PROPERTIES:
Isosorbide mononitrate is a vasodilator with general properties similar to those ofglyceiyl trinitrate. It is an active metabolite of the isosorbide dinitrate.
PHARMACOKINETICS:
Isosorbide mononitrate is rapidly absorbed from the gastro-mtestinal tract, peak plasma levels are reached in about 1 hour; onset of action occurs with 20 minutes and lasts for about 8-10 hours. Isosorbide mononitrate dose not undergo first-pass hepatic metabolism, and bioavilability is nearly 100%. It iswidefy distributed. Only about 2 % of Isosorbide mononitrate is excreted unchanged in the urine, an elimination half-life of about 4-5 hours.
INDICATIONS:
Mononitrate is used for the prophylaxis and treatment of coronary insufficiency disease, angina, andmyocardial infarction.
CONTRAINDICATIONS:
Hypersensitivity to the drug
Severe hypotension, hypovolaemia
Raised intracranial pressure due to head trauma or cerebral hemorrhage
Closed-angle glaucoma
Acute stage ofmyocardial infarction.
SIDE EFFECTS:
Flushing of the face, dizziness, tachycardia, and headache (the most common side effect ofMononitrat which usually decreases after a few days ).
Large doses cause vomiting, restlessness, syncope, and postural "hypotension.
PRECAUTIONS:
Mononitrat should be used with caution in patients with severe impairment
renal or hepatic function, and hypothyroidism.
Mononitrat could be used during pregnancy only if potential benefit justifies the potential risk to the fetus.
Mononitrat should be used with caution in nursing women.
Mononitrat may cause severe hypotension (dizziness, tachycardia, sweating, and syncope).
DRUG INTERACTIONS:
Alcohol enhances the effects ofMononitrat
Care should be taken and dose adjustment may be necessary when Mononitrat
and calcium channel blocker are used together.
DOSAGE AND ADMINISTRATION:
40mg 1-3 times daily up to 120mg daily .