Ismo 10, 20mg Tablet (Isosorbide Mononitrate) | Monoket Alternative | Angina Relief & Heart Health Medication

Precautions

Ismo contains isosorbide mononitrate, a nitrate medicine that can lower blood pressure. Use it exactly as prescribed and discuss your medical history and current medicines with your healthcare professional.

Important Precautions

• Low blood pressure: Ismo can cause significant hypotension, particularly in people who are already hypotensive or dehydrated.

• Dizziness and fainting: A sudden fall in blood pressure can cause dizziness or fainting, especially when standing up.

• Heart conditions: Tell your doctor about existing heart disease, heart failure, recent heart attack, or other cardiovascular conditions.

• Hypertrophic cardiomyopathy: Nitrate therapy may worsen angina associated with hypertrophic cardiomyopathy.

• Older adults: Older people may be more susceptible to orthostatic hypotension and falls associated with vasodilator treatment.

• Alcohol: Alcohol can increase the blood-pressure-lowering effects of isosorbide mononitrate.

• Dehydration: Tell your healthcare professional if you have experienced significant fluid loss from vomiting, diarrhea, excessive sweating, or another condition.

• Allergy: Do not use Ismo if you have previously experienced an allergic or unusual reaction to isosorbide mononitrate or other organic nitrates.

• Do not stop suddenly without advice: Long-term nitrate treatment may lead to physiological adaptation, and your doctor should determine how treatment is changed or discontinued.

Most Important Precaution

Never combine Ismo with sildenafil or other PDE-5 inhibitors unless a healthcare professional specifically determines an appropriate treatment plan. The combination can cause a potentially severe and dangerous drop in blood pressure.

If you develop severe dizziness, fainting, difficulty breathing, or worsening chest pain, seek prompt medical attention.

Usage

Take Ismo Tablet (Isosorbide Mononitrate) exactly as prescribed by your healthcare professional. The correct dose and dosing schedule depend on the specific Ismo formulation and your medical condition.

How to Take Ismo

• Take the tablet orally with water.

• Take it at the time recommended by your doctor.

• Do not increase or decrease the dose on your own.

• Do not take an additional tablet to obtain faster relief from chest pain.

• Follow the prescribed schedule consistently.

For extended-release isosorbide mononitrate products, tablets should generally be swallowed whole and should not be crushed or chewed. However, the instructions for the specific Ismo 10 mg or 20 mg product should be followed, as formulations can differ.

Missed Dose

If you miss a scheduled dose, take it when you remember unless it is close to the next scheduled dose. Do not take two doses together to compensate for a missed dose.

If You Experience Chest Pain

Ismo is intended to prevent angina rather than provide rapid relief of an acute attack. If you develop sudden chest pain, use the emergency treatment plan provided by your healthcare professional. If chest pain is severe, new, worsening, or does not improve as directed, seek emergency medical attention.

Important

Do not use Ismo more frequently or at a higher dose than prescribed. Excessive nitrate exposure can cause severe hypotension and other complications.

Uses

Ismo Tablet (Isosorbide Mononitrate) is primarily used to prevent angina pectoris associated with coronary artery disease.

What Is Angina?

Angina is chest discomfort that can occur when the heart muscle does not receive enough oxygen-rich blood for its needs. Coronary artery disease can restrict blood flow to the heart.

Isosorbide mononitrate helps reduce the heart's workload and oxygen demand by relaxing blood vessels.

Main Use of Ismo

• Prevention of angina associated with coronary artery disease

• Reduction in the frequency of angina episodes as part of an appropriate treatment plan

What Ismo Is Not Used For

Ismo should not be described as a medicine that:

• Immediately stops an acute angina attack

• Permanently cures coronary artery disease

• Replaces emergency treatment for sudden or severe chest pain

• Is used to treat erectile dysfunction

Oral isosorbide mononitrate does not act rapidly enough to abort an acute angina episode.

Why Ismo Helps Prevent Angina

By relaxing blood vessels, isosorbide mononitrate reduces venous return to the heart and can decrease cardiac workload and oxygen demand. This action helps reduce the likelihood of angina in patients for whom nitrate prevention is appropriate.

Side Effects

Ismo Tablet may cause side effects because isosorbide mononitrate relaxes blood vessels and lowers vascular resistance. Some effects are more noticeable when treatment is first started or when the dose is increased.

Common Side Effects

Possible side effects include:

• Headache

• Dizziness

• Lightheadedness

• Low blood pressure

• Weakness

• Nausea

• Flushing

Headache is one of the most commonly reported adverse effects of isosorbide mononitrate and can sometimes lead to discontinuation of treatment.

Blood Pressure-Related Effects

Ismo can cause orthostatic hypotension, meaning blood pressure may fall when moving from sitting or lying down to standing. This may result in dizziness, lightheadedness, or fainting.

Serious Symptoms

Seek urgent medical attention if you experience:

• Fainting or severe dizziness

• Severe or persistent chest pain

• Difficulty breathing

• Signs of a serious allergic reaction

• Severe weakness or symptoms associated with very low blood pressure

Important

Do not automatically stop prescribed nitrate therapy because of mild headache or dizziness without discussing it with your healthcare professional. Your doctor can determine whether the dose or treatment schedule needs adjustment.

