Imdur

Generic name: Isosorbide Mononitrate

Isosorbide Mononitrate tablets or extended-release tablets

What are isosorbide mononitrate tablets or extended-release tablets?

ISOSORBIDE MONONITRATE (Ismo., Imdur®, Monoket®) is a type of vasodilator. It relaxes blood vessels, increasing the blood and oxygen supply to your heart. It is effective in the long-term treatment of angina associated with coronary artery disease. Generic isosorbide mononitrate is available.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• anemia
• dizziness or fainting spells when rising from a sitting position
• glaucoma
• head injury, recent stroke, or bleeding in the brain
• low blood pressure, or low blood volume
• previous heart attack
• overactive thyroid
• stomach or intestinal disease
• an unusual or allergic reaction to isosorbide dinitrate, other medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I take this medicine?

Take isosorbide tablets by mouth. Follow the directions on the prescription label. Unless your prescriber or health care professional tells you otherwise for the regular tablets (Ismo®), take the first dose when you get up in the morning and the second dose about 7 hours later. Swallow regular tablets with a drink of water. Unless your prescriber or health care professional tells you otherwise for the sustained-release tablets (Imdur®), take once a day when you get up in the morning. Swallow sustained-release tablets whole; do not crush or chew. Take isosorbide mononitrate on an empty stomach, 1 hour before or 2 hours after food. Take at regular intervals. Try to take your doses at the same time each day, and continue to take them even if you feel better. It can take several weeks or longer to see the full effects of this medicine. Do not stop taking except on your prescriber's advice. Do not take your medicine more often than directed.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose (less than 6 hours for regular tablets or 12 hours for sustained-release tablets), take only that dose. Do not take double or extra doses.

What drug(s) may interact with isosorbide mononitrate?

• acetylcholine
• alcohol
• aspirin
• beta-blockers, often used for high blood pressure or heart problems
• histamine
• medicines for colds and breathing difficulties
• medicines for high blood pressure
• medicines for mental problems or psychotic disturbances
• medicines for pain
• sildenafil (Viagra®)
• tadalafil (Cialis®)
• vardenafil (Levitra®)
• water pills

Viagra® (sildenafil), Cialis® (tadalafil), or Levitra® (vardenafil) should not be taken with this medication to avoid severe side effects including very low blood pressure and other complications.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What side effects may I notice from taking isosorbide mononitrate?

Side effects that you should report to your prescriber or health care professional as soon as possible:

• bluish discoloration of lips, fingernails, or palms of hands
• dizziness or fainting
• dry mouth
• irregular heartbeat, palpitations
• low blood pressure
• skin rash
• sweating
• the feeling of extreme pressure in the head
• unusual tiredness or weakness

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):

• flushing of the face or neck
• headache
• nausea, vomiting

What should I watch for while taking isosorbide mononitrate?

Check your heart rate and blood pressure regularly while you are taking isosorbide mononitrate. Ask your prescriber or health care professional what your heart rate and blood pressure should be and when you should contact him or her. Tell your prescriber or health care professional if you feel your medicine is no longer having any effect.

You may get dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how isosorbide mononitrate affects you. To reduce the risk of dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Alcohol can make you more dizzy, and increase flushing and rapid heartbeats. Avoid alcoholic drinks.

Do not stop taking isosorbide mononitrate suddenly or your symptoms may get worse. Ask your prescriber or health care professional how to gradually reduce the dose.

Where can I keep my medicine?

Keep out of the reach of children.

Store between 15 and 30 degrees C (59 and 86 degrees F). Keep container tightly closed. Throw away any unused medicine after the expiration date.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.