GENERIC NAME: isosorbide mononitrate
BRAND NAMES: Imdur, Ismo, Monoket
DRUG CLASS AND MECHANISM: The pain of coronary heart
disease
(angina) usually occurs when the heart requires more blood and
oxygen than
its blood vessels supplying the heart can deliver. The demand
for oxygen
can be reduced and pain prevented in one of two ways. First, by
dilating
the veins and allowing more blood to "pool." This
reduces the
amount of blood returning to the heart and hence the heart's work and
need for oxygen. Second, by dilating the arteries of the body
and reducing
the pressure within the arteries. This reduces the pressure
that the heart
has to pump against and hence the Heart's work and need
for oxygen.
Isosorbide mononitrate reduces angina by dilating both the
veins and the
arteries.
Isosorbide mononitrate also increases supply of oxygen to the
heart by
dilating the arteries which supply the heart itself. Isosorbide
mononitrate is in the class of drugs called anti-anginal
medications.
Isosorbide mononitrate is the chief metabolite of isosorbide
dinitrate,
and most of the activity of isosorbide dinitrate is due to its
metabolite,
isosorbide mononitrate.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: Uncoated tablets (10mg, 20mg); sustained-
action
tablets (60mg, 120mg).
STORAGE: Isosorbide mononitrate should be stored at room
temperature - 15-30°C (59-86°F) - in a tight moisture-
proof
container.
PRESCRIBED FOR: Isosorbide mononitrate is used for the
prevention of angina. It can be used to decrease the frequency
and
severity of anginal (chest pain) episodes and to reduce the
need for
sublingual (taken under the tongue) nitroglycerin.
DOSING: ISMO is taken twice daily, with the two doses
taken 7
hours apart. Imdur generally is taken once daily. Doses are not
changed in
patients with liver or kidney diseases.
DRUG INTERACTIONS: Since isosorbide mononitrate can
cause
hypotension (low blood pressure), other medications which can
reduce blood
pressure may produce additive effects causing serious drops in
blood
pressure. Such drugs might include those used to treat high
blood
pressure, some antidepressants; some anti-psychotics, quinidine,
procainamide, benzodiazepines such as diazepam (Valium) or
opiates (e.g.
morphine).
Since ethanol also may intensify the blood pressure lowering
effect of
isosorbide mononitrate, patients receiving isosorbide
mononitrate should
be advised to use ethanol with caution.
PREGNANCY: Since most persons who use isosorbide
mononitrate are
over 50 years of age, experience with use during pregnancy is
limited.
Isosorbide mononitrate can be used during pregnancy if the
physician
believes the benefits justify the potential and unknown risks
to the
fetus.
NURSING MOTHERS: It is not known if isosorbide
mononitrate is secreted in breast milk.
SIDE EFFECTS: Headaches are the most common side effect
and
usually are dose-related (increase with higher dosages).
Headaches may
occur in about 1 in 10 (10%) to 1 in 5 (20%) of all persons
taking
isosorbide mononitrate. Far less frequently, dizziness, nausea,
vomiting,
and palpitations occur.
Last Editorial Review: 12/31/1997
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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