Isosorbide Mononitrate

Indications

Isosorbide Mononitrate is used for: Angina pectoris

Adult Dose

Oral Angina Pectoris Prevention of angina pectoris caused by coronary artery disease Adult: 20 mg 2-3 times daily. Dose may range from 20-120 mg daily. As LA form: One capsule once daily. Elderly: Intiate at lower doses.

Child Dose

Safety and efficacy not established

Renal Dose

Administration

Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).

Contra Indications

Severe hypotension or anaemia, hypovolaemia, heart failure due to obstruction, or raised intracranial pressure due to head trauma or cerebral haemorrhage.

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. Lactation: Unknown whether drug crosses into breast milk; use caution

Pregnancy-Lactation

Pregnancy category: C Lactation: Unknown whether drug crosses into breast milk; use caution

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.

Adverse Effects

Side effects of Isosorbide Mononitrate : 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.

Mechanism of Action

Isosorbide mononitrate relaxes vascular smooth muscles by stimulating cyclic-GMP. It decreases left ventricular pressure (preload) and arterial resistance (afterload).