Isosorbide Dinitrate
證據等級: L2 | 預測適應症: 10 個
## 藥師評估報告
Isosorbide Dinitrate：從 狹心症 到 肺高壓
一句話總結
Isosorbide dinitrate（二硝酸異山梨酯）是一種有機硝酸酯類血管擴張劑，用於預防和治療狹心症。TxGNN 模型預測它對**肺高壓 (pulmonary hypertension)** 有潛在治療效果，目前有超過 **20 篇文獻**支持此預測，證據等級高。
快速總覽
| 項目 | 內容 |
|---|---|
| 原適應症 | 預防及治療狹心症發作、冠狀動脈不全 |
| 預測新適應症 | 肺高壓 (pulmonary hypertension)、脫髮症 (alopecia) |
| TxGNN 預測分數 | 99.98% (肺高壓) |
| 證據等級 | L2 |
| 台灣上市 | 已上市 |
| 許可證數 | 多張 |
| 建議決策 | Explore |
預測適應症詳細分析
1. alopecia L5 99.99% 主要分析
為什麼這個預測合理？
Isosorbide dinitrate 通過釋放一氧化氮（NO）激活血管平滑肌細胞中的鳥苷酸環化酶，導致環磷酸鳥苷（cGMP）濃度升高，進而引起血管舒張。
</details>2. congenital hypotrichosis milia L5 99.99%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
3. hypotrichosis simplex of the scalp L5 99.99%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
4. pulmonary hypertension L4 99.98%
相關文獻（20 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 39164577 | 2025 | Article | Heart and vessels | The effects of bolus isosorbide dinitrate on pulmonary hypertension with cardiop... |
| 6423015 | 1984 | Article | Bulletin europeen de physiopat | Nitroglycerin and isosorbide dinitrate in pulmonary hypertension of chronic obst... |
| 28810603 | 2017 | Article | Experimental and therapeutic m | Intratracheal administration of isosorbide dinitrate improves pulmonary artery p... |
| 2498122 | 1989 | Article | Experimental and molecular pat | Comparative effects of isosorbide dinitrate, prednisolone, indomethacin, and ela... |
| 373940 | 1979 | Article | Clinical pharmacology and ther | Effects of isosorbide dinitrate on pulmonary hypertension in chronic obstructive... |
| 29377691 | 2018 | Article | Journal of medicinal chemistry | Identification of a Novel Hybridization from Isosorbide 5-Mononitrate and Bardox... |
| 3925746 | 1985 | Article | American heart journal | The role of isosorbide dinitrate in the treatment of perioperative hypertension. |
| 39398794 | 2024 | Article | Cureus | Burden of Pulmonary Hypertension in End-Stage Renal Disease Patients Receiving M... |
| 8908227 | 1996 | Article | Acta anaesthesiologica Scandin | Pulmonary vascular effects of nitroglycerin and isosorbide dinitrate in patients... |
| 6861502 | 1983 | Article | Critical care medicine | Treatment of portal hypertension with isosorbide dinitrate alone and in combinat... |
| 19620510 | 2009 | Article | Hypertension (Dallas, Tex. : 1 | Effects of fixed-dose isosorbide dinitrate/hydralazine on diastolic function and... |
| 2732445 | 1989 | Article | Journal of hepatology | Systemic and regional hemodynamic effects of isosorbide dinitrate in patients wi... |
| 7125407 | 1982 | Article | Annals of internal medicine | Vasodilators and prostaglandin inhibitors in primary pulmonary hypertension. |
| 3409916 | 1988 | Article | European heart journal | Long-term reduction of pulmonary hypertension in interstitial lung fibrosis by i... |
| 2521028 | 1989 | Article | Journal of cardiothoracic anes | The effects of intravenous nitroglycerin and isosorbide dinitrate on hemodynamic... |
| 3348140 | 1988 | Article | The American journal of cardio | Intravenous isosorbide dinitrate during open-heart surgery and its role in the t... |
| 6978691 | 1982 | Article | The Annals of thoracic surgery | Intravenous isosorbide dinitrate in the management of acute hypertension followi... |
| 22423590 | 2011 | Article | Proceedings of the Western Pha | Treatment with LA-419 prevents monocrotaline-induced pulmonary hypertension and ... |
| 1743025 | 1991 | Article | Cor et vasa | The effect of acute and chronic nitrate administration in precapillary and postc... |
