Isoket (Isosorbide dinitrate) is an organic nitrate of medium-long duration heart medication that is used in the treatment and prevention of angina pectoris. It has also been used in the treatment of congestive heart failure in particular associated with hydralazine (an arteriolar vasodilator) and in the treatment of esophageal spasms. Each Isoket retard tablet just contains a compound called isosorbide dinitrate.

The main function of the Isoket retard tablets serves is to carry out an easy prolongation of the revascularization process, in addition to avoiding or mitigating coronary spasm. This drug has a component that helps both peripheral arteries and veins to circulate, reducing pressure or preload, in other words, In addition, to helping with cardiac work. Isoket helps with acute left ventricular failure, It improves circulation, it functions as a treatment with acute myocardial infarction and with Severe angina pectoris.

The individual response of each patient requires adjusting the dose to their particular needs and the severity of the condition to be treated. Therefore, in some cases, it may be advisable to carry out an initial dose titration until the recommended normal isosorbide dinitrate dosage is reached.

Adults

The normal dose is 1 tablet every 3-4 hours, ingested whole, without chewing, with a sufficient amount of liquid.

On the other hand, the rapid absorption of isosorbide dinitrate sublingually means that this medicine can also be used in emergency situations, such as in acute angina attacks. In these cases, it is advisable to chew and deposit next under the tongue 1 tablet of Isoket 5 mg. This dose may be repeated in the event that symptoms are not adequately controlled or a new angina crisis appears.

In any case, the maximum daily dose of isosorbide dinitrate should not exceed 240 mg.

Elderly population

There is no evidence to suggest a dose adjustment in this group of patients.

Pediatric population

Isosorbide dinitrate is not recommended for use in children and adolescents due to the absence of data on safety and efficacy.

Patients with kidney and/or liver failure

No dosage adjustment is necessary in case of renal failure or liver cirrhosis.

After prolonged use for the treatment of chronic conditions, tolerance may develop in patients, reducing their effectiveness. Nitrate tolerance mechanisms have been thoroughly investigated in the past 30 years and several hypotheses have been proposed. The following isosorbide dinitrate side effects include:

• Serious allergic reactions (skin rash, hives, itching, shortness of breath, chest tightness, swelling of the mouth, face, lips, or tongue); Fainting; fast or slow heartbeat; nausea; new or worsening chest pain; vomiting
• Inadequate biotransformation of isosorbide dinitrate to its active ingredient "NO" (nitric oxide, or a species related to "NO")
• Neurohormonal activation, which causes sympathetic activation and the release of vasoconstrictors such as endothelin and angiotensin II that counteract vasodilation induced by isosorbide
• Plasma volume expansion
• The oxidative stress

Contradictions:

This medication is contraindicated in these cases:

• severe anemia
• Severe postural
• High intracranial
• Significant hypersensitivity or idiosyncrasy to nitroglycerin, nitrates or

Some tolerance and cross-tolerance with other nitrates can occur with long-term therapy or with overuse. Must be used with caution in patients with kidney disease or severe liver, those with low or normal pulmonary capillary pressure, and in those receiving pressure-lowering medications blood. With intermittent therapy, anginal episodes, they can be increased during the nitrate-free interval.

Precautions

Before using this medication, tell your doctor about your current list of medications, over-the-counter products (eg, vitamins, herbal supplements, etc.), allergies, pre-existing conditions, and current conditions (eg. , pregnancy, upcoming surgery, etc.). Some health disorders may make you more susceptible to the drug's side effects. Take it as directed by your doctor or follow the directions printed on the product label. The dose will depend on your condition.

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