isolazine tablet - Isosorbide Dinitrate (20mg) + Hydralazine (37.5mg) medicine

Isolazine Tablet: Complete Guide to Uses, Side Effects, and Safety

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🏭 Lupin Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 25, 2026
⚠️ Hepatotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for heart failure with reduced ejection fraction in African descent patients.
Reviewed by
SaathiMed Expert Panel | Sep 25, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Severe dizziness or fainting
  • Chest pain or difficulty breathing
  • Sudden swelling of face, lips, or throat
  • Yellowing of skin or eyes
  • Unusual bruising or bleeding
  • Joint pain with fever or rash
  • Decreased urine output

If experiencing severe symptoms, call emergency services immediately.

What is isolazine tablet used for?

This medicine is a combination of isosorbide dinitrate and hydralazine used to treat heart failure. It works by relaxing blood vessels to reduce the heart's workload and improve blood flow.

  • Generic Name: Isosorbide Dinitrate (20mg) + Hydralazine (37.5mg)
  • Manufacturer: Lupin Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 isolazine tablet के बारे में (Hindi Summary)

उपयोग: यह दवा हृदय विफलता (हार्ट फेल्योर) के इलाज में उपयोग की जाती है, खासकर उन रोगियों में जो अन्य दवाओं से ठीक से लाभ नहीं उठा पाते। यह रक्त वाहिकाओं को फैलाकर हृदय पर दबाव कम करती है और रक्त प्रवाह में सुधार करती है।

साइड इफेक्ट्स: आम दुष्प्रभावों में सिरदर्द, चक्कर आना, मतली, उल्टी, दस्त, तेज़ धड़कन और चेहरे पर लालिमा शामिल हैं। गंभीर दुष्प्रभावों में गंभीर निम्न रक्तचाप, बेहोशी, सीने में दर्द, अनियमित धड़कन और ल्यूपस जैसे लक्षण हो सकते हैं। किसी भी असामान्य लक्षण पर तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के निर्देशानुसार ही लें। शराब से बचें क्योंकि इससे चक्कर आ सकते हैं। अचानक उठने से बचें। अपने डॉक्टर को अपनी सभी स्वास्थ्य समस्याओं और दवाओं के बारे में बताएं। नियमित जांच कराएं।

💡 Did You Know? The first generic medicine was introduced in India in 1970 after the Patents Act was amended.

💊 isolazine tablet Uses & Benefits

[{"condition":"Heart failure with reduced ejection fraction","description":"This medicine is used to improve survival and reduce hospitalizations in patients with heart failure, particularly those of African descent, when added to standard therapy.","evidence":"Well-established"},{"condition":"Hypertension","description":"The combination may be used to lower blood pressure in certain patients, though it is not a first-line treatment.","evidence":"Limited"}]

Off-label uses: [{"condition":"Angina pectoris","description":"Isosorbide dinitrate component may be used to prevent angina attacks, but the combination is not standard for this use.","evidence":"Limited"}]

Primary treatment for: Heart failure with reduced ejection fraction

Also treats: Hypertension

📋 Drug Information

Generic Name(s)Isosorbide Dinitrate (20mg) + Hydralazine (37.5mg)
Brand Nameisolazine tablet
ManufacturerLupin Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassCARDIAC
Action Class
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a dry place, away from direct sunlight and moisture. Keep in the original container.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine with meals to reduce stomach upset.
2
Stand up slowly to avoid dizziness from low blood pressure.
3
Avoid alcohol completely while on this medicine.
4
Report any joint pain, fever, or rash immediately as it may indicate a lupus-like reaction.
5
Do not stop this medicine abruptly; consult your doctor first.
6
Monitor your blood pressure regularly and keep a record.
7
Inform your doctor if you experience numbness or tingling in hands or feet.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Shortness of breath
This medicine is commonly prescribed for heart failure.
Likely Use
✅
Fatigue
It helps improve cardiac output and reduce fatigue.
Likely Use
❌
Fever
This medicine is not a primary fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionIsosorbide Dinitrate is well absorbed from the gastrointestinal tract, but undergoes extensive first-pass metabolism. Hydralazine is also rapidly absorbed from the gastrointestinal tract. Food may affect the rate but not the extent of absorption.
DistributionBoth components are distributed widely in the body. Isosorbide Dinitrate is about 60% protein-bound, while hydralazine is about 87% protein-bound.
Protein BindingIsosorbide Dinitrate: approximately 60%; Hydralazine: approximately 87%.
MetabolismIsosorbide Dinitrate is metabolized in the liver to active metabolites, including isosorbide-5-mononitrate. Hydralazine is metabolized in the liver by acetylation, oxidation, and glucuronidation.
Half-LifeIsosorbide Dinitrate: about 1 hour; Hydralazine: about 2-8 hours (depending on acetylator status).
ExcretionBoth components and their metabolites are primarily excreted in the urine.
BioavailabilityIsosorbide Dinitrate: about 20-25% due to first-pass metabolism; Hydralazine: about 30-50%.
Onset of ActionIsosorbide Dinitrate: 15-30 minutes; Hydralazine: 20-30 minutes.
Peak Plasma TimeIsosorbide Dinitrate: about 1 hour; Hydralazine: about 1-2 hours.
Duration of ActionIsosorbide Dinitrate: up to 4-6 hours; Hydralazine: up to 6-12 hours.