| 3137065 | 1988 | Article | European heart journal | Control of perioperative hypertension during coronary artery surgery. A randomis... |
5. diffuse alopecia areata L5 99.98%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
6. vascular disease L1 99.97%
臨床試驗（49 項）
| 試驗編號 | 階段 | 狀態 | 人數 | 主要發現 |
|---|---|---|---|---|
| NCT02045459 | NA | COMPLETED | 79 | Assessment of Perfusion Reserve and Effects of Exercise in Microvascular Angina |
| NCT00803634 | PHASE3 | COMPLETED | 117 | A Safety and Efficacy Study of Blood Pressure Control in Acute Heart Failure - A... |
| NCT03011775 | PHASE4 | COMPLETED | 43 | Effect of Pioglitazone on Insulin Resistance, Progression of Atherosclerosis and... |
| NCT01676207 | N/A | COMPLETED | 120 | Prevalence of Extracardiac Coronary Collateral Supply Via the Internal Mammary A... |
| NCT04317846 | NA | COMPLETED | 165 | TransRadIal Evaluation STudy of diamEter Increase After Vasodilatory Drugs Admin... |
| NCT03451591 | PHASE2, PHASE3 | COMPLETED | 363 | LACunar Intervention (LACI-2) Trial-2: Assessment of Safety and Efficacy of Cilo... |
| NCT03255512 | PHASE1 | COMPLETED | 41 | Multi-center, Randomized, Placebo-controlled, Double-blind Group Comparison Stud... |
| NCT01631409 | N/A | WITHDRAWN | 0 | Estimation of the Long Term Effectiveness of Routine Use of Cardiac Shock Wave T... |
| NCT05082311 | N/A | COMPLETED | 55 | Prospective Cohort Study of Objective Cardiac and Vascular Changes in Pheochromo... |
| NCT02135315 | NA | COMPLETED | 1500 | One-year Outcome of Intensive Versus Standard Blood Pressure Treatment in Non-ST... |
| NCT01430780 | N/A | UNKNOWN | 68 | A Prospective Study to Evaluate the Influence of Oxygen Free Radical Injury Indu... |
| NCT01961453 | PHASE2 | WITHDRAWN | 0 | Targeting Wave Reflections to Improve Left Ventricular Hypertrophy, Fibrosis and... |
| NCT02627196 | NA | UNKNOWN | 1200 | Barostim Neo® - Baroreflex Activation Therapy® for Heart Failure |
| NCT06715007 | N/A | RECRUITING | 300 | Antiplatelet Therapy and Endothelial-stabilizing Agents in Cerebral Small Vessel... |
| NCT00685945 | NA | COMPLETED | 24 | Renin-Angiotensin Aldosterone System and Fibrinolysis(RAAS) Interaction in Human... |
| NCT01769079 | PHASE4 | COMPLETED | 95 | Withdrawal of Nitrate in Patients With Stable Angina - Multicenter Clinical Tria... |
| NCT02795910 | NA | UNKNOWN | 40577 | Integrated Primary Care for Diabetes and Cardiovascular Disease in Less Develope... |
| NCT04661709 | PHASE4 | UNKNOWN | 502 | Efficacy and Safety of Chinese Herbal Medicine Wen Xin Granules for the Treatmen... |
| NCT03171480 | PHASE4 | COMPLETED | 176 | Randomized Controlled Trial of Nitric-oxide Donor (NOD) Isosorbide Mononitrate (... |
| NCT00808652 | N/A | TERMINATED | 13 | Prevalence and Outcome of Brachial Artery Endothelial Function in Morbidly Obese... |
| NCT05954689 | NA | UNKNOWN | 50 | Femoral Artery Block for Reduction of Tourniquet Induced Hypertension: a Randomi... |
| NCT00337116 | PHASE4 | WITHDRAWN | 80 | Intravenous Isosorbide Dinitrate Versus Sublingual Isosorbide Dinitrate for the ... |
| NCT01471834 | NA | ACTIVE_NOT_RECRUITING | 40 | Neo Non-Randomized Hypertension Study |
| NCT01130168 | PHASE1 | COMPLETED | 38 | A Double-Blind, Randomized, Placebo-Controlled, 3-Period, Crossover Study to Eva... |
| NCT02870985 | NA | COMPLETED | 440 | BIOTRONIK-Safety and Clinical PerFormance of the Drug ELuting Orsiro Stent in th... |
