Front Desk: 469-391-0070
Isosorbide Mononitrate: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Isosorbide mononitrate is a medication primarily used to prevent chest pain (angina) and manage heart conditions such as heart failure and coronary artery disease. It works by relaxing blood vessels, which improves blood flow to the heart. Depending on your condition, it is typically taken once or twice daily. Always consult your healthcare provider before making any changes to your medication regimen.
Names of Medication
US Brand Name: Imdur (Isosorbide Mononitrate)
The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, “Isosorbide Mononitrate” is the generic name.
Pharmacologic Category
Nitrates
Antianginal agents
Isosorbide Mononitrate Dosage
Isosorbide mononitrate is prescribed for various heart-related conditions. Your doctor will determine the appropriate dose based on your specific needs. Do not adjust your dose without consulting your healthcare provider. If you need to speak with a doctor, you can schedule a telemedicine appointment with us.
Angina Pectoris (Chest Pain)
Initial dose: 30-60 mg once daily in the morning
Maintenance dose: 30-120 mg once daily
Length of treatment: Long-term, as directed by your doctor
Heart Failure
Initial dose: 20 mg twice daily
Maintenance dose: 40 mg twice daily
Length of treatment: Long-term, as directed by your doctor
Coronary Artery Disease (CAD)
Initial dose: 30-60 mg once daily
Maintenance dose: 30-120 mg once daily
Length of treatment: Long-term, as directed by your doctor
Myocardial Infarction (Heart Attack)
Initial dose: 20 mg twice daily
Maintenance dose: 40 mg twice daily
Length of treatment: Long-term, as directed by your doctor
Hypertension (High Blood Pressure)
Initial dose: 20 mg twice daily
Maintenance dose: 40 mg twice daily
Length of treatment: Long-term, as directed by your doctor
Atherosclerosis
Initial dose: 30-60 mg once daily
Maintenance dose: 30-120 mg once daily
Length of treatment: Long-term, as directed by your doctor
Pulmonary Hypertension
Initial dose: 20 mg twice daily
Maintenance dose: 40 mg twice daily
Length of treatment: Long-term, as directed by your doctor
Ischemic Heart Disease
Initial dose: 30-60 mg once daily
Maintenance dose: 30-120 mg once daily
Length of treatment: Long-term, as directed by your doctor
Stable Angina
Initial dose: 30-60 mg once daily
Maintenance dose: 30-120 mg once daily
Length of treatment: Long-term, as directed by your doctor
Unstable Angina
Initial dose: 20 mg twice daily
Maintenance dose: 40 mg twice daily
Length of treatment: Long-term, as directed by your doctor
Dosage Forms and Strengths
Tablets, Extended-Release: 30 mg, 60 mg, 120 mg
Tablets, Immediate-Release: 10 mg, 20 mg
Administration Instructions for Isosorbide Mononitrate
Take Isosorbide mononitrate exactly as prescribed by your doctor. Extended-release tablets are usually taken once daily in the morning, while immediate-release tablets are taken twice daily. Swallow the tablet whole with water. Do not crush or chew extended-release tablets, as this may cause the medication to be released too quickly. If you miss a dose, take it as soon as you remember, but avoid doubling up on doses. Always follow your doctor’s instructions carefully.
Contraindications
A contraindication is a specific condition where a medication should not be used because it may cause harm. It’s important to be aware of any contraindications before starting Isosorbide mononitrate.
Common Contraindications for Isosorbide Mononitrate
Severe Anemia: Isosorbide mononitrate can lower blood pressure, which may worsen symptoms in individuals with severe anemia (a condition where the blood lacks enough healthy red blood cells to carry oxygen).
Allergy to Nitrates: If you have had an allergic reaction to nitrates, such as nitroglycerin, you should not take Isosorbide mononitrate. Allergic reactions may include rash, swelling, or difficulty breathing.
Use of PDE-5 Inhibitors: Medications like sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) should not be taken with Isosorbide mononitrate. These drugs can cause a dangerous drop in blood pressure when combined with nitrates.
Acute Myocardial Infarction (Heart Attack): Isosorbide mononitrate is not recommended for the immediate treatment of a heart attack. It is intended for long-term management, not emergency situations.
Severe Hypotension (Low Blood Pressure): If you already have low blood pressure, Isosorbide mononitrate can exacerbate this condition, leading to dizziness, fainting, or even shock.
If you have any of these conditions, consult your healthcare provider before starting Isosorbide mononitrate. If you’re unsure, schedule a telemedicine appointment with one of our providers to discuss your health history and determine the best treatment plan for you.
Isosorbide Mononitrate Drug Interactions
Isosorbide mononitrate can interact with other medications, potentially increasing the risk of side effects or reducing the effectiveness of your treatment. Be sure to inform your healthcare provider about all medications you are currently taking, including over-the-counter drugs and supplements.
Medications that May Interact with Isosorbide Mononitrate
Sildenafil (Viagra): Combining these medications can cause a dangerous drop in blood pressure.
Tadalafil (Cialis): Like sildenafil, tadalafil can lead to severe hypotension when taken with Isosorbide mononitrate.
Vardenafil (Levitra): Another PDE-5 inhibitor that should not be used with Isosorbide mononitrate due to the risk of low blood pressure.