FAQs

1. What is Ismo Tablet?

Ismo Tablet contains isosorbide mononitrate, an organic nitrate medicine used primarily to prevent angina associated with coronary artery disease.

2. What is Ismo 10mg used for?

Ismo 10 mg may be prescribed for the prevention of angina associated with coronary artery disease. The appropriate strength and schedule depend on the individual treatment plan.

3. What is Ismo 20mg used for?

Ismo 20 mg contains a higher amount of isosorbide mononitrate than the 10 mg strength and may be prescribed according to the patient's individual treatment requirements.

4. How does Ismo work?

Isosorbide mononitrate relaxes blood vessels, particularly veins. This reduces venous return to the heart and can decrease cardiac workload and oxygen demand.

5. Can Ismo stop sudden chest pain?

No. Oral isosorbide mononitrate does not act rapidly enough to abort an acute angina attack. Follow the emergency treatment plan provided by your healthcare professional for sudden chest pain.

6. Can I take Ismo with sildenafil?

No, unless a healthcare professional specifically directs otherwise. Sildenafil can greatly increase the blood-pressure-lowering effect of isosorbide mononitrate and may cause severe hypotension.

7. Can I take Ismo with tadalafil?

Tadalafil is also a PDE-5 inhibitor and should not be combined with nitrate medicines such as isosorbide mononitrate because of the risk of significant hypotension. Discuss all erectile-dysfunction medicines with your doctor before taking Ismo.

8. Can I drink alcohol while taking Ismo?

Alcohol may increase the blood-pressure-lowering effect of isosorbide mononitrate and can increase dizziness or fainting. Discuss alcohol use with your healthcare professional.

9. What are the common side effects of Ismo?

Headache, dizziness, lightheadedness, and low blood pressure are among the possible adverse effects. Headache is particularly common with nitrate therapy.

10. Why does Ismo cause headaches?

Isosorbide mononitrate relaxes and widens blood vessels. This vasodilation can cause headaches, particularly when treatment is started or the dose is changed.

11. Can Ismo cause low blood pressure?

Yes. Even relatively small doses can cause significant hypotension in susceptible patients. Dizziness or fainting may occur, particularly when standing.

12. Can I stop Ismo suddenly?

Do not change or stop long-term nitrate treatment without speaking with your healthcare professional. Your doctor can determine the safest way to modify treatment.

13. What should I do if I miss an Ismo dose?

Take the missed dose when you remember unless it is nearly time for the next dose. Do not double the next dose. Follow the specific instructions provided with your prescription.

14. Can Ismo be used during pregnancy?

Tell your healthcare professional if you are pregnant, planning pregnancy, or breastfeeding. The potential benefits and risks should be assessed by a healthcare professional before treatment.

15. Can older adults take Ismo?

Older adults may be more susceptible to hypotension and orthostatic effects from nitrate medicines. Dose selection and monitoring should take age, medical conditions, and other medicines into account.

16. Is Ismo the same as isosorbide dinitrate?

No. Isosorbide mononitrate and isosorbide dinitrate are different nitrate medicines, although isosorbide mononitrate is the major biologically active metabolite of isosorbide dinitrate.

17. Can Ismo cure coronary artery disease?

No. Ismo is used to help prevent angina symptoms; it does not cure the underlying coronary artery disease.

18. Can I take Ismo for an occasional headache or chest discomfort?

Ismo should only be taken for the medical indication for which it was prescribed. It should not be self-administered for unexplained chest discomfort.

19. What should I do if chest pain gets worse while taking Ismo?

Follow your healthcare professional's emergency plan. New, severe, worsening, or persistent chest pain can require urgent medical evaluation and should not simply be treated by taking additional Ismo.

20. Is Ismo available by prescription?

Isosorbide mononitrate is a prescription cardiovascular medicine in many countries. Availability and prescription requirements vary by location.

Interactions

Isosorbide mononitrate can interact with medicines and substances that also lower blood pressure or affect blood-vessel tone.

PDE-5 Inhibitors — Important

Do not combine Ismo with sildenafil, tadalafil, vardenafil, avanafil, or other PDE-5 inhibitors unless specifically directed by a healthcare professional.

Combining sildenafil with isosorbide mononitrate can substantially amplify the vasodilating effect and cause severe hypotension.

This interaction is particularly important because PDE-5 inhibitors are commonly used for erectile dysfunction.

Other Blood-Pressure-Lowering Medicines

Ismo may have additive blood-pressure-lowering effects with other vasodilators and antihypertensive medicines.

Calcium Channel Blockers

Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers are used with organic nitrates. Your healthcare professional may need to adjust treatment or monitor your blood pressure more closely.

Alcohol

Alcohol can enhance the vasodilatory and blood-pressure-lowering effects of isosorbide mononitrate and may increase dizziness or fainting.

Other Medicines

Tell your doctor or pharmacist if you use:

• Blood-pressure medicines

• Other nitrate medicines

• Medicines for erectile dysfunction

• Calcium channel blockers

• Other vasodilators

• Medicines that may affect blood pressure

Do not start or stop another medicine without discussing it with your healthcare professional.