Isosorbide mononitrate, sold under many brand names, is a medication used for heart-related chest pain (angina), heart failure and esophageal spasms.[2] It can be used both to treat and to prevent heart-related chest pain; however, it is generally less preferred than beta blockersorcalcium channel blockers.[2] It is taken by mouth.[2]
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| Trade names | Monoket, Imdur, others |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a682348 |
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| Routes of administration | By mouth |
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| Bioavailability | >95% |
| Protein binding | <5% |
| Metabolism | Liver |
| Elimination half-life | 5 hours |
| Excretion | Kidney (93%) |
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| ECHA InfoCard | 100.036.527  |
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| Formula | C6H9NO6 |
| Molar mass | 191.139 g·mol−1 |
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Common side effects include headache, low blood pressure with standing, blurry vision, and skin flushing.[2] Serious side effects may include low blood pressure especially if also exposed to PDE5 inhibitors such as sildenafil.[2] Use is not recommended in pregnancy.[3] It is believed to work by relaxing smooth muscle within blood vessels.[2]
It was patented in 1971 and approved for medical use in 1981.[4] It is available as a generic medication.[3] In 2021, isosorbide was the 111th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[5][6]
Isosorbide mononitrate is a nitrate-class drug used for the prevention of angina pectoris.[7] The sublingual patch has an onset of five minutes and a duration of action of one hour. The oral, slow release tablet has an onset of thirty minutes, and a duration of 8 hours.
The following adverse effects have been reported in studies with isosorbide mononitrate:
Very common: Headache predominates (up to 30%) necessitating withdrawal of 2 to 3% of patients, but the incidence reduces rapidly as treatment continues.[7]
Common: Tiredness, sleep disturbances (6%) and gastrointestinal disturbances (6%) have been reported during clinical trials with isosorbide mononitrate modified-release tablets, but at a frequency no greater than for placebo. Hypotension (4 to 5%), poor appetite (2.5%), nausea (1%)[7]
Adverse effects associated with the clinical use of the drug are as expected with all nitrate preparations. They occur mainly in the early stages of treatment.[7]
Hypotension (4%) with symptoms such as dizziness and nausea (1%) have been reported. In general, these symptoms disappear during long-term treatment.[7]
Other reactions that have been reported with isosorbide mononitrate-modified release tablets include tachycardia, vomiting, diarrhoea, vertigo, and heartburn.[7]
It is sold in the US by Lannett Company, under the brand name Monoket,[7][8] and was also sold in the US under the name Imdur,[9] and marketed in the UK under the trade names: Isotard, Monosorb, Chemydur. In India, this drug is available under the brand names of Ismo, Imdur, Isonorm, Monotrate, Solotrate, and Monit. In Russia it is occasionally used under the brand names Monocinque and Pektrol. In Australia, this drug is available under the brand name Duride.[citation needed]
