Products
Isosorbide mononitrate was commercially available in the form of divisible extended-release tablets (Corangin). It was approved in many countries in 1987 and was withdrawn from the market in 2014. Other nitrates can be used as substitutes, such as isosorbide dinitrate.
Structure and properties
Isosorbide mononitrate (C6H9NO6, Mr = 191.1 g/mol) is an organic nitrate. It exists as a white crystalline powder that is readily soluble in water. Isosorbide mononitrate is a metabolite of isosorbide dinitrate and is closely related to it.
Effects
Isosorbide mononitrate (ATC C01DA14) has vasodilatory and antianginal properties.
Indications
- Treatment of coronary artery disease, prevention of attacks of angina pectoris, in pectanginal symptoms after myocardial infarction.
- Treatment of chronic heart failure (combination therapy).
Dosage
According to the professional information. The tablets are usually taken once a day and independently of meals.
Contraindications
Isosorbide mononitrate is contraindicated in hypersensitivity and in certain cardiovascular conditions (e.g., very low blood pressure, shock). It must not be combined with phosphodiesterase-5 inhibitors such as sildenafil (Viagra) because it may cause a dangerous drop in blood pressure. For complete precautions, see the drug label.
Interactions
Combination with phosphodiesterase-5 inhibitors is contraindicated. Other drugs that affect blood pressure may also cause drug-drug interactions, for example, antihypertensives and alcohol. Other interactions are possible with dihydroergotamine, acetylsalicylic acid, and NSAIDs.
Adverse effects
Possible adverse effects include headache, nausea, vomiting, flushing, fainting, dizziness, low blood pressure, and rapid pulse. The side effects are essentially a result of vasodilatation. Tolerance may develop with prolonged use.
