Comparative Pharmacology
Head-to-head clinical analysis: DILATRATE SR versus ISOSORBIDE DINITRATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILATRATE SR versus ISOSORBIDE DINITRATE.
DILATRATE-SR vs ISOSORBIDE DINITRATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
DILATRATE-SR (isosorbide dinitrate) is a vasodilator that relaxes vascular smooth muscle via the release of nitric oxide (NO), which activates guanylate cyclase, increasing cGMP levels. This leads to venous and arterial dilation, reducing preload and afterload.
Isosorbide dinitrate is a nitrate vasodilator that relaxes vascular smooth muscle via release of nitric oxide (NO), which activates guanylate cyclase, increasing cGMP, leading to venous and arterial dilation. Venodilation reduces preload; arterial dilation reduces afterload, decreasing myocardial oxygen demand.
40 mg orally twice daily, 6–8 hours apart, as sustained-release formulation. Maximum dose: 160 mg twice daily.
Oral: 5-40 mg every 6 hours; sublingual: 2.5-5 mg every 2-3 hours for acute angina or prophylaxis; chewable: 5-10 mg every 2-3 hours; intravenous: initial 1-2 mg/hour, increase by 1-2 mg/hour every 3-5 minutes until response, usual range 2-10 mg/hour (titrate to effect).
None Documented
None Documented
Clinical Note
moderateIsosorbide dinitrate + Etacrynic acid
"The risk or severity of adverse effects can be increased when Isosorbide dinitrate is combined with Etacrynic acid."
Clinical Note
moderateIsosorbide dinitrate + Bumetanide
"The risk or severity of adverse effects can be increased when Isosorbide dinitrate is combined with Bumetanide."
Clinical Note
moderateIsosorbide dinitrate + Hydrochlorothiazide
"The risk or severity of adverse effects can be increased when Isosorbide dinitrate is combined with Hydrochlorothiazide."
Clinical Note
moderateTerminal half-life is 4-6 hours, but clinical effect lasts 8-12 hours due to sustained-release formulation.
Terminal elimination half-life is approximately 1-4 hours (mean ~1.5 hours) for isosorbide dinitrate; active metabolites (isosorbide-5-mononitrate) have longer half-life (~4-6 hours). Clinical context: Short half-life necessitates frequent dosing or use of extended-release formulations for sustained antianginal effect.
Renal excretion of inactive metabolites accounts for approximately 60-80% of clearance, with biliary/fecal elimination contributing 20-40%.
Renal excretion of metabolites (approximately 80-100% of absorbed dose as inactive metabolites, primarily isosorbide-2-mononitrate and isosorbide-5-mononitrate); less than 2% excreted unchanged in urine. Biliary/fecal excretion is minimal.
Category C
Category A/B
Nitrate
Nitrate
Isosorbide dinitrate + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Isosorbide dinitrate."