Isosorbide
Mononitrate (Imdur, ISMO, Monoket) |
Category:
Description:
Indications:
Contraindications:
Precautions:
-
Pregnancy
category C; use caution in nursing mothers
-
Acute
MI, hypertrophic cardiomyopathy, glaucoma
-
Volume
depletion, hypotension, abrupt withdrawal
-
Continuous
delivery without nitrate-free interval (tolerance develops)
Adverse
Reactions (Side Effects):
-
CNS:
agitation, anxiety, apprehension, confusion, dizziness,
dyscoordination, headache, hypoesthesia, hypokinesia, insomnia,
nervousness, nightmares, restlessness, vertigo, weakness
-
CV:
atrial fibrillation, cardiovascular collapse, crescendo angina,
dysrhythmias, edema, hypotension, PVC’s, rebound hypertension,
retrosternal discomfort, syncope, tachycardia
-
EENT:
blurred vision, diplopia
-
GI:
abdominal pain, diarrhea, dyspepsia, involuntary passing of feces,
nausea, tenesmus, vomiting
-
GU:
dysuria, impotence, involuntary passing of urine, urinary frequency
-
HEME:
hemolytic anemia, methemoglobinemia
-
MS:
arthralgia, muscle twitching
-
SKIN:
cold sweat, crusty skin lesions, exfoliative dermatitis, flushing,
pallor, perspiration, pruritis, rash
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Dosage:
Administered
orally: Asymmetric dosing regimens provide a daily nitrate-free interval
to minimize the development of tolerance.
-
Adult:
-
PO
5-20mg 2 times daily (with the 2 doses 7 hours apart);
-
PO
SUS REL 30-60mg 1 time daily initially, titrate to 120-240mg 1
time daily if necessary
Special
considerations:
-
Headache
may be a marker for drug activity; do not try to avoid by altering
treatment schedule; aspirin or acetaminophen may be used for relief
-
Dissolve
SL tablets under tongue; do not crush, chew, or swallow
-
Do
not crush chewable tablets before administering
-
Avoid
alcohol
-
Make
changes in position slowly to prevent fainting
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The information contained here is an
abbreviated summary. For more detailed and complete information, consult the
manufacturer's product information sheets or standard textbooks
Source: Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
This information is provided by The Brookside Associates. The Brookside
Associates, LLC. is a private organization, not affiliated with any governmental
agency. The opinions presented here are those of the author and do not
necessarily represent the opinions of the Brookside Associates or the Department
of Defense. The presence of any advertising on these pages does not constitute
an endorsement of that product or service by either the US Department of Defense
or the Brookside Associates. All material presented here is unclassified.
C. 2009, 2014, All Rights Reserved
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