Composition
Cap 20 mg/40 mg/ 50 mg/60 mg: Isosorbide mononitrate 20 mg/40 mg/50 mg/60 mg. Tab 10 mg/20 mg/40 mg/60 mg: Isosorbide mononitrate 10 mg/20 mg/40 mg/60 mg.
Indications & Dosage
Prophylaxis of angina, Adjunct in congestive heart failure: Adult: Initially 20 mg 2-3 times a day, alternatively initially 40 mg twice daily, increased if necessary up to 120 mg daily in divided doses. Prophylaxis of angina, Adjunct in congestive heart failure (for patients who have not previously had a nitrate): Adult: Initially 10 mg twice daily, increased if necessary up to 120 mg daily in divided doses. Children: Not recommended.
Contraindications
Hypersensitivity to nitrates; hypotensive conditions and hypovolaemia; hypertrophic cardiomyopathy; aortic stenosis; cardiac tamponade; constrictive pericarditis; mitral stenosis; toxic pulmonary oedema; head trauma; cerebral haemorrhage; cerebrovascular disease; marked anaemia.
Precautions
Hypothyroidism, malnutrition, hypothermia, recent history of myocardial infarction, heart failure due to obstruction, hypoxaemia or other ventilation and perfusion abnormalities, susceptibility to angle-closure glaucoma, metal-containing transdermal systems should be removed before magnetic resonance imaging procedures, cardioversion, or diathermy, avoid abrupt withdrawal, monitor blood pressure and heart rate during IV infusion.
Interactions
Sildenafil, tadalafil, vardenafil, ethanol, heparin, alteplase, ergot alkaloids.
Pregnancy
Caution advised, avoid unless potential benefit outweighs risk.
Lactation
Caution advised
Side Effects
Postural hypotension, tachycardia, paradoxical bradycardia, throbbing headache, dizziness, nausea, vomiting, heartburn, flushing, syncope, temporary hypoxaemia, rash. Rare: angle-closure glaucoma. Injection Specific side-effects include severe hypotension, diaphoresis, apprehension, restlessness, muscle twitching, retrosternal discomfort, palpitation, abdominal pain, prolonged administration has been associated with methaemoglobinaemia.