Isosorbide mononitrate + aspirin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult: PO Prophylaxis of myocardial infarction; Prophylaxis of angina Per tab contains isosorbide mononitrate (ISMN) 60 mg and aspirin 75 mg: 1-2 tab in the morning. Per tab contains ISMN 60 mg and aspirin 150 mg: 1 tab in the morning.
Contraindications
Aspirin: Active gastro-ulceration, hypothrombinaemia, hypersensitivity, patients with history of ulceration or dyspepsia, children <12 yr, bleeding diathesis (like haemophilia) and concurrent use of anticoagulants. ISMN: hypersensitivity, acute circulatory failure, cardiogenic shock, severe hypotension, obstructive hypertrophic cardiomyopathy, pericardiac tamponade, low filling pressure, aortic and/or mitral valve stenosis, diseases associated with raised intracranial pressure, glaucoma, arterial hypoxemia and cor pulmonale, constructive pericarditis, orthostatic disturbances of circulatory regulation.
Special Precautions
Infants with hyperbilirubinuria because of risk of kernicterus resulting from displacement of bilirubin from plasma albumin. Neonates, children, nursing mothers, elderly, volume depletion, hypotension. Hypotension induced by ISMN may be accompanied by paradoxical bradycardia and increased angina pectoris. Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy.
Adverse Reactions
Aspirin: Epigastric discomfort, gastric bleeding, rhinitis, urticaria, angioneurotic oedema, worsening of asthma, elevation of transaminases, hepatomegaly. Isosorbide mononitrate: Nausea, vomiting, urinary and faecal incontinence, abdominal pain, headache, apprehension, restlessness, weakness, vertigo, dizziness, tachycardia, palpitation, orthostatic hypotension.
Drug Interactions
Aspirin: Caution to be exercised while using aspirin with anticoagulants. Large doses of salicylates including aspirin may exert hypoglycaemic action and may enhance the effect of the oral hypoglycaemics. If necessary, the dosage of the hypoglycaemic agent must be reduced while the salicylate is given. This hypoglycaemic action may also affect the insulin requirements of diabetics. Aspirin may decrease the effects of probenecid, sulfinpyrazone and phenylbutazone. Sodium excretion produced by spironolactone may be decreased in the presence of salicylates. Alcohol and aspirin exhibit synergistic effect in causing GI bleeding. Risk of GI ulceration may be seen following concomitant admin of pyrazolone derivatives (phenylbutazone, oxyphenylbutazone and possibly, dipyrone) with aspirin. Urinary alkalisers may decrease aspirin effectiveness. Phenobarbital is likely to decrease aspirin effectiveness by enzyme induction. Aspirin is likely to increase the serum phenytoin levels. Aspirin's anti-inflammatory action may be decreased by propanolol probably by competing for the same receptors. Isosorbide mononitrate: Orthostatic hypotension may occur with combined use of calcium channel blockers, antihypertensive agents, phenothiazines and TCAs. Use of ISMN with alcohol may produce severe hypotension and collapse.
CIMS Class
ATC Classification
C01DA14 - isosorbide mononitrate ; Belongs to the class of organic nitrate vasodilators. Used in the treatment of cardiac disease.
Disclaimer: This information is independently developed by CIMS based on isosorbide mononitrate + aspirin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to CIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, CIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 CIMS. All rights reserved. Powered by CIMSAsia.com
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