Take orally with a glass of water, with or without food. To avoid tolerance, ensure a nitrate-free interval (typically 7-10 hours) between doses.

Isosorbide Mononitrate is metabolized to nitric oxide (NO), which activates guanylyl cyclase, leading to increased cGMP. This results in smooth muscle relaxation, particularly in vascular smooth muscle, causing vasodilation of both arteries and veins. This reduces preload and afterload, decreasing myocardial oxygen demand.

• •Hypersensitivity to isosorbide mononitrate or other nitrates
• •Severe hypotension, cardiogenic shock, or uncompensated heart failure
• •Concomitant use with phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil) due to risk of severe hypotension

Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.

Symptoms include severe hypotension, persistent throbbing headache, dizziness, palpitation, visual disturbances, flushing, nausea, vomiting, sweating, and syncope. Treatment is supportive, including elevation of legs, fluid administration, and vasopressors if needed.

Pregnancy Category C. Use only if potential benefit outweighs risk to the fetus. Excretion in breast milk is unknown; caution advised during breastfeeding.