Should be taken on an empty stomach: Take 30 min before meals.
Contraindications
Hypersensitivity to isosorbide or known idiosyncratic reaction to organic nitrates. Increased ICP (eg, head trauma or cerebral hemorrhage). W/hold treatment in presence of cardiogenic shock or risk of shock developing.
Use of nitrates during early days of acute phase of MI. Nitrate dependence may occur w/ chronic use. Gradually reduce administration to avoid possible w/drawal effects (eg, chest pain, acute MI & sudden death). Do not discontinue abruptly. May develop tolerance to isosorbide & cross-tolerance to other nitrates & nitrites. Patients w/ glaucoma. May cause a slight decrease in mean BP (approx 10-15 mmHg). Patients prone or might be affected by hypotension. Pregnancy.
May antagonise effects of histamine or epinephrine, acetylcholine & similar agents. May enhance marked sensitivity to hypotensive effects (eg, nausea, vomiting, restlessness, perspiration & collapse) w/ alcohol.
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