you to remember to take your doses regularly. If you forget to take a dose at your usual time, take it when you remember. However, if it is nearly time to take your next dose when you remember, then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.
Få ut det mesta av din behandling
Tillbaka till innehållModified-release isosorbide dinitrate tablets are not suitable to take to treat chest pain during an angina attack. Your doctor will prescribe you a short-acting nitrate for you to take if this happens. Glyceryl trinitrate (GTN) is commonly prescribed for this.
Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress
The longer you take isosorbide dinitrate, the more your body can become used to it (called tolerance) and then it can have less of an effect. To avoid this, your doses may not be prescribed at equal intervals throughout the day. It is important that you follow the instructions your doctor gives you about when to take your doses.
It is best not to drink alcohol while you are on isosorbide dinitrate. Alcohol will increase the risk of you experiencing side-effects such as feeling dizzy and light-headed.
Om du ska genomgå en operation eller tandbehandling, kom ihåg att informera den som utför behandlingen om vilka mediciner du tar.
If you buy any medicines, please check with a pharmacist that they are suitable for you to take with isosorbide dinitrate.
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Can isosorbide dinitrate cause problems?
Tillbaka till innehållAlong with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with isosorbide dinitrate.
You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
Common isosorbide dinitrate side-effects | Vad kan jag göra om jag upplever detta? |
Huvudvärk | Ask your doctor or pharmacist to recommend a suitable painkiller. This side-effect usually disappears after a few days |
Feeling dizzy or tired | Kör inte och använd inte verktyg eller maskiner när du är påverkad |
Feeling your heart is beating quickly, flushing | Om någon av dessa blir besvärlig, tala med din läkare |
If you experience any other symptoms which you think may be due to the medicine, please speak with your doctor or pharmacist for further advice.
How to store isosorbide dinitrate
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Viktig information om alla läkemedel
Tillbaka till innehållViktig information om alla läkemedel
Ta aldrig mer än den föreskrivna dosen. Om du misstänker att du eller någon annan kan ha tagit en överdos av denna medicin, gå till akutmottagningen på ditt lokala sjukhus. Ta med behållaren, även om den är tom.
Denna medicin är för dig. Ge den aldrig till andra människor även om deras tillstånd verkar vara detsamma som ditt.
Behåll inte föråldrade eller oönskade mediciner. Ta dem till ditt lokala apotek som kommer att ta hand om dem åt dig.
Om du har några frågor om denna medicin, fråga din apotekare.
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Vanliga frågor
What is isosorbide dinitrate and what does it do for someone with angina?
Isosorbide dinitrate is a medicine primarily used to prevent angina pain. Angina happens when your heart muscle doesn't get enough blood and oxygen, usually due to narrowed coronary arteries. This medicine works by relaxing and widening blood vessels throughout your body, which reduces the strain on your heart, and also specifically widens the blood vessels in your heart to increase blood flow to the heart muscle.
Can I use isosorbide dinitrate to treat an angina attack when it's happening?
Standard tablets of isosorbide dinitrate can sometimes be used for quick relief of angina pain. However, modified-release versions are not suitable for treating an angina attack. For acute attacks, your doctor will likely prescribe a short-acting nitrate like Glyceryl Trinitrate (GTN).
What should I do if I forget to take a dose of isosorbide dinitrate?
If you forget to take a dose at your usual time, take it as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and just take your next dose when it's due. Do not take two doses together to make up for a missed one.
Are there any specific foods or drinks I should avoid while taking isosorbide dinitrate?
It is best not to drink alcohol while taking isosorbide dinitrate. Alcohol can increase your risk of side-effects such as feeling dizzy and light-headed.
How do I know if my isosorbide dinitrate tablets are the 'standard' or 'modified-release' type?
Your doctor will inform you which type of tablets you have been prescribed. The dosage instructions, including whether they are standard (taken three or four times a day) or modified-release (taken twice daily), will also be printed on the label of your medicine pack.
What should I do if I experience headaches after starting isosorbide dinitrate?
Headaches are a common side-effect and usually disappear after a few days as your body adjusts to the medicine. You can ask your doctor or pharmacist to recommend a suitable painkiller to help manage this during the initial period.
Why is it important to attend regular appointments with my doctor while on this medication?
Regular appointments with your doctor are important so they can monitor your progress. Also, your body can become used to isosorbide dinitrate over time, which can reduce its effectiveness (a phenomenon called tolerance). Your doctor may adjust your dosing schedule to prevent this.
Vidare läsning och referenser
- Manufacturer's PIL, Isoket Retard® 20 mg tablets; Norgine Limited, The electronic Medicines Compendium. Dated May 2019.
- Manufacturer's PIL, Isosorbide Dinitrate Tablets 10 mg, 20 mg; Chemidex Pharma Ltd. The electronic Medicines Compendium. Dated July 2021.
- Mediciner Komplett BNF 89:e Utgåvan; Brittiska Läkarföreningen och Kungliga Farmaceutiska Sällskapet i Storbritannien, London.
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About the authorView full bio

Michael Stewart, MRPharmS
Medicine Leaflet Review Manager – Contractor, Pharmacist
BPharm (Hons), MRPharmS
Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.
About the reviewer

Sid Dajani
Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.
Artikelhistorik
Informationen på denna sida är skriven och granskad av kvalificerade kliniker.
Next review due: 18 Oct 2027
21 Oct 2024 | Senaste versionen

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