{"id":14558,"date":"2021-10-04T15:49:29","date_gmt":"2021-10-04T15:49:29","guid":{"rendered":"https:\/\/zeepedia.com\/?p=14558"},"modified":"2021-10-11T07:55:21","modified_gmt":"2021-10-11T07:55:21","slug":"ismo","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/ismo\/","title":{"rendered":"Ismo &#8211; Isosorbide mononitrate uses, dose and side effects"},"content":{"rendered":"\n<p>10 mg&nbsp;tablets<br>isosorbide mononitrate<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">1. What Ismo is and what it is used for<\/h2>\n\n\n\n<p>Ismo contains&nbsp;isosorbide mononitrate&nbsp;which&nbsp;dilates the&nbsp;blood vessels and thereby reduces the work of the heart in&nbsp;angina pectoris.<\/p>\n\n\n\n<p>Preventive treatment of angina pectoris (&nbsp;angina pectoris&nbsp;).<\/p>\n\n\n\n<p>Isosorbide mononitrate contained&nbsp;in Ismo may also be approved for the treatment of other conditions not mentioned in this product information.&nbsp;Ask your doctor, pharmacist, or other healthcare professional if you have any further questions, and always follow their instructions.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2. What you need to know before taking Ismo<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Do not take Ismo<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>if you are allergic to&nbsp;isosorbide mononitrate&nbsp;or any of the other ingredients of this medicine (listed in section 6)<\/li><li>if you are allergic to&nbsp;organic nitrates<\/li><li>if you suffer from severe impaired blood circulation or&nbsp;shock<\/li><li>if your heart has severely impaired pump function (&nbsp;cardiogenic&nbsp;shock&nbsp;), so that your&nbsp;blood pressure&nbsp;does not become high enough<\/li><li>if you have decreased blood volume (severe&nbsp;hypovolemia&nbsp;)<\/li><li>if you have pericarditis<\/li><li>if you have accumulation of fluid in the pericardium around the heart (&nbsp;cardiac tamponade&nbsp;)<\/li><li>if you are also taking&nbsp;phosphodiesterase&nbsp;\u20115 \u2011 inhibitors, e.g.&nbsp;sildenafil, vardenafil or taldalfil.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>Talk to your doctor or pharmacist before taking Ismo.<\/p>\n\n\n\n<p>Consult a physician before starting treatment with Ismo if you:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>have&nbsp;hypertrophic&nbsp;obstructive&nbsp;cardiomyopathy&nbsp;(heart muscle disease)<\/li><li>have low&nbsp;blood pressure<\/li><li>have problems with low&nbsp;blood pressure&nbsp;, e.g.&nbsp;when getting up from sitting (&nbsp;orthostatic&nbsp;circulatory dysregulation)<\/li><li>have disease of the blood vessels in the brain (&nbsp;cerebrovascular&nbsp;disease)<\/li><li>have narrowing of the heart valves (aortic stenosis and \/ or&nbsp;mitral stenosis&nbsp;)<\/li><li>has increased pressure in the skull<\/li><li>have&nbsp;anemia&nbsp;(&nbsp;anemia&nbsp;)<\/li><li>have a lack of oxygenation of the blood (&nbsp;hypoxemia&nbsp;)<\/li><li>has impaired thyroid function<\/li><li>is malnourished<\/li><li>have low body temperature (&nbsp;hypothermia&nbsp;)<\/li><li>recently had a heart attack<\/li><li>taking drugs to lower&nbsp;blood pressure&nbsp;et<\/li><\/ul>\n\n\n\n<p>Ismo is not suitable for the treatment of&nbsp;acute&nbsp;angina attack or heart attack.<\/p>\n\n\n\n<p>Drugs of the&nbsp;phosphodiesterase&nbsp;-5&nbsp;inhibitor&nbsp;type&nbsp;must not be taken at the same time as Ismo.&nbsp;Ingestion of Ismo within 24 hours after ingestion of&nbsp;phosphodiesterase&nbsp;-5 inhibitors should be done with caution due to the risk of severe hypotension.<\/p>\n\n\n\n<p>Reduced effect of Ismo so-called&nbsp;tolerance development&nbsp;and that the reduced effect also applies to nitrates other than&nbsp;isosorbide mononitrate&nbsp;so-called cross-tolerance has been described.<\/p>\n\n\n\n<p>If Ismo is taken, a transient lack of oxygenation of the blood (&nbsp;hypoxemia&nbsp;) may occur.<\/p>\n\n\n\n<p>If you have coronary heart disease, it can lead to a lack of oxygen in the heart muscles.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Children<\/h2>\n\n\n\n<p>The safety and efficacy of Ismo in children have not been established.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Other drugs and Ismo<\/h2>\n\n\n\n<p>Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n<p>Ismo must not be used at the same time as drugs of the&nbsp;phosphodiesterase&nbsp;-5&nbsp;inhibitor&nbsp;type, e.g.