How It Works

This medicine combines two vasodilators with complementary actions. Isosorbide Dinitrate is a nitrate that is converted to nitric oxide in the body. Nitric oxide activates guanylate cyclase, increasing cyclic GMP, which leads to relaxation of vascular smooth muscle, especially in veins. This reduces preload and cardiac workload. Hydralazine directly relaxes arterial smooth muscle, reducing peripheral vascular resistance and afterload. Together, they reduce the workload on the heart and improve cardiac output in heart failure.

Mechanism Steps

1
Nitrate conversion to nitric oxide: Isosorbide Dinitrate is metabolized to nitric oxide, which activates guanylate cyclase.
2
Increased cyclic GMP: Activation of guanylate cyclase increases cyclic GMP levels in vascular smooth muscle cells.
3
Venodilation: Increased cyclic GMP leads to relaxation of venous smooth muscle, reducing preload.
4
Arterial dilation by hydralazine: Hydralazine directly relaxes arterial smooth muscle, reducing systemic vascular resistance and afterload.
5
Reduced cardiac workload: The combined reduction in preload and afterload decreases myocardial oxygen demand and improves cardiac efficiency.

💡 How to Take isolazine tablet

Strength: Tablet: Isosorbide Dinitrate 20 mg + Hydralazine 37.5 mg

1Take this medicine by mouth with a glass of water.
2Swallow the tablet whole; do not crush or chew.
3Take with meals to reduce stomach upset.
4Follow your doctor's instructions exactly.
5Do not stop taking this medicine without consulting your doctor.

Dosage Information

Adult DosageThe usual adult dose is one tablet taken orally two to three times daily, or as prescribed by your doctor. The dose may be adjusted based on your condition and response. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly 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 ImpairmentUse with caution in patients with renal impairment. Dose adjustment may be necessary. Consult your doctor.
Hepatic ImpairmentUse with caution in patients with hepatic impairment. Dose adjustment may be necessary. Consult your doctor.
Maximum Daily DoseThe maximum recommended daily dose is 3 tablets (60 mg isosorbide dinitrate and 112.5 mg hydralazine) or as prescribed by your doctor.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset and improves tolerance.
High-fat meals
May delay absorption
Fatty foods can slow the rate of absorption.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of isolazine tablet

✅ Common Side Effects

Headache (Common (10-30%))
Usually resolves with continued use. If severe, consult your doctor.
Dizziness (Common (5-15%))
Rise slowly from sitting or lying positions. Avoid driving if affected.
Nausea (Common (5-10%))
Take with food to reduce stomach upset.
Flushing (Common (5-10%))
Usually temporary. Stay hydrated.
Palpitations (Uncommon (1-5%))
Report to your doctor if persistent or bothersome.

🚨 Serious Side Effects

Severe hypotension (Rare (<1%))
Seek immediate medical attention if you faint or experience severe dizziness.
Lupus-like syndrome (Rare (<1%))
Report joint pain, fever, or rash to your doctor immediately.
Peripheral neuropathy (Rare (<0.1%))
Report numbness, tingling, or weakness in hands or feet.
Blood dyscrasias (Very rare (<0.01%))
Report unusual bruising, bleeding, or signs of infection.

⚠️ Rare Side Effects

Hepatitis
Report yellowing of skin or eyes, dark urine, or abdominal pain.
Drug-induced fever
Consult your doctor if fever develops without clear cause.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Sildenafil Major
Alcohol Major
Other antihypertensives Major
NSAIDs Moderate
MAOIs Moderate

🚨 Major Interactions

  • Phosphodiesterase-5 inhibitors (e.g., sildenafil)
  • Alcohol
  • Other antihypertensives

⚡ Moderate Interactions

  • NSAIDs
  • Monoamine oxidase inhibitors (MAOIs)

🍷 Alcohol Interaction

Alcohol can intensify the blood pressure-lowering effects of this medicine, leading to dizziness, fainting, or severe hypotension. It is advisable to avoid alcohol while taking this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to nitrates or hydralazine","Severe hypotension","Severe aortic stenosis","Systemic lupus erythematosus","Concurrent use with phosphodiesterase-5 inhibitors"]

⚠️ Warnings & Precautions

["May cause severe hypotension, especially with alcohol or other antihypertensives.","Can cause lupus-like syndrome; monitor for joint pain, fever, rash.","May cause peripheral neuropathy; report numbness or tingling.","Use with caution in patients with renal or hepatic impairment.","Avoid abrupt withdrawal; taper gradually under medical supervision."]