| NCT02305095 | N/A | COMPLETED | 225 | Genomic Analysis of the Enhanced Response to Heart Failure Therapy in African Am... |
| NCT02573051 | PHASE2 | WITHDRAWN | 0 | Misoprostol Plus Isosorbide Mononitrate Versus Misoprostol For Termination Of An... |
| NCT00143195 | PHASE4 | COMPLETED | 200 | Open Label Study Comparing Amlodipine vs Long-acting Nitrates in Patients With C... |
| NCT03072121 | PHASE4 | UNKNOWN | 440 | Study of Curative Effect Evaluation of Shexiang Baoxin Pill on Coronary Artery D... |
| NCT01720160 | NA | UNKNOWN | 98 | Barostim HOPE4HF Study |
| NCT00683696 | PHASE2, PHASE3 | TERMINATED | 1680 | Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) |
| NCT02152579 | PHASE3 | UNKNOWN | 86 | Open Monocentric Clinical Study for the Evaluation of Efficacy and Safety of 20 ... |
| NCT02481323 | PHASE2 | COMPLETED | 57 | Preventing Cognitive Decline and Dementia From Cerebral Small Vessel Disease |
| NCT02011620 | PHASE4 | WITHDRAWN | 0 | Influence of Nitrates on Bone Remodeling and Endothelial Function in Patients Wi... |
| NCT00871871 | PHASE1 | COMPLETED | 64 | A Randomized, Double-Blind, Placebo-Controlled, 2-Part Study to Evaluate the Mul... |
| NCT00943852 | PHASE1 | COMPLETED | 13 | A Double-Blind, Randomized, Placebo-Controlled, 5-Period Crossover Study to Eval... |
| NCT04051957 | PHASE2 | TERMINATED | 9 | Isosorbide Mononitrate For Anti-Vascular Endothelial Growth Factor (VEGF) Induce... |
| NCT07252544 | PHASE3 | NOT_YET_RECRUITING | 3156 | Isosorbide Mononitrate and Butylphthalide to Reduce the Risk of Disability in Pa... |
| NCT02789033 | PHASE3 | COMPLETED | 68 | Efficacy of the Combination of Isosorbide Dinitrate Spray and Chitosan in Diabet... |
| NCT02228408 | PHASE4 | COMPLETED | 17 | A Phase IV Randomized, Double-blind, Active-controlled, Single-center Study of t... |
| NCT02522208 | PHASE1 | COMPLETED | 12 | Randomized, Open-Label, Daily Dose, 2-sequence, 2-way Crossover Pharmacodynamic ... |
| NCT01768182 | NA | COMPLETED | 30 | Short-term Folinic Acid Supplementation Improves Vascular Reactivity in HIV-infe... |
| NCT01513070 | PHASE4 | COMPLETED | 120 | A Randomized Double-blind Placebo-controlled Clinical Trials of the Blood-quicke... |
| NCT00000478 | PHASE3 | COMPLETED | N/A | Asymptomatic Cardiac Ischemia Pilot (ACIP) Study |
| NCT00810381 | NA | COMPLETED | 14 | Ocular Hemodynamic Effects of Nitrovasodilators in Healthy Subjects |
| NCT05671250 | PHASE2 | COMPLETED | 30 | Novel Bioactive Smart Dressings for Diabetic Foot Ulcers: a Randomized Controlle... |
| NCT03072082 | PHASE4 | UNKNOWN | 440 | Study of Curative Effect Evaluation of DanLou Tablet on Coronary Artery Disease ... |
| NCT04206865 | PHASE4 | WITHDRAWN | 0 | Prospective Comparison of ARNI to Alternate Oral Vasodilator Therapies to Determ... |
| NCT01270139 | NA | COMPLETED | 180 | Plasmonic Photothermal Therapy of Flow-Limiting Atherosclerotic Lesions With Sil... |
相關文獻（20 篇）
| PMID | 年份 | 類型 | 期刊 | 主要發現 |
|---|---|---|---|---|
| 9951954 | 1999 | Article | Drugs | Long-acting isosorbide mononitrate. |
| 3925742 | 1985 | Article | American heart journal | Nitrate tolerance. |
| 1576038 | 1992 | Article | AACN clinical issues in critic | Nitrates. |
| 2113003 | 1990 | Article | European journal of clinical p | Nitrates: why and how should they be used today? Current status of the clinical ... |
| 7873466 | 1994 | Article | Cardiovascular drugs and thera | Clinical pharmacokinetics of nitrates. |
| 6430767 | 1984 | Article | Herz | Nitrate tolerance. |
