Isocrate 20mg Tablet (isosorbide Dinitrate): Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Severe chest pain that does not respond to usual treatment
- Fainting or loss of consciousness
- Bluish discoloration of lips, skin, or nails
- Severe headache with vision changes
- Sudden swelling of face, lips, or throat
- Irregular or very fast heartbeat
- Yellowing of skin or eyes
If experiencing severe symptoms, call emergency services immediately.
What is isocrate 20mg tablet used for?
Isosorbide dinitrate 20 mg is an oral nitrate used to prevent angina attacks. It works by relaxing blood vessels, improving blood flow to the heart, and reducing the heart's workload. It is not for immediate relief of an acute angina attack.
- Generic Name: Isosorbide Dinitrate (20mg)
- Manufacturer: Roussel Laboratories Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 isocrate 20mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा एंजाइना (सीने में दर्द) के दौरों को रोकने के लिए इस्तेमाल की जाती है। यह रक्त वाहिकाओं को फैलाकर हृदय तक रक्त का प्रवाह बढ़ाती है और हृदय पर दबाव कम करती है। यह तीव्र एंजाइना हमले के इलाज के लिए नहीं है।
साइड इफेक्ट्स: सबसे आम दुष्प्रभाव सिरदर्द है, जो आमतौर पर शुरुआत में होता है और धीरे-धीरे कम हो जाता है। चक्कर आना, चेहरे पर गर्मी लगना, और धड़कन तेज होना भी हो सकता है। गंभीर दुष्प्रभाव दुर्लभ हैं लेकिन इनमें गंभीर निम्न रक्तचाप और मेथेमोग्लोबिनेमिया शामिल हैं।
सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। अचानक बंद न करें। शराब से बचें। सिल्डेनाफिल जैसी दवाएं न लें। उठते-बैठते समय धीरे-धीरे उठें। किसी भी सर्जरी या दंत चिकित्सा से पहले अपने डॉक्टर को इस दवा के बारे में बताएं।
💊 isocrate 20mg tablet Uses & Benefits
[{"condition":"Chronic stable angina prophylaxis","description":"Reduces the frequency and severity of angina attacks by improving coronary blood flow and reducing cardiac workload.","evidence":"Well-established"},{"condition":"Vasospastic angina","description":"Helps prevent coronary artery spasms that cause chest pain.","evidence":"Well-established"},{"condition":"Heart failure with reduced ejection fraction","description":"Used in combination with hydralazine to improve symptoms and survival, especially in certain populations.","evidence":"Well-established"}]
Off-label uses: [{"condition":"Esophageal spasm","description":"Sometimes used to relieve chest pain caused by esophageal motility disorders.","evidence":"Limited"},{"condition":"Anal fissure","description":"Topical forms have been used off-label, but oral use is not standard.","evidence":"Limited"}]
Primary treatment for: Angina pectoris
Also treats: Coronary artery disease, Heart failure
📋 Drug Information
| Generic Name(s) | Isosorbide Dinitrate (20mg) |
| Brand Name | isocrate 20mg tablet |
| Manufacturer | Roussel Laboratories Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | CARDIAC |
| Action Class | NO Donors |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
Isosorbide dinitrate is a nitrate that is converted in the body to nitric oxide. Nitric oxide activates guanylate cyclase, increasing cyclic GMP levels in vascular smooth muscle cells. This leads to relaxation of smooth muscle, primarily in veins but also in arteries. The result is venous dilation, reduced preload, and decreased myocardial oxygen demand. Coronary artery dilation also improves blood supply to ischemic heart muscle.
Mechanism Steps
💡 How to Take isocrate 20mg tablet
Strength: Isosorbide Dinitrate 20 mg immediate-release tablet
Dosage Information
| Adult Dosage | The usual adult dose for prevention of angina is 5 to 20 mg taken two to three times daily, but the exact dose and frequency must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function, and response to therapy. Do not self-adjust the dose. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients may be more sensitive to the blood pressure-lowering effects. Start with a lower dose and monitor closely. Dose must be individualized by a qualified clinician. |
| Renal Impairment | No specific dose adjustment is established for renal impairment. Use with caution and monitor blood pressure. Dose must be individualized by a qualified clinician. |
| Hepatic Impairment | Use with caution in patients with severe hepatic impairment. Dose must be individualized by a qualified clinician. |
| Maximum Daily Dose | The maximum recommended daily dose is 120 mg, but this must be individualized by a qualified clinician. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of isocrate 20mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Sildenafil | Major | |
| Tadalafil | Major | |
| Riociguat | Major | |
| Alcohol | Moderate | |
| Beta-blockers | Moderate | |
| Calcium channel blockers | Moderate | |
| Diuretics | Moderate | |
| NSAIDs | Minor |
🚨 Major Interactions
- Phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil)
- Riociguat
⚡ Moderate Interactions
- Alcohol
- Antihypertensives (e.g., beta-blockers, calcium channel blockers)
- Diuretics
🍷 Alcohol Interaction
Alcohol can increase the blood pressure-lowering effect of this medicine, leading to dizziness, fainting, and severe hypotension. It is best to avoid alcohol while taking this medicine.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Hypersensitivity to isosorbide dinitrate or other nitrates","Severe hypotension (systolic blood pressure
⚠️ Warnings & Precautions
["Do not use for acute angina attacks; use sublingual nitroglycerin as prescribed.","Tolerance may develop with continuous use; a nitrate-free interval is often recommended.","Avoid abrupt discontinuation to prevent rebound angina.","Use with caution in patients with low blood pressure or volume depletion.","May cause dizziness; avoid driving or operating machinery until you know how it affects you.","Inform your doctor if you have liver or kidney disease."]
