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Administration
Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
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Contraindications
Severe hypotension, hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, aortic or mitral valve stenosis, acute circulatory failure/shock, circulatory collapse, cardiogenic shock, acute MI with low left ventricular filling pressure, conditions associated with increased intracranial pressure (e.g. cerebral haemorrhage, head trauma), closed-angle glaucoma, marked anaemia, hypovolaemia. Concomitant use with phosphodiesterase-5 (PDE-5) inhibitors (e.g. sildenafil) or riociguat.
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Special Precautions
Patient with recent history of MI, inferior wall MI and suspected right ventricular infarctions; hypothyroidism, hypoxaemia, malnutrition, hypothermia. Not indicated for the treatment of acute angina attacks. Avoid abrupt withdrawal. Severe renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause dizziness, blurred vision, and postural hypotension; if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure and heart rate.
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Adverse Reactions
Significant: Severe hypotension accompanied by paradoxical bradycardia and increased angina pectoris; orthostatic hypotension, syncope; increased intracranial pressure; drug tolerance, CNS depression, headache.
Cardiac disorders: Tachycardia.
Ear and labyrinth disorders: Vertigo.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, gastrointestinal disturbance.
General disorders and administration site conditions: Asthenia, tiredness.
Nervous system disorders: Dizziness, restlessness.
Psychiatric disorders: Somnolence, sleep disturbance.
Skin and subcutaneous tissue disorders: Rash, pruritus, increased sweating.
Respiratory, thoracic and mediastinal disorders: Transient hypoxaemia.
Vascular disorders: Pallor, flushing.
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Drug Interactions
Increased risk of orthostatic hypotension with Ca channel blockers. Additive hypotensive effect with other vasodilators, β-blockers, angiotensin II receptor antagonists, ACE inhibitors, aldesleukin, alprostadil, and TCAs. May increase the plasma levels and hypertensive effects of dihydroergotamine.
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CIMS Class
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ATC Classification
C01DA14 - isosorbide mononitrate ; Belongs to the class of organic nitrate vasodilators. Used in the treatment of cardiac disease.
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