Riociguat (Adempas): This medication for pulmonary hypertension can also cause dangerously low blood pressure when combined with Isosorbide mononitrate.
Ergotamine (Ergomar): Used for migraines, this drug may increase the risk of side effects when taken with Isosorbide mononitrate.
If you are taking any of these medications, speak with your healthcare provider before starting Isosorbide mononitrate. You can easily schedule a telemedicine visit with one of our providers to review your medications and ensure your treatment is safe.
Isosorbide Mononitrate in Pregnancy
Is it safe to take Isosorbide mononitrate during pregnancy? The safety of Isosorbide mononitrate during pregnancy has not been extensively studied. It is classified as a Category C medication by the FDA, which means that while animal studies have shown some risk to the fetus, there are no well-controlled studies in humans. If you are pregnant or planning to become pregnant, it’s essential to discuss the potential risks and benefits of taking Isosorbide mononitrate with your healthcare provider. They can help you carefully weigh the benefits of the medication against any possible risks to your baby.
Isosorbide Mononitrate while Breastfeeding
Is it safe to take Isosorbide mononitrate while breastfeeding? There is limited information on whether Isosorbide mononitrate passes into breast milk. Given the lack of data, it’s important to consult your healthcare provider before using this medication while breastfeeding. They can help you determine if the benefits of taking Isosorbide mononitrate outweigh any potential risks to your baby.
Estimated Cost of Isosorbide Mononitrate Medication
The cost of a 30-day supply of Isosorbide mononitrate can vary depending on the dosage and the pharmacy. Without insurance, the estimated cost for a 30-day supply using a GoodRX coupon typically ranges from $10 to $20. Prices may fluctuate, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRX for the most up-to-date pricing.
Possible Alternatives to Isosorbide Mononitrate
If Isosorbide mononitrate isn’t the right option for you, there are other treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore these alternatives further.
Angina Pectoris
Alternative Medications: Nitroglycerin (Nitrostat), Beta-blockers (e.g., metoprolol), Calcium channel blockers (e.g., amlodipine)
Lifestyle Changes: Regular exercise, a heart-healthy diet, and stress management can help alleviate angina symptoms.
Heart Failure
Alternative Medications: ACE inhibitors (e.g., lisinopril), ARBs (e.g., losartan), Beta-blockers (e.g., carvedilol)
Lifestyle Changes: Reducing salt intake, maintaining a healthy weight, and engaging in regular physical activity can improve heart function.
Coronary Artery Disease
Alternative Medications: Statins (e.g., atorvastatin), Antiplatelet drugs (e.g., aspirin), Beta-blockers
Lifestyle Changes: Quitting smoking, following a balanced diet, and managing cholesterol levels can help prevent further artery blockage.
Myocardial Infarction (Heart Attack)
Alternative Medications: Aspirin, Beta-blockers, ACE inhibitors
Lifestyle Changes: Cardiac rehabilitation, a heart-healthy diet, and regular exercise can support recovery after a heart attack.
Hypertension (High Blood Pressure)
Alternative Medications: ACE inhibitors, ARBs, Diuretics (e.g., hydrochlorothiazide)
Lifestyle Changes: Reducing sodium intake, staying physically active, and managing stress can help lower blood pressure.
Atherosclerosis
Alternative Medications: Statins, Antiplatelet drugs, Antihypertensives
Lifestyle Changes: Quitting smoking, maintaining a healthy diet, and regular exercise can slow the progression of atherosclerosis.
Pulmonary Hypertension
Alternative Medications: Sildenafil (Revatio), Bosentan (Tracleer), Epoprostenol (Flolan)
Lifestyle Changes: Avoiding high altitudes and managing fluid intake can help alleviate symptoms.
Ischemic Heart Disease
Alternative Medications: Antiplatelet drugs, Statins, Beta-blockers
Lifestyle Changes: A heart-healthy diet, regular exercise, and quitting smoking can help manage ischemic heart disease.
Stable Angina
Alternative Medications: Nitroglycerin, Beta-blockers, Calcium channel blockers
Lifestyle Changes: Regular physical activity, a balanced diet, and stress management can help reduce symptoms of stable angina.
Unstable Angina
Alternative Medications: Antiplatelet drugs, Beta-blockers, ACE inhibitors
Lifestyle Changes: Immediate medical attention is crucial, but long-term lifestyle changes such as quitting smoking and managing cholesterol can help prevent future episodes.
Recent Updates on Isosorbide Mononitrate Research
Recent studies have focused on the long-term effectiveness of Isosorbide mononitrate in managing chronic heart conditions like angina and heart failure. A 2022 study published in the Journal of Cardiovascular Pharmacology found that Isosorbide mononitrate, when combined with other heart medications, can improve exercise tolerance and reduce the frequency of angina attacks in patients with stable angina. Ongoing research is also exploring the potential benefits of Isosorbide mononitrate in treating pulmonary hypertension, though more studies are needed to confirm its effectiveness in this area.
As new research emerges, it’s important to stay informed about your treatment options. You can always schedule a telemedicine appointment with one of our providers to discuss the latest findings and how they may impact your care.
