isosorbide mononitrate


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isosorbide dinitrate

Angitak (UK), Apo-ISDN (CA), Cedocard (UK), Cedocard-SR (CA), Dilatrate-SR, Isochron, Isoket (UK), Isordil Titradose, Novo-Sorbide (CA), PMS-Isosorbide (CA), Soni-Slo SR, Sorbid

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.
References in periodicals archive ?
Of the eight drugs taken by the patient, isosorbide mononitrate was not considered to cause liver damage.
Overdoses of propafenone HCI, isosorbide mononitrate, morphine sulfate and dextroamphetamine sulfate can have serious or life-threatening consequences," says a company statement.
On the fifth day of their hospitalization for acute bleeding of esophageal varices, 144 patients with cirrhosis were randomized to either endoscopic ligation or treatment with the [beta]-blocker nadolol and the nitrate isosorbide mononitrate.
235 Kremers Urban Isosorbide mononitrate 54,370,259
has received Food and Drug Administration approval for isosorbide mononitrate, an angina drug that Schering-Plough Corp.
80mg, Tab Finasteride 5mg, Tab Folic Acid 5 mg Tab Glimepride 2 mg, Tab Glimipride 1mg, Tab Isosorbide Mononitrate 20mg, Tab Leflunamide 20mg, Tab Levofloxacin 500mg, Tab Losartan 50mg, Tab Vildagliptin 50mg, Tab Gliclazide 80mg, Tab Levetiracetam 500mg, Tab Linagliptin 5mg, etc.
Teva has also introduced isosorbide mononitrate tablets and prednisolone syrup USP, 15 mg.