&nbsp;sildenafil, vardenafil, and tadalafil as it can lead to a sharp drop in blood pressure, impaired blood supply (&nbsp;ischemia&nbsp;), and disturbed blood circulation with permanent damage to the heart and brain.<\/p>\n\n\n\n<p>If you are taking the following medicines at the same time as Ismo, the blood pressure-lowering (hypotensive) effect of Ismo may be increased:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>other vasodilators (vasodilators)<\/li><li>antihypertensives (medicines to treat high&nbsp;blood pressure&nbsp;) e.g.&nbsp;ACE inhibitors&nbsp;,&nbsp;beta-blockers&nbsp;, calcium channel&nbsp;blockers&nbsp;and&nbsp;diuretics&nbsp;(&nbsp;diuretics&nbsp;)<\/li><li>neuroleptics&nbsp;(medicines for certain mental illnesses)<\/li><li>sapropterin (drug used to lower the level of the amino acid phenylalanine in the blood of patients with phenylketonuria)<\/li><li>tricyclic antidepressants&nbsp;(used for depression)<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Ismo with alcohol<\/h2>\n\n\n\n<p>Concomitant treatment with Ismo and alcohol consumption may potentiate the antihypertensive effect of Ismo.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p>If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.<\/p>\n\n\n\n<p><strong>Pregnancy<\/strong><\/p>\n\n\n\n<p>Limited experience of use during pregnancy.&nbsp;Therefore consult a doctor before using Ismo during pregnancy.<\/p>\n\n\n\n<p><strong>Breast-feeding<\/strong><\/p>\n\n\n\n<p>It is not known if Ismo passes into breast milk.&nbsp;Therefore consult a doctor&nbsp;<em>before<\/em>&nbsp;use during breastfeeding.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>Ismo may impair the ability to react.&nbsp;This should be taken into account when increased attention is required, eg when driving or using machines.&nbsp;This applies above all at the beginning of the treatment or when the treatment is changed and in connection with alcohol.<\/p>\n\n\n\n<p>You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.&nbsp;One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or&nbsp;side effects.&nbsp;Descriptions of these effects and&nbsp;side effects&nbsp;can be found in other sections.&nbsp;Read all the information in this leaflet for guidance.&nbsp;If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Ismo contains milk sugar (lactose)<\/h2>\n\n\n\n<p>Ismo contains 74 mg of milk sugar (&nbsp;lactose&nbsp;) per tablet.<\/p>\n\n\n\n<p>If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">3. How to take Ismo<\/h2>\n\n\n\n<p>Always take this medicine exactly as your doctor or pharmacist has told you.&nbsp;Ask your doctor or pharmacist if you are unsure.<\/p>\n\n\n\n<p>Dose&nbsp;one is determined by the doctor who adjusts it individually for you.<\/p>\n\n\n\n<p>The recommended&nbsp;dose&nbsp;is two 10 mg tablets in the morning and the afternoon with food.&nbsp;Dose&nbsp;one can be increased to four 10 mg tablets twice daily if needed.<\/p>\n\n\n\n<p>To avoid headaches, it is recommended to start with a 10 mg tablet twice daily for the first 2 days of treatment.<\/p>\n\n\n\n<p>Discontinuation of Ismo treatment should be gradual so that the symptoms of angina do not worsen.<\/p>\n\n\n\n<p>The tablets should not be chewed but swallowed whole with liquid (eg a glass of water) with a meal.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you take more Ismo than you should<\/h2>\n\n\n\n<p>If you have ingested too much medicine or if e.g.&nbsp;If a child has inadvertently ingested the medicine, contact a doctor, hospital, or the Poison Information Center for risk assessment and advice.<\/p>\n\n\n\n<p>Symptoms of overdose may include&nbsp;<em>:<\/em>&nbsp;decreased blood pressure with impaired blood circulation (&nbsp;orthostatic&nbsp;dysregulation), increased&nbsp;heart rate&nbsp;(reflex tachycardia), palpitations (&nbsp;palpitations&nbsp;), pulsating headache, anxiety (&nbsp;excitation&nbsp;), reddening of the skin, cold sweats, weakness (&nbsp;asthenia&nbsp;), dizziness, dizziness&nbsp;stupor&nbsp;), fainting, nausea, vomiting and diarrhea.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you forget to take Ismo<\/h2>\n\n\n\n<p>Do not take a double&nbsp;dose&nbsp;to make up for a forgotten tablet.<\/p>\n\n\n\n<p>If you forget to take a tablet, take it the same day as soon as you remember.&nbsp;Continue treatment as usual the next morning.