Isosorbide Mononitrate

Brand names of isosorbide mononitrate

  • Elan
  • Elantan
  • Imdur
  • Ismo
  • Monoket

Isosorbide mononitrate belongs to a class of drugs known as nitrates and are used to treat as well as prevent angina (a medical condition characterized by excruciating attacks of spasmodic choking). Other medications in the class of nitrates comprise isosorbide dinitrate (Isordil Titradose, Isochron and Dilatrate - SR) and nitroglycerin (Nitrostat, Nitrolingual, NitroQuick, Nitro-Dur and a number of others). Basically, drugs belong to the class of nitrates are blood vessel dilators (vasodilators). It is important that the blood returning from the body to the heart through the veins needs to be pumped by the heart via the lungs and into the arteries of the body in opposition to the high pressure in the arteries. To bring about this task, it is essential for the muscle of the heart to produce and use energy. This energy is produced with the help of oxygen carried to the heart by the blood.

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Angina pectoris (an unexpected extreme pain in the chest, frequently together with feelings of suffocation) is caused owing to insufficient flow of blood carrying oxygen to the heart's muscle. All nitrates, counting isosorbide mononitrate, rectify the disparity between the stream of blood and oxygen to the heart and the job needed to be done by the heart by expanding the arteries as well as the veins in the body. Dilation or expansion of the veins lessens the amount of blood returning to the heart and hence, it needs to be pumped. In fact, the dilation of the arteries helps to reduce the pressure in the arteries in opposition of which the heart requires pumping blood. As a result of these two impacts, the work of the heart is lessened and, therefore, needs less blood as well as oxygen.

Things you need to tell your physician before taking isosorbide mononitrate

As in the case of using any other medicament, you need to adopt a number of precautions before you start your treatment with isosorbide mononitrate. Before taking this medication, it is important for you to tell your doctor if you have any allergic reaction to isosorbide mononitrate, any of its ingredients or any other medication. In addition, tell your doctor about all the prescription and non-prescription (over-the-counter) drugs as well as herbal products being used by you. Also inform your doctor if you are taking any vitamins, minerals or dietary supplements.

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Prior to taking isosorbide mononitrate, you should also tell your physician about your entire medical history, especially if you are suffering or have ever suffered from any heart ailment, liver or kidney diseases, high blood pressure (hypertension). Also tell your doctor if you have suffered a heart attack recently or are suffering from or have recently suffered from any brain hemorrhage or head injury. Especially inform your doctor if you are suffering from anemia (poor iron levels in the bloodstream) or hypoxemia (low oxygen levels in the blood) or have any thyroid problems. In addition, inform your doctor if you have glaucoma (enhance pressure within the eye), suffer from hypothermia (low body temperature) and/ or are suffering from poor nutrition.

Women who wish to take isosorbide mononitrate for their condition ought to tell their doctor if they are pregnant, planning to become pregnant or are breast feeding. On the other hand, males should inform their doctor if they are suffering from erectile dysfunction (ED) and whether they are taking any medication to treat this condition.

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Isosorbide mononitrate, which belongs to the class of drugs known as nitrates, is generally used to prevent angina (chest pain) in patients having specific heart conditions, for instance, coronary artery disease. Isosorbide mononitrate works by unwinding as well as dilating blood vessels in order to allow the blood to flow more effortlessly to the heart. However, it needs to be noted that isosorbide mononitrate dose provides relief from existing chest pain or angina that has already started. This medicine may be taken independently or taken along with other drugs to treat the symptoms of heart failure, for example, breathing trouble.

How to use isosorbide mononitrate

Isosorbide mononitrate is an oral medication that needs to be taken twice everyday or as prescribed by your doctor. The first dose of the medication should be taken in the morning when you wake up, while the second dose should be taken after an interval of seven hours. Remember to take the medication around the same time everyday. Do not take the medication in excess or in fewer amounts than what has been prescribed. Follow your doctor's instructions strictly while being treated with isosorbide mononitrate. In order to obtain the maximum benefit of taking isosorbide mononitrate, take the medication regularly. It is advisable not to discontinue the medication without prior consultation with your doctor. In fact, a number of conditions may actually deteriorate when patients stop taking isosorbide mononitrate suddenly. In fact, before stopping this medication, it is essential to decrease the dosage of isosorbide mononitrate gradually.

