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The main action of Isosorbide Dinitrate is relaxation of vascular smooth muscle and dilatation of peripheral arteries and veins. The dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing preload. Arteriolar relaxations reduce systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (after load). Isordil causes direct smooth muscle relaxation. Isordil relaxes bigger conducting coronary arteries.

The common side effects reported with Isordil are recurrent headache, transient episodes of lightheadedness, hypotension syncope, crescendo, angina, and rebound hypertension.

Isosorbide Dinitrate can cause hypotension in upright posture. Hence Isosorbide Dinitrate should be used carefully in patients with volume depletion or who are already hypotensive. It is not advisable to consume the Isordil during pregnancy. If it is an absolute must to take Isordil during pregnancy, it should be administered under the supervision of a medical practitioner. Isordil is not administered to nursing mothers as it gets excreted in breast milk. The use of Isosorbide Dinitrate is contraindicated in pediatric patients.

The recommended starting dosage of Isordil in adults is 5 to 20 mg two or three times daily. The maintenance dose of Isordil is 10 to 40mg two or three times daily. To minimize tolerance dose-free interval of at least 14 hours is recommended daily.