Has your doctor prescribed you a medicine for chest pain, which is what we medically call angina? Among those medicines, you may have seen the name Isosorbide Mononitrate. This is a medicine that is often given to people with heart disease. So, you probably have a lot of questions about this medicine. Don't worry, today we will talk simply about this medicine, what it does, how to use it, and things to be careful about.
Simply put, what happens with this medicine?
Isosorbide Mononitrate is a drug in a class of medications called nitrates. Its main function is to prevent chest pain, or angina.
Think of your heart as a water pump that works non-stop. When the blood vessels that carry blood to and from this pump become narrow, the pump has to work harder. That's when chest pain occurs. This medicine works by widening (relaxing) the blood vessels around the heart. This makes it easier for blood to flow, reducing the workload on the heart. This reduces the pain of angina.
Very important: This medicine is used to prevent pain, not to treat sudden chest pain. Your doctor may have given you another medicine (such as a sublingual tablet) for sudden pain.
Things to tell your doctor before starting medication
Before prescribing this medicine to you, your doctor needs to have a complete picture of your health condition. Therefore, if any of the following apply to you, be sure to tell your doctor about it.
- If you have previously had a heart attack or heart failure .
- If you have had an allergic reaction to this Isosorbide Mononitrate medicine, other nitrate-type medicines, or any other medicine, food, or dye.
- If you are pregnant, or are expecting a baby .
- If you are a breastfeeding mother .
Based on this information, it will be easier for the doctor to decide whether this medicine is right for you or not.
How exactly do I use this medicine?
- How to take: Swallow this tablet with a glass of water.
- Follow your doctor's instructions: Take the prescribed dose, at the prescribed time, exactly as your doctor prescribes. Never take more than prescribed.
- Avoid stopping suddenly: This is the most important thing. Do not stop taking this medicine suddenly for any reason without consulting your doctor. Doing so may make your symptoms (chest pain) worse. If you need to stop taking the medicine, you should do so by gradually reducing the dose. Your doctor will explain how to do this.
- Giving to children: This medicine is not usually given to children. Special medical advice is required.
What to do if you take too much medicine? (Overdose)
If you think you have taken more than the prescribed dose, do not delay . Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or, go to the nearest hospital Emergency Treatment Unit (ETU) as soon as possible.
This medicine has been prescribed for you only. Do not give this medicine to someone else just because they have the same symptoms as you.
What if I miss a dose of medication?
If you forget to take a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take your next dose at the scheduled time. Never take two doses at once to make up for a missed dose.
Other drugs that interact with this medicine (Interactions)
Some medications can cause dangerous side effects when taken with Isosorbide Mononitrate. Therefore, it is very important to tell your doctor about all the medications you are taking (including vitamins and herbal remedies).
| Do not take Isosorbide Mononitrate with these at all! | |
|---|---|
| ED medication | Medications like Avanafil, Sildenafil, Tadalafil, Vardenafil. Taking these two together can cause dangerously low blood pressure. |
| Riociguat | This is also a medicine that affects blood pressure. |
| Talk to your doctor about taking these together. | |
| Other medications for high blood pressure | Blood pressure may drop further . |
| Other medications taken for angina or heart disease | Interactions may occur. |
Additionally, drinking alcohol can increase your dizziness and heart rate, so it is wise to avoid alcohol while taking this medication.
Things to be careful about when taking medicine
- Dizziness: You may feel dizzy or lightheaded while taking this medicine. Avoid driving, operating machinery, and doing other tasks that require alertness until you know exactly how this medicine affects you.
- Changing positions: To avoid dizziness and fainting, don't get up suddenly from a sitting position or from bed. Get up slowly . This is especially important if you are an older person.
- Blood pressure and heart rate: Check your blood pressure and heart rate regularly as directed by your doctor. Learn what normal values are and when you should call your doctor.
- Medicines for other illnesses: When you have a cough, cold, or body ache, do not buy medicine from the pharmacy without consulting your doctor. Some medicines contain ingredients that can increase your blood pressure.
Side effects of the medicine
Like any medicine, Isosorbide Mononitrate can cause some side effects. Some are serious, while others are common.
| If these symptoms occur, call your doctor immediately. | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Low blood pressure | Dizziness, fainting, blue eyes. |
| Slow heartbeat | Dizziness, fainting, difficulty breathing, unusual tiredness. |
| Increased chest pain (Angina) | Increasing pain, pressure, or tightness in the chest, neck, back, or arms. |
| Symptoms of Methemoglobinemia | (This is when the blood's ability to carry oxygen decreases) - Severe headache, unusual tiredness, difficulty breathing, nausea, vomiting, rapid heartbeat, blue skin or lips. |
| Increased pressure around the brain | Severe headache, blurred vision, vision changes, nausea, vomiting. |
| Usually not serious, but tell your doctor if it persists. | |
| Headache | This is normal when you first start taking the medication and will subside within a few days. |
| Dizziness | Change positions slowly as mentioned above. |
| Flushing | Feeling of warmth on the skin or redness of the face. |
Take-Home Message
- Isosorbide Mononitrate is a medicine given to prevent chest pain (angina). It is not a medicine given for sudden pain.
- Never stop taking this medicine suddenly without asking your doctor .
- Never take this with Sildenafil (like Viagra), a medicine used for erectile dysfunction. It is very dangerous.
- As dizziness may occur while taking the medicine, get up slowly when getting up from a sitting or lying position.
- If you experience any serious side effects (severe headache, vision changes, difficulty breathing, increased chest pain), tell your doctor immediately .
- Inform your doctor about all medications you are taking.
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