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
Indication
Angina pectoris
Contra Indication
Severe hypotension or anaemia, hypovolaemia, heart failure due to obstruction, or raised intracranial pressure due to head trauma or cerebral haemorrhage.
Dose
N/A
Side Effect
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.
Pregnancy Category
Name :
C
Description
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
Mode of Action
Isosorbide mononitrate relaxes vascular smooth muscles by stimulating cyclic-GMP. It decreases left ventricular pressure (preload) and arterial resistance (afterload).
Interaction
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.
Pregnancy Category Note
Pregnancy category: C
Lactation: Unknown whether drug crosses into breast milk; use caution
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
N/A
Administration
Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
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