🤱 Lactation Safety

Not established from the available information. Consult your doctor before breastfeeding.

💊 Overdose Management

Overdose can cause severe hypotension, tachycardia, and shock. Seek immediate medical attention. Treatment is supportive and symptomatic. Gastric lavage may be considered if recent ingestion. Monitor vital signs and provide intravenous fluids and vasopressors if needed.

⏰ 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

General Safety

Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without medical advice. Stand up slowly from a sitting or lying position to avoid dizziness. Avoid alcohol, as it can increase the blood pressure-lowering effect and worsen dizziness. Inform your doctor if you have kidney or liver disease, low blood pressure, or a history of autoimmune disease. Regular monitoring of blood pressure, heart rate, and symptoms is important. Do not use this medicine if you are pregnant or planning pregnancy without consulting your doctor. Keep all follow-up appointments and report any new or worsening symptoms promptly.

👴 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)

This medicine is not recommended during pregnancy unless clearly needed. Consult your doctor if you are planning pregnancy or become pregnant.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist that you are taking this medicine, as it can affect blood pressure during surgery. Dose adjustments may be needed.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine, as it can cause dizziness or low blood pressure during dental procedures. Take precautions to avoid sudden position changes.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce heart strain.
🥗
Follow a low-sodium diet to manage fluid retention.
😴
Engage in regular, moderate exercise as advised by your doctor.
💧
Avoid alcohol and smoking.
🧘
Get adequate rest and manage stress.

🏋️ Exercise Considerations

Avoid strenuous exercise until you know how this medicine affects you, as it can cause dizziness. Start slowly and increase activity gradually under your doctor's guidance.

🥗 Diet Recommendations

Limit salt intake to reduce fluid retention.
Eat a balanced diet rich in fruits and vegetables.
Avoid high-fat meals that may delay absorption.
Stay well hydrated unless advised otherwise.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or lightheadedness, especially when standing up. Avoid driving or operating heavy machinery until you know how it affects you. Take breaks and rise slowly.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. If you experience severe side effects, contact your doctor immediately for advice on dose adjustment or alternative treatment.

📅 Long-Term Use Effects

Long-term use may require monitoring for lupus-like syndrome, peripheral neuropathy, and liver function. Regular follow-up with your doctor is essential to adjust the dose and manage any side effects.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Angiotensin receptor-neprilysin inhibitors (ARNIs)

Another class of heart failure medicines that may be used instead or in addition.

Evidence: Well-established
Beta-blockers

Standard therapy for heart failure that may be combined with this medicine.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific vaccine interactions are known. However, consult your doctor before receiving any vaccine while on this medicine.

📦 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 crossing time zones, adjust dosing times gradually as advised by your doctor. Keep enough supply for your trip and carry it in your hand luggage.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 58-year-old man with heart failure
He was prescribed this medicine after standard therapy was not enough. Within a few weeks, his shortness of breath improved, and he could walk further without fatigue. He learned to take it with food to avoid nausea and to rise slowly to prevent dizziness.
💡 Lesson: Consistent use and lifestyle adjustments can significantly improve quality of life.
👤 A 62-year-old woman with heart failure and hypertension
She started this medicine and noticed better blood pressure control and less swelling in her legs. She experienced mild headaches initially, which faded after a week. She emphasized the importance of not missing doses.
💡 Lesson: Side effects often diminish with time, and adherence is key to benefits.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within 30-60 minutes, but full benefits for heart failure may take several weeks.

Q: Can I stop taking this medicine if I feel better?

A: No, you should not stop without consulting your doctor. Stopping suddenly can worsen your condition.

Q: What should I do if I miss a dose?

A: Take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and continue your regular schedule. Do not double the dose.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for isolazine tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can cure heart failure.
    Fact: This medicine helps manage symptoms and improve survival but does not cure heart failure.
  • Myth: You can stop taking this medicine once you feel better.
    Fact: You should not stop without consulting your doctor, as it may worsen your condition.

🔄 Alternative Options

Generic Alternatives

  • Isosorbide Dinitrate + Hydralazine generic tablets

Brand Alternatives

  • Isolazine Tablet

📊 Comparison with Similar Medicines

[{"medicine":"Isosorbide Dinitrate alone","difference":"Only reduces preload; less effective for heart failure."},{"medicine":"Hydralazine alone","difference":"Only reduces afterload; less effective for heart failure."}]

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