Isosorbide mononitrate oral

[eye-so-SOR-byd] Pregnancy Category: C

Imdur, ISMO, Monoket [Rx] Classification: Coronary vasodilator, antianginal drug

See also Antianginal Drugs—Nitrates/Nitrites and Isosorbide dini-trate.

■ Action/Kinetics: Isosorbide mononitrate is the major metabolite of isosorbide dinitrate. The mononitrate is not subject to first-pass metabolism. Bioavailability is nearly 100%. Onset: 30-60 min. tVi: About 5 hr. Uses: Prophylaxis of angina pectoris. Contraindications: To abort acute anginal attacks. Use in acute MI or CHF.

Special Concerns: Use with caution in clients who may be volume depleted or who are already hypoten-sive. Use with caution during lactation. Safety and effectiveness have not been determined in children. The benefits have not been established in acute MI or CHF. Side Effects: CV: Hypotension (may be accompanied by paradoxical bradycardia and increased angina pectoris). CNS: Headache, lightheadedness, dizziness. GI: N&V. Miscellaneous: Possibility of methemoglobine-mia.

Drug Interactions

Ethanol / Additive vasodilation Sildenafil citrate / T Risk for adverse cardiovascular events How Supplied: Tablet: 10 mg, 20 mg; Tablet, extended release: 30 mg, 60 mg, 120 mg

Dosage-

Imdur Tablets

Prophylaxis of angina. Initial: 30 mg (given as one-half of the 60-mg tablet) or 60 mg once daily; then, dosage may be increased to 120 mg given as 2—60-mg tablets once daily. Rarely, 240 mg daily may be needed.

ISMO, Monoket Tablets

Prevention and treatment of angina.

Adults: 20 mg b.i.d. with the doses 7 hr apart (it is preferable that first dose be given on awakening). An initial dose of 5 mg may be best for clients of small stature; the dose should then be increased to at least 10 mg by the second or third day of therapy.

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