Isosorbide Mononitrate 10mg Tabs

Isosorbide mononitrate is an organic nitrate that acts as a vasodilator. It is metabolized to nitric oxide (NO), which activates guanylate cyclase, increasing intracellular cyclic guanosine monophosphate (cGMP). This leads to dephosphorylation of myosin light chains, resulting in relaxation of vascular smooth muscle. The primary effect is venodilation, which reduces preload and myocardial oxygen demand. It also causes arterial dilation, reducing afterload and improving coronary blood flow.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Abnormal heartbeat (fast or slow)
New or worsening chest pain

Other Possible Side Effects

Like all medications, this drug can cause side effects. Although many people do not experience any side effects or only have mild ones, it is essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other symptoms that bother you or do not go away, contact your doctor:

Dizziness
Headaches (common when starting the medication, but often improves over time; do not adjust your dosage without consulting your doctor)
* Other side effects not listed here

If you have questions or concerns about side effects, consult your doctor for medical advice. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction and its symptoms.
If you have a history of heart failure, which means your heart is not pumping blood as well as it should.
If you have recently experienced a heart attack.
If you are currently taking any of the following medications: Avanafil, riociguat, sildenafil, tadalafil, or vardenafil.

Please note that this is not an exhaustive list of all potential interactions. To ensure your safety, it is crucial to discuss all of your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. This includes any health problems you may have. Before starting, stopping, or changing the dose of any medication, always consult with your doctor to confirm that it is safe to do so in conjunction with this medication.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

When starting this medication, avoid driving and other activities that require alertness until you understand how it affects you. To minimize the risk of dizziness or fainting, stand up slowly after sitting or lying down, and exercise caution when climbing stairs.

Follow your healthcare provider's instructions for monitoring your blood pressure. Additionally, be aware that this medication may interfere with certain laboratory tests, so it is crucial to notify all your healthcare providers and laboratory personnel that you are taking this drug.

Before consuming alcohol, consult with your doctor. If you experience new or worsening chest pain or pressure, seek immediate emergency medical attention.

Long-term, uninterrupted use of this medication can lead to reduced effectiveness, a phenomenon known as tolerance. To avoid this, ensure you have a daily "nitrate-free" period. If you notice the medication is not working as well as it previously did, discuss this with your doctor. Do not exceed the prescribed dosage.

If you are 65 years or older, use this medication with caution, as you may be more susceptible to side effects.

If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor to discuss the potential benefits and risks to both you and your baby.

• Phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil, vardenafil, avanafil) - concurrent use can cause profound and prolonged hypotension.

• Riociguat (soluble guanylate cyclase stimulator) - concurrent use can cause severe hypotension.
• Other vasodilators (e.g., alpha-blockers, calcium channel blockers, other antihypertensives) - may potentiate hypotensive effects.
• Alcohol - may potentiate hypotensive effects.

• Ergot alkaloids (e.g., ergotamine) - nitrates may reduce the anti-migraine effect of ergot alkaloids.
• Sapropterin - may increase hypotensive effects.

• Headache (common, often transient)
• Dizziness or lightheadedness (especially upon standing)
• Flushing
• Nausea
• Hypotension symptoms (e.g., blurred vision, weakness, syncope)

Pregnancy Category C. Animal studies have shown adverse effects on the fetus, but there are no adequate and well-controlled studies in pregnant women. Use only if the potential benefit justifies the potential risk to the fetus.

It is not known whether isosorbide mononitrate is excreted in human milk. Caution should be exercised when administered to a nursing mother. The decision to breastfeed during therapy should consider the potential for infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.

Safety and effectiveness in pediatric patients have not been established. Not recommended for routine use in children.

Elderly patients may be more susceptible to the hypotensive effects of nitrates. Start with lower doses and titrate carefully, monitoring blood pressure closely.

• To prevent nitrate tolerance, immediate-release isosorbide mononitrate should be dosed to allow for a daily nitrate-free interval (e.g., 7 hours between doses).
• Headache is a very common side effect, especially at the beginning of therapy. It often diminishes with continued use. Patients should be counseled that this indicates the drug is working.
• This medication is for prophylaxis of angina, not for acute relief. Patients should have sublingual nitroglycerin for acute attacks.
• Counsel patients on the absolute contraindication with PDE5 inhibitors (e.g., Viagra, Cialis) due to the risk of severe, life-threatening hypotension.
• Patients should be advised to avoid alcohol due to additive hypotensive effects.

• Beta-blockers (e.g., metoprolol, atenolol)
• Calcium channel blockers (e.g., amlodipine, diltiazem, verapamil)
• Ranolazine
• Long-acting nitrates (e.g., isosorbide dinitrate, nitroglycerin patches)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further evaluation and guidance. To ensure your safety and the effectiveness of your treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider for clarification. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.