Isosorbide mononitrate is cleared by denitration to isosorbide and glucuronidation as the mononitrate, with 96% of the administered dose excreted in the urine within 5 days and only about 1% eliminated in the feces. At day 42, the 120 and 240 mg dose of Imdur Tablets demonstrated a significant increase in total treadmill time at 4 and 12 hours post dosing, but by day 42, the 30 and 60 mg doses no longer were differentiable from placebo.
Dose adjustments of either class of agents may be necessary.Nitrates and nitrites may interfere with the Zlatkis-Zak color reaction, causing falsely low readings in serum cholesterol determinations.No evidence of carcinogenicity was observed in rats exposed to isosorbide mononitrate in their diets at doses of up to 900 mg/kg/day for the first 6 months and 500 mg/kg/day for the remaining duration of a study in which males were dosed for up to 121 weeks and females were dosed for up to 137 weeks. This strategy is inappropriate for organic nitrates. Get your prescription refilled before you run out of medicine completely.Store at room temperature away from moisture, heat, and light. The increases in exercise tolerance on day 14, although statistically significant compared to placebo, were about half of that seen on day 1 of the trial.Imdur Tablets are indicated for the prevention of angina pectoris due to coronary artery disease. Isosorbide mononitrate is primarily metabolized by the liver, but unlike oral isosorbide dinitrate, it is not subject to first-pass metabolism.
Patients should resist the temptation to avoid headaches by altering the schedule of their treatment with isosorbide mononitrate, since loss of headache may be associated with simultaneous loss of antianginal efficacy.
Only after nitrates have been absent from the body for several hours has their antianginal efficacy been restored. Version: 13.01.The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. If you require BNF for Children, use Initially 20 mg 2–3 times a day, alternatively initially 40 mg twice daily, increased if necessary up to 120 mg daily in divided doses.Initially 10 mg twice daily, increased if necessary up to 120 mg daily in divided doses.Manufacturers advise avoid unless potential benefit outweighs risk.There can be variation in the licensing of different medicines containing the same drug.Forms available from special-order manufacturers include: oral suspension, oral solutionProphylaxis of angina (for patients who have not previously had a nitrate)Adjunct in congestive heart failure (for patients who have not previously had a nitrate) Hypotension induced by isosorbide mononitrate may be accompanied by paradoxical bradycardia and increased angina pectoris.Elderly patients may be more susceptible to hypotension and may be at a greater risk of falling at therapeutic doses of nitroglycerin.Nitrate therapy may aggravate the angina caused by hypertrophic cardiomyopathy, particularly in the elderly.The table below shows the frequencies of the adverse events that occurred in >5% of the subjects in three placebo-controlled North American studies in which patients in the active treatment arm received 30 mg, 60 mg, 120 mg, or 240 mg of isosorbide mononitrate as Imdur Tablets once daily. If generic versions of this product have been approved by the FDA, there may be Isosorbide mononitrate (ISMN), an organic nitrate and the major biologically active metabolite of isosorbide dinitrate (ISDN), is a vasodilator with effects on both arteries and veins.ISMN is a white, crystalline, odorless compound which is stable in air and in solution, has a melting point of about 90°C, and an optical rotation of +144° (2% in water, 20°C).Isosorbide mononitrate is freely soluble in water, ethanol, methanol, chloroform, ethyl acetate, and dichloromethane.The Imdur product is an oral extended-release formulation of ISMN, the major active metabolite of isosorbide dinitrate; most of the clinical activity of the dinitrate is attributable to the mononitrate.The principal pharmacological action of ISMN and all organic nitrates in general is relaxation of vascular smooth muscle, producing dilatation of peripheral arteries and veins, especially the latter.