Elimination: Excreted primarily by kidneys. Metabolism: Metabolized in liver by denitration and conjugation to inactive metabolites. Duration: Regular release 5≡2 h sustained release 12 h. Peak: Regular release 30≦0 min sustained release 3≤ h. Pharmacokinetics Absorption: Completely and rapidly absorbed from GI tract 93% reaches systemic circulation. calcium channel blockers may cause orthostatic hypotension. Aspirin may increase nitrate serum levels. Interactions Drug: Alcohol may cause severe hypotension and cardiovascular collapse. Special Senses: Diplopia, blurred vision, photophobia, conjunctivitis. Skin: Rash, pruritus, hot flashes, acne, abnormal texture. Respiratory: Bronchitis, pneumonia, upper respiratory tract infection, nasal congestion, bronchospasm, coughing, dyspnea, rales, rhinitis. GU: Renal calculus, UTI, atrophic vaginitis, dysuria, polyuria, urinary frequency, decreased libido, impotence. GI: Nausea, vomiting, dry mouth, abdominal pain, constipation, diarrhea, dyspepsia, flatulence, tenesmus, gastric ulcer, hemorrhoids, Hematologic: Hypochromic anemia, purpura, thrombocytopenia, methemoglobinemia (high doses). CV: Aggravation of angina, abnormal heart sounds, murmurs, MI, transient hypotension, palpitations. Migraine headache, paresthesia, vertigo, ptosis, tremor. Store sustained release tablets in a tight container.Īdverse Effects ( 1%) CNS: Headache, agitation, anxiety, confusion, loss of coordination, hypoesthesia, hypokinesia, insomnia or somnolence, nervousness,.Give first dose in morning on arising and second dose 7 h later with twice daily dosing regimen.Up to 120 mg once daily after several days if needed (max: dose 240 mg) 7 h apart Sustained release (Imdur) 30≦0 mg every morning, may increase Route & Dosage Prevention of AnginaĪdult: PO Regular release (ISMO, Monoket) 20 mg b.i.d. Hypersensitivity to nitrates severe anemia closed-angle glaucoma, postural hypotension, head trauma, cerebral hemorrhage With antianginal and antiischemic effects. It is equally or more effective than isosorbide dinitrate in the treatment of chronic, stable angina. With a consequent reduction in myocardial oxygen consumption. It decreases preloadĪs measured by pulmonary capillary wedge pressure (PCWP), and left ventricular end volume and diastolic pressure (LVEDV), Isosorbide mononitrate is a long-acting metabolite of the coronary vasodilator isosorbide dinitrate. Pregnancy Category: C (category B for sustained release form)ġ0 mg, 20 mg tablets 30 mg, 60 mg, 120 mg sustained release tablets Actions ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATEĬlassifications: cardiovascular agent nitrate vasodilator

Isosorbide mononitrate er