🤱 Lactation Safety
It is not known whether isosorbide dinitrate is excreted in human breast milk. Consult your doctor before breastfeeding.
💊 Overdose Management
Overdose can cause severe hypotension, headache, dizziness, palpitations, and methemoglobinemia. Seek emergency medical attention immediately. Treatment is supportive and symptomatic, including intravenous fluids, elevation of legs, and if necessary, administration of vasopressors. Methylene blue may be used for methemoglobinemia.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.
Additional Safety Advice
Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop suddenly, as this can worsen angina. Rise slowly from sitting or lying positions to avoid dizziness. Avoid alcohol because it can increase the blood pressure-lowering effect. Do not take erectile dysfunction drugs such as sildenafil, tadalafil, or vardenafil while on this medicine. Inform all healthcare providers that you take this medicine, especially before surgery or dental procedures. Store at room temperature away from moisture and heat.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients may be more sensitive to the blood pressure-lowering effects. Start with a lower dose and monitor closely for dizziness and falls.
🤰 Pregnancy Planning (TTC)
Consult your doctor if you are planning pregnancy or are pregnant. The safety of this medicine during pregnancy is not well established.
🏥 Post-Surgery Considerations
Inform your surgeon and anesthesiologist that you take this medicine. It may interact with medications used during surgery and affect blood pressure.
🦷 Dental Procedures
Inform your dentist that you take this medicine, as it may affect blood pressure and interact with certain dental anesthetics.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
Avoid strenuous exercise until you know how this medicine affects you. It may cause dizziness or lightheadedness. Consult your doctor before starting any new exercise program.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness or lightheadedness, especially when standing up quickly. Avoid driving or operating heavy machinery until you know how it affects you. Inform your employer if your job involves such activities.
🛑 When to Stop This Medicine
Do not stop this medicine suddenly without consulting your doctor, as it can worsen angina. Your doctor may adjust or discontinue based on your condition.
📅 Long-Term Use Effects
Long-term use may lead to tolerance, reducing effectiveness. A nitrate-free interval is often recommended. Regular monitoring of blood pressure and symptoms is advised. Do not stop suddenly without medical advice.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Diet, exercise, and stress management can complement medicine.
Evidence: Well-establishedBeta-blockers, calcium channel blockers, or ranolazine may be alternatives.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
No specific vaccine interactions are established. Follow routine vaccination schedules as advised by your doctor.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
Carry this medicine in its original packaging with a copy of your prescription. Store at room temperature and protect from moisture. If traveling across time zones, adjust dosing times gradually as advised by your doctor. Keep enough supply for the entire trip. Check customs regulations for carrying prescription medicines.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: It starts working within 30 to 60 minutes after oral administration, with peak effects around 1 hour.
A: No, this medicine is for prevention. For acute attacks, use sublingual nitroglycerin as prescribed.
A: Take it as soon as you remember if less than half the dosing interval has passed. Otherwise, skip it and continue your regular schedule. Do not double dose.
🤔 Common Patient Concerns
🔄 Substitutes for isocrate 20mg tablet
View AllAlternative brands with exact same active ingredient:
-
nonit 20mg tabletAventure Pharma ₹46.88 60.7% COSTLIER
-
cardicap 20mg capsule trSun Pharmaceutical Industries Ltd ₹60.33 106.8% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: Isosorbide dinitrate can be used to treat an acute angina attack.
Fact: It is for prevention, not for immediate relief. Sublingual nitroglycerin is used for acute attacks. - Myth: It is safe to take with erectile dysfunction drugs.
Fact: Combining with PDE5 inhibitors can cause life-threatening hypotension and is contraindicated.
🔄 Alternative Options
Generic Alternatives
- Isosorbide Dinitrate 20 mg tablet (various manufacturers)
Brand Alternatives
- Isocrate 20mg tablet