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Isosorbide Mononitrate ER
Isosorbide Mononitrate ER (extended-release) is a nitrate medication primarily used for the prevention of angina pectoris (chest pain) due to coronary artery disease. It works by dilating blood vessels, which reduces the heart's workload and improves blood flow to the heart muscle.
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Frequently Asked Questions
How long does it take for Isosorbide Mononitrate ER to start working?
Isosorbide Mononitrate ER usually starts to work within 30 minutes to 1 hour after administration, with peak effects occurring several hours later.
Can I take Isosorbide Mononitrate ER with other medications?
Always consult your healthcare provider before combining Isosorbide Mononitrate ER with other medications, especially phosphodiesterase inhibitors or other antihypertensives.
What should I do if I miss a dose of Isosorbide Mononitrate ER?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Is it safe to use Isosorbide Mononitrate ER during pregnancy?
Isosorbide Mononitrate ER should be used during pregnancy only if clearly needed, and the risks and benefits should be discussed with a healthcare provider.
Can Isosorbide Mononitrate ER cause weight gain?
Weight gain is not a common side effect of Isosorbide Mononitrate ER. Any significant changes in weight should be discussed with a healthcare provider.
Comprehensive Drug Guide
How Does Isosorbide Mononitrate ER Work?
Isosorbide mononitrate acts by relaxing and dilating blood vessels through the release of nitric oxide. This reduces the amount of blood returning to the heart (preload) and decreases the oxygen demand of the heart, thus alleviating angina symptoms.
Common Dosages
- Extended-release tablets: Common dosages include 30 mg, 60 mg, and 120 mg.
Typical Dosing
- The usual starting dose is 30 mg taken once daily in the morning. The dose may be increased based on clinical response, with a typical maintenance dose ranging from 30 mg to 120 mg.
Typical Dosing
FDA Approved Indications
- Prevention of angina pectoris due to coronary artery disease.
Who Shouldn't Take Isosorbide Mononitrate ER?
- Known hypersensitivity to isosorbide mononitrate or any components of the formulation
- Severe anemia
- Increased intracranial pressure
- Concurrent use with phosphodiesterase inhibitors (e.g., sildenafil, tadalafil) due to the risk of severe hypotension
Advice From The Pharmacist
- Patients should be advised to take isosorbide mononitrate ER at the same time each day to maintain consistent blood levels.
- Encourage patients to avoid sudden discontinuation of the medication, as this may lead to rebound angina.
- Inform patients about the possibility of headaches as a common side effect and advise them to manage these with over-the-counter analgesics as needed.
Side Effects of Isosorbide Mononitrate ER
Common Side Effects
- Headache
- Dizziness or lightheadedness
- Flushing
- Nausea
- Fatigue
Uncommon/Severe Side Effects
- Severe hypotension (low blood pressure)
- Tachycardia (rapid heartbeat)
- Allergic reactions (anaphylaxis)
Risks and Warnings of Isosorbide Mononitrate ER
- Cardiovascular Risks: Monitor blood pressure regularly, especially after initiation or dose adjustment.
- Tolerance: Patients may develop tolerance to nitrates over time, which can reduce effectiveness. A nitrate-free interval may be beneficial to prevent tolerance.
Interactions with Isosorbide Mononitrate ER
Common Drug Interactions
- Phosphodiesterase Inhibitors: Concurrent use can lead to severe hypotension and should be avoided.
- Other Antihypertensives: Caution is advised as combined use may enhance the blood pressure-lowering effects.
Alternatives to Isosorbide Mononitrate ER
- Other Nitrates: Such as nitroglycerin for acute angina relief.
- Beta-blockers: For managing angina and reducing heart workload.
- Calcium Channel Blockers: For angina management.
