ISOKET®

Mode of action

Isosorbide dinitrate belongs to the group of nitrates, from which nitrogen monoxide (NO) can be released after being absorbed into the body. Nitric oxide causes blood vessels to dilate (Vasodilation), especially of the veins and larger coronary arteries. In this way, nitrates lead to a reduction in the so-called preload, i.e. the volume of blood that accumulates in the venous system in front of the heart and has to be pumped by the heart. This is important for patients with heart failure, for example, since the heart is no longer “strong” enough to pump the pent up volume. Nitrates can help relieve the heart a little and reduce the need for oxygen. However, they are not the therapy of first choice in the treatment of heart failure because - unlike other drugs - they do not have any life-prolonging effect. Furthermore, nitrates lead to an improved blood flow in the coronary arteries, which plays a decisive role in patients with coronary heart disease (CHD). Depending on the type of application, ISDN has a duration of action of 30 minutes to 12 hours. When administered sublingually (under the tongue), the effect occurs after about 1 minute.

Side effects

A typical side effect the nitrate is the so-called "Nitrate headache“That through Dilation of cerebral vessels (Vasodilation of intracranial vessels) occurs and often regresses in the course of therapy. It can too Drop in blood pressure (Hypotension) and one Increase in heart rate (Tachycardia), especially after getting up from lying down (orthostatic hypotension). Other possible side effects are seizure-like Reddening of the skin (Flush), allergic reaction, nausea, Vomit and other.
Please note the "Nitrate tolerance“, Which occurs in all nitrates which are enzyme-dependently activated. With continuous feed it occurs within 24-48 hours to a Weakened effect. To avoid this, one should regularly nitrate-free interval be respected.

Contraindications

Isosorbide dinitrate must not be used in case of known hypersensitivity to the active substance acute circulatory failure, cardiogenic shock, at a systolic blood pressure <90 mmHg (Hypotension), at hypertrophic obstructive cardiomyopathy (HOCM) and at Narrowing of the mitral or aortic valve (Stenosis).

Interactions

A combination of ISDN and drugs used to treat Erectile dysfunction from the group of Phosphodiesteres V inhibitors (e.g. Sildenafil, trade name Viagra®) is strictly contraindicated as it leads to a severe drop in blood pressure can lead. The combination of ISDN with antihypertensive drugs (Antihypertensive drugs) should be done carefully.

Dosing of Isoket®

Isoket® is available in different Application forms. The Tablets are for oral intake Not to treat an acute situation but to avoid it (prophylaxis) e.g. thought of angina attacks. They are both in retarded as well as in less retarded Form available, the retarded form is characterized by a longer duration of action off, so the tablets have to be taken less often. Tablets for sublingual application are placed under the tongue so that they dissolve there. This leads to a clear faster onset of action than when swallowing the tablet. Thus, this application form is for treatment acute situations suitable, e.g. an angina pectoris attack in coronary artery disease. Same goes for that spray of which a few Strokes be given in the oral cavity. ISDN is also available as Infusion solution available for intravenous administration in acute situations. Exact dosages and the choice of the appropriate form of application can be found in the specialist medical information and in the doctor's consultation.

costs

As an example, a dose is selected for each form of application to illustrate the costs.

Isoket® tablets 20 mg 17 cents per tablet

Isoket® sublingual tablets, 22 cents per tablet, if a prescription is available for each multipack, 5 euros each.

Isoket® spray 15 ml about 28 euros, if a prescription is available, the fee is reduced to 5 euros.

Isoket® 0.1% solution for infusion, 10 ampoules just under 27 euros, if a prescription is available 5 euros.