Isosorbide mononitrate


Concise Prescribing Info
Indications/Uses
Long-term management of angina pectoris and heart failure.
Dosage/Direction for Use
Adult : PO 20 mg 2-3 times/day. Usual range: 20-120 mg/day.
Dosage Details
Oral
Management of angina, Heart failure
Adult: 20 mg 2-3 times daily. Dose may range from 20-120 mg daily.
Elderly: Intiate at lower doses.
Administration
Should be taken on an empty stomach.
Contraindications
Severe hypotension or anaemia, hypovolaemia, heart failure due to obstruction, or raised intracranial pressure due to head trauma or cerebral haemorrhage.
Special Precautions
Severe renal or severe hepatic impairment, hypothyroidism, malnutrition, or hypothermia. Caution in patients who are already hypotensive. May aggravate angina caused by hypertrophic cardiomyopathy. Tolerance may develop after long-term treatment. Lactation.
Adverse Reactions
Hypotension, tachycardia, flushing, headache, dizziness, palpitation, syncope, confusion. Nausea, vomiting, abdominal pain. Restlessness, weakness and vertigo. Dry mouth, chest pain, back pain, oedema, fatigue, abdominal pain, constipation, diarrhoea, dyspepsia and flatulence.
Potentially Fatal: Severe hypotension and cardiac failure.
Overdosage
Symptoms: Increased intracranial pressure, with or without persistent throbbing headache, confusion and moderate fever, vertigo, palpitations, visual disturbances, nausea and vomiting.
Drug Interactions
Hypotensive effects may be increased when used with alcohol or vasodilators. Concurrent use with calcium channel blockers may lead to marked orthostatic hypotension.
Potentially Fatal: Significant hypotension may occur when used with phosphodiesterase-5 inhibitors.
Lab Interference
False decrease in serum cholesterol.
Action
Description: Isosorbide mononitrate relaxes vascular smooth muscles by stimulating cyclic-GMP. It decreases left ventricular pressure (preload) and arterial resistance (afterload).
Onset: 20 min (oral as conventional tab).
Duration: 8-10 hr (oral as conventional tab).
Pharmacokinetics:
Absorption: Readily absorbed from the GIT (oral); peak plasma concentrations after 1 hr.
Distribution: Widely distributed: Smooth muscle cells of the blood vessels.
Metabolism: Converted to inactive metabolites including isosorbide and isosorbide glucuronide.
Excretion: Via urine (2% as unchanged); 4-5 hr (elimination half-life).
Storage
Store at 20-25°C.
MIMS Class
Disclaimer: This information is independently developed by MIMS based on Isosorbide mononitrate from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS 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 © 2020 MIMS. All rights reserved. Powered by MIMS.com
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