Drugs On Review

What is Ismo?

Ismo is a brand name for isosorbide mononitrate, a vasodilator used mainly for the preventative treatment of angina pectoris, to reduce the frequency and severity of angina episodes and reduce the need to use nitrate medications in sublingual pill or spray form. Ismo does not reduce chest pain which has already begun.

Ismo is a nitrate vasodilator which works by dilating blood vessels. This reduces blood pressure, and reduces the workload of the heart, relieving chest pain.

What form is Ismo available in?

Ismo is sold in tablets of 10 or 20 mg. It is also available in extended release tablets of 30, 60 and 120 mg.

Ismo dosing and administration

The recommended dosage of Ismo is 20 mg twice daily. The first dose should be taken on rising in the morning and the second seven hours later. This schedule avoids developing tolerance to the drug. It is important to take Imso at the same time each day and the most benefit will be gained from taking it regularly. If extended release tablets are used, the dosage should be between 30 and 240 mg once per day. If Ismo ceases to be effective in preventing your chest pain, discuss a change of dosage with your doctor. The drug becomes effective approximately one hour after ingestion of the first dose and lasting until at least five hours after the second dose.

Common adverse effects from Ismo

The most common side effect of Ismo is headaches and the severity of these is directly proportional to the dose. It should be borne in mind that the headache is a sing that the drug is working. Dizziness and nausea may also occur. Other side effects include tachycardia, vomiting, diarrhea, vertigo and dyspepsia. Side effects tend to diminish with long-term treatment. If headaches are problematic, ask your doctor to recommend an analgesic such as aspirin or acetaminophen. There may be rare occurrences of dysuria, urinary frequency and erectile dysfunction.

Ismo warnings and precautions

Ismo should not be taken with PDE 5 type medications for erectile dysfunction or while using alcohol. If you are pregnant or may become pregnant, or if you are breast feeding, you should discuss the use of Ismo with your doctor. Ismo should not be taken before physical activity, including sexual activity.

Interactions with Ismo

Ismo should not be taken with the erectile dysfunction medications sildenafil(Viagra), tadalafil (Cialis) or vardenafil (Levitra) because the combined vasodilatory effect of these can lead to dangerously low blood pressure. Ismo may interact with calcium channel blockers to cause orthostatic hypotension. There have been reports of sudden fall in drug pressure when Ismo is combined with propranolol.

What if I take an accidental overdose of Ismo?

Symptoms of Ismo overdose may include bradycardia, vision disturbances, nausea and vomiting, sweating, clammy skin, cyanosis of extremities. If you suspect that you or someone else my have taken an overdose of Ismo you should seek urgent medical assistance.