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- What is isosorbide mononitrate, and how does it work (mechanism of action)?
- What brand names are available for isosorbide mononitrate?
- Is isosorbide mononitrate available as a generic drug?
- Do I need a prescription for isosorbide mononitrate?
- What are the side effects of isosorbide mononitrate?
- What is the dosage for isosorbide mononitrate?
- Which drugs or supplements interact with isosorbide mononitrate?
- Is isosorbide mononitrate safe to take if I'm pregnant or breastfeeding?
- What else should I know about isosorbide mononitrate?
What is isosorbide mononitrate, and how does it work (mechanism of action)?
Isosorbide mononitrate is in the class of drugs called nitrates that are used for treating and preventing angina. Other nitrates include nitroglycerin (Nitrostat, NitroQuick, Nitrolingual, Nitro-Dur and others) and isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron). Nitrates are vasodilators (dilators of blood vessels). Blood returning from the body in the veins must be pumped by the heart through the lungs and into the body's arteries against the high pressure in the arteries. In order to accomplish this work, the heart's muscle must produce and use energy ("fuel") which requires oxygen brought to the heart by the blood. The FDA approved isosorbide mononitrate in December 1991.
Angina pectoris (angina) or "heart pain" is due to an inadequate flow of blood (and oxygen) to the muscle of the heart. Nitrates, including isosorbide mononitrate, correct the imbalance between the flow of blood and oxygen to the heart and the work that the heart must do by dilating the arteries and veins in the body. Dilation of the veins reduces the amount of blood that returns to the heart that must be pumped. Dilation of the arteries lowers the pressure in the arteries against which the heart must pump. As a consequence of both effects, the heart works less and requires less blood and oxygen.
What brand names are available for isosorbide mononitrate?
Imdur (discontinued brand), Ismo (discontinued brand), Monoket
What are the side effects of isosorbide mononitrate?
Headaches are the most common side effect of isosorbide mononitrate and usually are dose related (increase with higher doses). Flushing may occur because isosorbide mononitrate dilates (enlarges) blood vessels. Isosorbide mononitrate may cause a severe drop in blood pressure when rising from a sitting position, causing:
To reduce the risk of low blood pressure, patients should rise slowly from a sitting position.
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What is the dosage for isosorbide mononitrate?
The recommended starting dose of isosorbide mononitrate is 5 to 10 mg of immediate release tablets twice daily. The dose can be increased to 10 mg twice daily after 2 to 3 days. The target does is 20 mg twice daily. The two doses should be administered 7 hours apart in order to avoid tolerance (decreased effect after several doses). The dose for extended release tablets is 30-240 mg once daily.
Which drugs or supplements interact with isosorbide mononitrate?
Sildenafil (Viagra), tadalafil (Cialis), avanafil (Stendra),and vardenafil (Levitra) increase the blood pressure lowering effects of isosorbide mononitrate and may cause excessive reductions in blood pressure. Therefore, patients taking isosorbide mononitrate should not receive sildenafil, tadalafil, avanafil or vardenafil.
Severe reductions in blood pressure, especially when changing posture (orthostatic hypotension), may occur when isosorbide mononitrate is combined with calcium channel blockers [for example, diltiazem (Cardizem, Dilacor, Tiazac and several others), verapamil (Calan, Verelan, Verelan PM, Isoptin, Isoptin SR, Covera-HS)], which also reduce blood pressure.
Is isosorbide mononitrate safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of isosorbide mononitrate in pregnant women..
It is not known if isosorbide mononitrate is excreted in human breast-milk
What else should I know about isosorbide mononitrate?
What preparations of isosorbide mononitrate are available?
Tablets (immediate release): 10, 20 mg. Tablets (extended release): 30, 60, 120 mg.
How should I keep isosorbide mononitrate stored?
Isosorbide mononitrate should be stored at room temperature, 15 C - 30 C (59 F - 86 F) in a tight, moisture- proof container.
Medically reviewed by Eni Williams; PharmD., Ph.D.
FDA Prescribing Information
Quick GuideHeart Disease: Symptoms, Signs, and Causes
Isosorbide mononitrate (Imdur, Ismo, Monoket) is in a class of drugs called nitrates. Isosorbide mononitrate (Imdur, Ismo, Monoket) is used to treat angina pectoris (heart pain, chest pain). Side effects, drug interactions, warnings and precautions, and safety during pregnancy should be reviewed prior to taking this medication.
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FDA Prescribing Information
Top isosorbide mononitrate Related ArticlesComplete List
Angina SymptomsAngina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
Chest PainChest pain is a common complaint by a patient in the ER. Causes of chest pain include broken or bruised ribs, pleurisy, pneumothorax, shingles, pneumonia, pulmonary embolism, angina, heart attack, costochondritis, pericarditis, aorta or aortic dissection, and reflux esophagitis. Diagnosis and treatment of chest pain depends upon the cause and clinical presentation of the patient's chest pain.
Congestive Heart Failure (CHF) OverviewCongestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Dizziness (Dizzy)Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include:
- low blood pressure,
- heart problems,
- dehydration, and
- other medical conditions.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
isosorbide dinitrateIsosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is a medication in the nitrate drug class. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. This medications comes in tablets, sustained release, and immediate release via sublingual administration. Side effects, drug interactions, and safety during pregnancy information should be reviewed prior to taking this medication.