isosorbide mononitrate

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isosorbide mononitrate

Angeze (UK), Chemydur (UK), Cibral (UK), Cibral XL (UK), Dynamin (UK), Dynamin XL (UK), Elantan (UK), Elantan LA (UK), Imazin XL (UK), Imdur (UK), Imo LA (UK), Isib (UK), ISMO (UK), Isodur (UK), Ketanodur (UK), Modisal (UK), Monigen (UK), Monigen XL (UK), Monit (UK), Monit LS (UK), Monoket (UK), Monomax (UK), Monomax SR (UK), Monomax XL (UK), Monomil (UK), Monosorb (UK), Trangina (UK), Trangina XL (UK), Xismox (UK), Zemon (UK), Zemon XL (UK)

Pharmacologic class: Nitrate

Therapeutic class: Antianginal

Pregnancy risk category C

Action

Promotes peripheral vasodilation and reduces preload and afterload, decreasing myocardial oxygen consumption and increasing cardiac output. Also dilates coronary arteries, increasing blood flow and improving collateral circulation.

Availability

isosorbide dinitrate

Capsules: 40 mg

Capsules (extended-release): 40 mg

Tablets: 2.5 mg, 5 mg, 10 mg, 20 mg, 30 mg, 40 mg

Tablets (chewable): 5 mg, 10 mg

Tablets (extended-release): 20 mg, 40 mg

Tablets (sublingual): 2.5 mg, 5 mg, 10 mg

isosorbide mononitrate

Tablets: 10 mg, 20 mg

Tablets (extended-release): 30 mg, 60 mg, 120 mg

Indications and dosages

Treatment and prophylaxis in situations likely to provoke acute angina pectoris

Adults: 2.5 to 5 mg S.L. May repeat dose q 5 to 10 minutes for a total of three doses in 15 to 30 minutes.

Prophylaxis of angina pectoris

Adults: 5 to 40 mg P.O. (dinitrate conventional tablets) two to three times daily. Or 5 to 20 mg (mononitrate conventional tablets) b.i.d. Or 30 to 60 mg (mononitrate extended-release tablets) once daily. After several days, dosage may be increased to 120 mg (given as single 120-mg tablet or two 60-mg tablets) once daily. Rarely, 240 mg/day (mononitrate extended-release tablets) may be needed.

Off-label uses

• Heart failure

Contraindications

• Hypersensitivity to drug
• Severe anemia
• Acute myocardial infarction
• Angle-closure glaucoma
• Concurrent sildenafil therapy

Precautions

Use cautiously in:
• head trauma, volume depletion
• elderly patients
• pregnant or breastfeeding patients
• children.

Administration

• Give oral form 30 minutes before or 1 to 2 hours after a meal. Make sure patient swallows tablets or capsules whole.
• Have patient wet S.L. tablet with saliva before placing it under tongue. To avoid tingling sensation, have him place tablet in buccal pouch.

Adverse reactions

CNS: dizziness, headache, apprehension, asthenia, syncope

CV: orthostatic hypotension, tachycardia, paradoxical bradycardia, rebound hypertension

EENT: sublingual burning (with S.L. route)

GI: nausea, vomiting, dry mouth, abdominal pain

Skin: flushing

Interactions

Drug-drug.Aspirin: increased isosorbide blood level and effects

Beta-adrenergic blockers, calcium channel blockers, phenothiazines: additive hypotension

Dihydroergotamine: antagonism of dihydroergotamine effects

Sildenafil: severe and potentially fatal hypotension

Drug-diagnostic tests.Cholesterol: decreased level

Methemoglobin, urine vanillylmandelic acid: increased levels

Patient monitoring

• Monitor ECG and vital signs closely, especially blood pressure.

In suspected overdose, assess for signs and symptoms of increased intracranial pressure.
• Monitor arterial blood gas values and methemoglobin levels.

Patient teaching

• Teach patient to take oral drug 30 minutes before or 1 to 2 hours after a meal.
• Inform patient that drug may cause headache. Advise him to treat headache as usual and not to alter drug schedule. If headache persists, tell him to contact prescriber.
• Instruct patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure decrease.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and tests mentioned above.

isosorbide mononitrate

an active metabolite of isosorbide dinitrate, having the same actions and uses. It is administered orally.

isosorbide mononitrate

A drug used to treat ANGINA PECTORIS and HEART FAILURE. Brand names are Elantan, Imdur, Isib 60XL, Ismo, MCR-50, Monit, Mono-Cedocard and Monomax SR.

isosorbide mononitrate (ī´sōsor´-bīd mon´ōnī´trāt),

n brand name: ISMO;
drug class: antianginal, organic nitrate;
action: decreases preload/afterload, which is responsible for decreasing left ventricular end-diastolic pressure, systemic vascular resistance; arterial and venous dilation;
use: prevention of angina pectoris caused by coronary artery disease.
References in periodicals archive ?
Using the description in the ancient Hellenic legend for Cadmus and Harmony, we can make a lot of connections between the Balkans and Egypt, and we can make a reconstruction of the migration waves of Egyptians in the Balkans, especially for those who are in the present territory of Albania," said Rubin Zemon, an assistant professor of anthropology and humanities at the University of Information Science and Technology (UIST) "St Paul the Apostle" in Macedonia.
Here Fogleman adds depth and nuance to the kinds of experiences and encounters in Suriname described by Richard Price and Natalie Zemon Davis and in the Danish Caribbean islands by Jon Sensbach.
Continue reading "Natalie Zemon Davis on Jewish Slaveowners Celebrating Passover in 17th-Century Suriname" at.
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Beginning in the mid-1970s, however, such feminist historians as Natalie Zemon Davis favored populist history over the study of women worthies (p.
Dem kleinen Buch fehlt es an dem, was die amerikanische Historikerin Natalie Zemon Davies einmal als "global consciousness" bezeichnet und eingefordert hat.
As historian Natalie Zemon Davis reminds us, from at least the days of Herodotus and Thucydides, poetry and prose, storytelling and history, have had a complementary but tension-filled relationship whose "distinctions were often blurred in practice.
Cette synthese s'inscrit dans la foulee des grandes etudes de Daniel Roche, Arlette Farge, Jean Delumeau, Jean Nicolas et Natalie Zemon Davis.
Asi se fue consolidando un campo especifico de la historia de las mujeres gracias al esfuerzo academico de Gerda Lerner, Natalie Zemon Davies, Mary Hartman, Lois Banner, Renata Bridenthal, Claudia Koonz, Sheila Rowbotham, Judith Bennet y Nora Nash, entre otras.
Natalie Zemon (1956: 101) nos explica que en Holbein, la Muerte se encuentra con su victima en medio del ambiente y actividades que la persona viva realiza.
This, to a degree, undermines the historiographical construction of the patriarchal society but Wilson admits that the evidence to prove whether the ritual, as Natalie Zemon Davis long ago suggested, was a moment when women as a group were on top is fragmentary at best.
40) posits anthropology and history as antithetical, and ignores their productive interplay in works by notable historians like Natalie Zemon Davis, and luminary anthropologists like James Clifford.