$37.67

ISORDIL TEMBIDS

Take this medicine exactly as directed by your doctor. It will work only if taken correctly.

This form of nitrate is used to reduce the number of angina attacks. In most cases, it will not relieve an attack that has already started because it works too slowly (the extended-release form releases medicine gradually over a 6-hour period to provide its effect for 8 to 10 hours). Check with your doctor if you need a fast-acting medicine to relieve the pain of an angina attack.

Take this medicine with a full glass (8 ounces) of water on an empty stomach. If taken either 1 hour before or 2 hours after meals, it will start working sooner.

Extended-release capsules and tablets are not to be broken, crushed, or chewed before they are swallowed. If broken up, they will not release the medicine properly.

Dosing

The dose of nitrates will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of nitrates. If your dose is different, do not change it unless your doctor tells you to do so.

The number of capsules or tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking nitrates.

For isosorbide dinitrate
• For angina (chest pain):
  • For regular (short-acting) oral dosage forms (capsules or tablets):
    • Adults 5 to 40 mg four times a day.
    • Children Dose must be determined by your doctor.
  • For long-acting oral dosage forms (extended-release capsules or tablets):
    • Adults 20 to 80 mg every eight to twelve hours.
    • Children Dose must be determined by your doctor.

For isosorbide mononitrate
• For angina (chest pain):
  • For regular (short-acting) oral dosage form (tablets):
    • Adults 20 mg two times a day. The two doses should be taken seven hours apart.
    • Children Use and dose must be determined by your doctor.
  • For long-acting oral dosage forms (extended-release tablets):
    • Adults 30 to 240 mg once a day.
    • Children Use and dose must be determined by your doctor.

For nitroglycerin
• For angina (chest pain):
  • For long-acting oral dosage forms (capsules or tablets):
    • Adults 2.5 to 9.0 mg every eight to twelve hours.
    • Children Dose must be determined by your doctor.

Missed dose

If you are taking this medicine regularly and you miss a dose, take it as soon as possible. However, if the next scheduled dose is within 2 hours (or within 6 hours for extended-release capsules or tablets), skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nitrates, the following should be considered:

Allergies Tell your doctor if you have ever had any unusual or allergic reaction to nitrates or nitrites. Also tell your health care professional if you are allergic to any other substances, such as certain foods, preservatives, or dyes.

Pregnancy Nitrates have not been studied in pregnant women. However, studies in rabbits given large doses of isosorbide dinitrate have shown adverse effects on the fetus. Before taking these medicines, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding It is not known whether these medicines pass into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking these medicines and who wish to breast-feed should discuss this with their doctor.

Children Studies on these medicines have been done only in adult patients, and there is no specific information comparing use of nitrates in children with use in other age groups.

Older adults Dizziness or lightheadedness may be more likely to occur in the elderly, who may be more sensitive to the effects of nitrates.

Other medicines Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking nitrates, it is especially important that your health care professional know if you are taking any of the following:

• Antihypertensives (high blood pressure medicine) or
• Other heart medicine May increase the effects of nitrates on blood pressure

• Sildenafil (e.g., Viagra) or
• Tadalafil (e.g., Cialis) or
• Vardenafil (e.g., Levitra) These medicines which treat sexual impotence be used together with nitrates. You should tell your doctor right away if you are taking one of these drugs.

• Anemia (severe)

• Glaucoma May be worsened by nitrates

• Head injury (recent) or
• Stroke (recent) Nitrates may increase pressure in the brain, which can make problems worse

• Heart attack (recent) Nitrates may lower blood pressure, which can aggravate problems associated with heart attack

• Kidney disease or
• Liver disease Effects may be increased because of slower removal of nitroglycerin from the body

• Overactive thyroid