Ismo Indication:

For the prevention of angina pectoris due to coronary artery disease.

Ismo Mechanism Of Action:

Similar to other nitrites and organic nitrates, isosorbide dinitrate is converted to nitric oxide (NO), an active intermediate compound which activates the enzyme guanylate cyclase (atrial natriuretic peptide receptor A). This stimulates the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP) which then activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, eventually resulting in the dephosphorylation of the myosin light chain of the smooth muscle fiber. The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation.

Ismo Drug Interactions:

Dihydroergotamine Possible antagonism of action
Dihydroergotoxine Possible antagonism of action
Ergonovine Possible antagonism of action
Ergotamine Possible antagonism of action
Methylergonovine Possible antagonism of action
Methysergide Possible antagonism of action
Sildenafil Possible significant hypotension with this combination
Tadalafil Possible significant hypotension with this combination
Vardenafil Possible significant hypotension with this combination

Ismo Food Interactions:

Take without regard to meals. Absorption is faster on an empty stomach.

Ismo Generic Name:


  • Dianhydrosorbitol 2,5-dinitrate
  • Sorbide nitrate
  • Sorbide, dinitrate
  • Sorbidnitrate

Drug Type:

Small Molecule; Approved


Absorption of isosorbide dinitrate after oral dosing is nearly complete, but bioavailability is highly variable (10% to 90%), with extensive first-pass metabolism in the liver. The average bioavailability of isosorbide dinitrate is about 25%.

Toxicity (Overdose):

Symptoms of overdose include reduced cardiac output and hypotension.

Protein Binding:

Very low



Half Life:

1 hour

Dosage Forms of Ismo:

Tablet, extended release Oral
Tablet Oral
Tablet Sublingual

Chemical IUPAC Name:

[(3S,3aS,6R,6aS)-6-nitrooxy-2,3,3a,5,6,6a-hexahydrofuro[2,3-d]furan-3-yl] nitrate

Organisms Affected:

Humans and other mammals

Ismo to general, pharmacology

General, pharmacology..
General health