| name | Isosorbide Mononitrate |
| classification | Nitrate, Antianginal |
| pharmacokinetics | Isosorbide mononitrate is rapidly absorbed from the gastrointestinal tract. Maximum plasma concentrations are typically reached within 1-2 hours. It's primarily metabolized in the liver, and the active metabolite, isosorbide dinitrate, is formed. The drug is primarily excreted via the kidneys as metabolites. The bioavailability of isosorbide mononitrate is generally high. However, individual variations in metabolism can affect its pharmacokinetics. |
| suggested dosage | | male 25 70kg | | initial | Typically 10-20 mg every 8 hours. Adjust dosage based on patient response and tolerance. | | maintenance | Titrate dose to achieve optimal symptom control. May require 20-40 mg every 8 hours, or 30-60 mg once daily in sustained release formulations. |
| | important note | Dosage adjustments may be required based on individual patient needs and the severity of their condition. Always consult with a physician for appropriate dosing recommendations. |
|
| indications | Isosorbide mononitrate is primarily used to prevent angina pectoris (chest pain) and improve exercise tolerance. It works by relaxing blood vessels, increasing blood flow to the heart, and decreasing workload on the heart. |
| safety in pregnancy | Limited data available; use with caution and only when the potential benefit outweighs the potential risk. Consult with a physician during pregnancy. Use of nitrates during pregnancy should be carefully considered due to potential effects on the fetus. |
| safety in breastfeeding | Limited data available; use with caution and only when the potential benefit outweighs the potential risk. Consult with a physician. The drug may be excreted in breast milk. |
| side effects | | 1 | Headache (common, often transient, usually responds to continued use) | | 2 | Hypotension (low blood pressure) | | 3 | Lightheadedness/dizziness | | 4 | Flushing | | 5 | Nausea | | 6 | Tachycardia (increased heart rate) | | 7 | Fatigue | | 8 | Postural hypotension (low blood pressure upon standing) | | 9 | Syncope (fainting) | | 10 | Serious allergic reactions (rash, hives, swelling) |
|
| alternatives | |
| contraindications | | 1 | Hypersensitivity to isosorbide mononitrate or related compounds | | 2 | Severe anemia | | 3 | Severe hypotension | | 4 | Known significant autonomic dysfunction | | 5 | Recent significant coronary artery bypass graft surgery (CABG). | | 6 | Concurrent use of other vasodilating agents (e.g., PDE5 inhibitors). (Requires careful monitoring and specialist consultation) |
|
| interactions | | 1 | | drug class | PDE5 Inhibitors (e.g., sildenafil, tadalafil) | | interaction description | Significant risk of severe hypotension. Avoid concurrent use unless specifically advised and monitored by a physician. |
| | 2 | | drug class | Alcohol | | interaction description | May increase hypotensive effects. |
| | 3 | | drug class | Other vasodilators | | interaction description | Additive effects on blood pressure lowering; use cautiously. |
|
|
| warnings and precautions | | 1 | Take with caution in patients with renal or hepatic impairment. | | 2 | Monitor blood pressure closely, especially during initiation of therapy. | | 3 | Patients with a history of heart disease should be closely monitored. | | 4 | Avoid abrupt cessation of therapy. | | 5 | Do not take with recreational drugs as this can be dangerous. |
|
| additional informations | Sustained-release formulations may cause gastric upset. Always take with food for better absorption. |
| important disclaimer | This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment. |