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop taking Ismo<\/h2>\n\n\n\n<p>You may feel unwell if you suddenly stop taking Ismo.&nbsp;Tell your doctor if you stop taking this medicine.<\/p>\n\n\n\n<p>If you have any further questions on the use of this product, ask your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">4. Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause&nbsp;side effects&nbsp;, although not everybody gets them.<\/p>\n\n\n\n<p><strong>Very common (may affect more than 1 user in 10)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>headache (so-called &#8220;nitrate headache&#8221;).&nbsp;Occurs frequently at the beginning of treatment and usually disappears after a few weeks of treatment.<\/li><\/ul>\n\n\n\n<p><strong>Common (may affect up to 1 in 10 people)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>dizziness<\/li><li>low&nbsp;blood pressure&nbsp;(&nbsp;hypotension&nbsp;)<\/li><li>elevated&nbsp;heart rate&nbsp;(&nbsp;tachycardia&nbsp;)<\/li><li>nausea<\/li><\/ul>\n\n\n\n<p><strong>Uncommon (may affect up to 1 in 100 people)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>vomiting<\/li><li>transient redness (&nbsp;erythema&nbsp;)<\/li><\/ul>\n\n\n\n<p><strong>Rare (may affect up to 1 in 1,000 people)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>fainting<\/li><li>allergic skin reactions<\/li><\/ul>\n\n\n\n<p><em>Reporting of side effects<\/em><\/p>\n\n\n\n<p>If you get any side effects, talk to your doctor, pharmacist or nurse.&nbsp;This also applies to any side effects not mentioned in this information.&nbsp;You can also report side effects directly to the Medical Products Agency.&nbsp;By reporting side effects, you can help increase drug safety information.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">5. How to store Ismo<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Used before the expiry date which is stated on the carton.&nbsp;The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>Medicines should not be disposed of via wastewater or household waste.&nbsp;Ask your pharmacist how to dispose of medicines no longer required.&nbsp;These measures will help to protect the environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">6. Contents of the packaging and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>The active substance is&nbsp;isosorbide mononitrate&nbsp;10 mg per tablet.<\/li><li>The other ingredients are anhydrous&nbsp;lactose&nbsp;74 mg,&nbsp;colloidal&nbsp;anhydrous silica, magnesium stearate.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and contents of the pack<\/h2>\n\n\n\n<p>100 tablets (white, round, marked ISMO \/ 10)<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorization Holder and Manufacturer<\/h2>\n\n\n\n<p><strong>Holder of a marketing authorization<\/strong><\/p>\n\n\n\n<p>Riemser Pharma GmbH<\/p>\n\n\n\n<p>An der Wiek 7<\/p>\n\n\n\n<p>DE-17493 Greifswald &#8211; Insel Riems<\/p>\n\n\n\n<p>Germany<\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Kern Pharma SL<\/p>\n\n\n\n<p>Polygono Ind.&nbsp;Colon II<\/p>\n\n\n\n<p>Venus II<\/p>\n\n\n\n<p>08228 Terrassa (Barcelona)<\/p>\n\n\n\n<p>Spain<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ismo contains isosorbide mononitrate which dilates the blood vessels and thereby reduces the work of the heart in angina pectoris.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,12116],"tags":[12286,12290,12289,12291,12209,12213,12219,2210,12287,12210,12288,12211],"class_list":["post-14558","post","type-post","status-publish","format-standard","hentry","category-medicines","category-i","tag-ismo","tag-ismo-side-effects","tag-ismo-tablet","tag-ismo-uses","tag-isosorbide-mononitrate","tag-isosorbide-mononitrate-tablet","tag-side-effects-of-isosorbide-mononitrate","tag-tablet","tag-what-is-ismo","tag-what-is-isosorbide-mononitrate","tag-what-ismo-is-used-for","tag-what-isosorbide-mononitrate-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/14558","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=14558"}],"version-history":[{"count":6,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/14558\/revisions"}],"predecessor-version":[{"id":14790,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/14558\/revisions\/14790"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=14558"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=14558"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=14558"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}