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While this is a rare occurrence, if isosorbide mononitrate is taken for a prolonged period, it may not work as effectively as desired. Therefore, it is best to change the dosing of the medication from time to time. If you find that the medication is not working well for you, tell your doctor about it. Especially, tell your doctor if your chest pain worsens or occurs more frequently even after taking this medication.

How isosorbide mononitrate works

Belonging to the family of drugs known as nitrates, isosorbide mononitrate works by unwinding/ dilating the smooth muscles of the blood vessels and improving the supplies of blood as well as oxygen to the heart. In addition, this medication also facilitates in lessening the workload of the heart and its requirement for oxygen.

Side effects

Less common

Possible interactions

Like most other medicaments, even isosorbide mononitrate is known to interact with a number of medicines, especially herbal products or minerals, alcohol, tobacco and marijuana. Hence, these substances should not be taken while you are being treated with isosorbide mononitrate. In addition, people taking this medication should avoid exposure to heat and cold. While exposure to hot environments may result is a considerable decline in the blood pressure of such patients, being in cold environments is likely to enhance the requirement for this medication as well as diminish the efficacy of isosorbide mononitrate. People taking isosorbide mononitrate should also avoid physical exertion and undertaking heavy exercises. Using this medication has the potential of enhancing your ability to be more energetic when you are not enduring the angina pain. Hence, it is advisable to exercise caution and avoid too much physical exertion.

It may be noted that using the herb hawthorn and co-enzyme Q10 have the aptitude to have an influence on the manner in which our heart functions. In effect, co-enzyme Q10 also has the potential to interact adversely when used concurrently with aspirin. On the other hand, the United States Food and Drug Administration (FDA) has approved the use of soy containing phytoestrogens, such as soy milk, tofu and others, for diminishing the risks of heart ailments provided they enclose a minimum of 6.35 grams of soy protein in each serving. It is important to note that patients having edema (an augmented fluid accumulation) due to heart weakness should never use couch grass or nettle. Although, hawthorn (the Crataegus type) is known to be beneficial for patients who have suffered heart failure, it should not be taken concurrently or combined with any heart medication. Nevertheless, it is important that you tell your doctor about all the herbal products you are taking as well as if you want to take any new herbal medicine while being treated with isosorbide mononitrate. It is advisable that you do not add any new medication to your list without prior consultation with your doctor.

People taking isosorbide mononitrate should avoid taking alcoholic beverages, as it may result in side effects of using this mediation. In fact, using alcoholic beverages while you are taking isosorbide mononitrate may enhance the blood pressure lowering effect of this medicine. Similarly smoking tobacco is also harmful for people taking isosorbide mononitrate and, hence, it should be avoided in all forms. Nicotine also has the ability to diminish the efficacy of the medication. Marijuana smoking too has the aptitude to reduce the efficacy of this medication and, at the same time, result in gentle to moderate enhancement in angina. In addition, it may possibly cause changes in electrocardiogram resulting in confusing reading.


Never discontinue taking abruptly, but consult your doctor first if you want to stop taking this medication for some reason. In fact, it is advisable to reduce the dosage of the medication gradually before you stop taking it at all. For instance, after a prolonged use of isosorbide mononitrate, you should decrease the dosage of the medication gradually over a period of two to four weeks before discontinuing with it.

Storage instructions

Isosorbide mononitrate should always be stored at room temperature ranging between 68°F and 77°F (20°C and 25°C). In addition, you should ensure that you store this medication in a dark and dry place. Never ever store this medication in your bathroom, which is mostly damp. Also take care to keep the medication in such a place, which is beyond the reach of children and pets.

If you want to discard the outdated medicines or those that are no longer needed, dispose of them in a proper and safe manner. If required, you may also consult your pharmacist or the neighborhood disposal company regarding how to discard the expired and unwanted medicines in a safe manner.


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