| 30687454 | 2018 | Article | Oxidative medicine and cellula | The Endothelin Receptor Antagonist Macitentan Improves Isosorbide-5-Mononitrate ... |
| 36219567 | 2023 | Article | Stroke and vascular neurology | Cilostazol and isosorbide mononitrate for the prevention of progression of cereb... |
| 813510 | 1976 | Article | The American journal of cardio | Comparative effects of nitroglycerin and isosorbide dinitrate on coronary collat... |
| 3325229 | 1987 | Article | Current medical research and o | Isosorbide-5-mononitrate and isosorbide dinitrate retard in the treatment of cor... |
| 29682995 | 2018 | Article | Diabetes & vascular disease re | Efficacy and safety of the combination of isosorbide dinitrate spray and chitosa... |
| 1969017 | 1990 | Article | Lancet (London, England) | Synergistic effect of prostaglandin E1 and isosorbide dinitrate in peripheral va... |
| 15758018 | 2005 | Article | The New England journal of med | Isosorbide dinitrate and hydralazine in blacks with heart failure. |
| 805037 | 1975 | Article | Chest | Effectiveness of isosorbide dinitrate and nitroglycerin in relieving angina pect... |
| 319662 | 1977 | Article | The American journal of medici | Effect of swallowed isosorbide dinitrate on blood pressure, heart rate and exerc... |
| 2709744 | 1989 | Article | Klinische Wochenschrift | Pharmacokinetics of isosorbide dinitrate, isosorbide-2-nitrate and isosorbide-5-... |
| 3893078 | 1985 | Article | American heart journal | History of the synthesis and pharmacology of isosorbide dinitrate. |
| 1094819 | 1975 | Article | American heart journal | Comparative hemodynamic effects of placebo and oral isosorbide dinitrate in pati... |
| 6423015 | 1984 | Article | Bulletin europeen de physiopat | Nitroglycerin and isosorbide dinitrate in pulmonary hypertension of chronic obst... |
| 7369307 | 1980 | Article | American journal of ophthalmol | Isosorbide and isorbide dinitrate. |
7. hypertrichosis (disease) L5 99.97%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
8. kyphoscoliotic heart disease L5 99.96%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
9. visceral calciphylaxis L5 99.96%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
10. arterial thoracic outlet syndrome L5 99.95%
目前尚無針對此適應症的專門臨床研究。此為 TxGNN 模型預測結果，需進一步驗證。
資料來源：DDInter 2.0（原文內容請參閱該網站）
**青光眼** 🔴 Major
- 應謹慎使用本藥物。
**Cardiomyopathy, Hypertrophic** 🟡 Moderate
- 注意事項：Organic nitrates and nitrites may aggravate the angina associated with hypertrophic cardiomyopathy and should be administered cautiously in patients w...
**Myocardial Infarction** 🟢 Minor
- 不應使用本藥物。需定期監測。風險包括：低血壓。
**Anemia** 🟢 Minor
- 本藥物在此情況下禁用。風險包括：貧血。可能有嚴重不良反應。
**Diseases requiring hemodialysis** 🟢 Minor
- 風險包括：低血壓。可能危及生命。
**低血壓** 🟢 Minor
- 本藥物在此情況下禁用。需定期監測。風險包括：低血壓。可能有嚴重不良反應。
**Intracranial Hypertension** 🟢 Minor
- 風險包括：出血。
### 藥物-食物交互作用 (DFI)
資料來源：DDInter 2.0（原文內容請參閱該網站）
**酒精** 🟡 Moderate
- 影響：產生協同作用。
- 建議：建議避免併用。需監測療效或不良反應。
## 結論與下一步
**決策：Explore**
**理由：**
ISDN 對肺高壓的治療具有清晰的藥理機轉和豐富的文獻支持。多項研究顯示它能有效降低肺動脈壓力。然而，全身性血管擴張作用可能限制其在前毛細血管性肺高壓的應用。目前肺動脈高壓的標準治療已有更選擇性的藥物（如前列環素類似物、PDE5 抑制劑），ISDN 可能更適合作為輔助治療或特定亞群的替代選擇。
**若要推進需要：**
- 明確 ISDN 在不同類型肺高壓中的定位
- 與現有標準治療的比較研究
- 確定最佳給藥途徑（吸入 vs 口服 vs 靜脈）
- 長期安全性和耐受性數據
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---
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免責聲明
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
本報告僅供學術研究參考，不構成醫療建議。藥物使用請遵循醫師指示，切勿自行調整用藥。任何老藥新用決策需經過完整的臨床驗證與法規審查。
最後審核：2026-02-20 | 審核者：TwTxGNN Research Team
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