MDElliottMD: home-claude category backfill (parser-claude gap closure)

2026-05-23T10:43:45Z

home-claude category backfill (parser-claude gap closure)

← Older revision		Revision as of 10:43, 23 May 2026
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	== References ==		== References ==
	<references />		<references />
			[[Category:Nitrates]]
			[[Category:Vasodilators]]
			[[Category:Antianginals]]

MDElliottMD: parser-claude batch MedTemplate pre-fill, Top 300 #125

2026-05-23T04:21:34Z

parser-claude batch MedTemplate pre-fill, Top 300 #125

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{{MedTemplate
| generic = Isosorbide (dinitrate, mononitrate)
| brand = Imdur (mononitrate ER), Isordil (dinitrate); generics; with hydralazine as BiDil for HFrEF in self-identified Black patients
| structure =
| classes = [[:Category:Nitrates|Organic nitrate]], [[:Category:Vasodilators|Vasodilator]], [[:Category:Antianginals|Antianginal]]
| uses = <vote slug="stable-angina-use">Stable angina (prophylaxis)</vote>, <vote slug="hfref-african-american-use">Heart failure with reduced ejection fraction (with hydralazine)</vote>, <vote slug="esophageal-spasm-use">Esophageal spasm (off-label)</vote>
| starting_dose = Isosorbide mononitrate ER: 30-60 mg PO once daily in the morning, titrate to 120-240 mg/d; isosorbide dinitrate IR: 5-20 mg PO TID with a 12-14 hour nitrate-free interval to prevent tolerance
| preparations = Mononitrate 10, 20 mg IR; 30, 60, 120 mg ER; dinitrate 5, 10, 20, 30, 40 mg IR and ER
| fda_max = 240 mg/d (mononitrate ER); 160 mg/d (dinitrate)
| pill_id =
| routes = Oral, sublingual (dinitrate)
| onset = SL: 2-5 minutes; PO mononitrate: 30-60 minutes
| duration = Mononitrate ER: 12-24 hours; dinitrate IR: 4-6 hours
| halflife = Mononitrate ~5 hours; dinitrate ~1 hour<ref name="imdur-label">FDA Prescribing Information, Imdur (isosorbide mononitrate ER), AstraZeneca, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/019091s039lbl.pdf</ref>
| bioavailability = Mononitrate ~100% (no first-pass; the principal advantage over dinitrate); dinitrate ~20%<ref name="imdur-label" />
| pregnancy = Limited data.{{citation needed}}
| legal = [[USLegal:Prescription only|Rx-only]] in US
| mechanism = <vote slug="isosorbide-mech-claim">Isosorbide nitrates are enzymatically denitrated (largely by mitochondrial aldehyde dehydrogenase, ALDH2) to release nitric oxide (NO), which activates soluble guanylyl cyclase, raises cGMP, and relaxes vascular smooth muscle predominantly in the venous capacitance bed (preload reduction) at typical doses, with arterial vasodilation at higher doses.</vote> '''Phosphodiesterase-5 inhibitors''' (sildenafil, tadalafil, vardenafil) catastrophically potentiate nitrate-induced hypotension — concurrent use is absolutely contraindicated. Daily nitrate-free intervals (12-14 hours) restore responsiveness and limit tolerance development; this is why mononitrate ER is dosed once-daily in the morning rather than continuously<ref name="imdur-label" />.
}}

== References ==
<references />

Isosorbide - Revision history

MDElliottMD: home-claude category backfill (parser-claude gap closure)

MDElliottMD: parser-claude batch MedTemplate pre-fill, Top 300 #125