Monofast
Generic Name
Isosorbide Mononitrate
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| monofast 10 mg tablet | ৳ 15.00 | ৳ 150.00 |
Description
Overview of the medicine
Monofast 10 mg Tablet contains Isosorbide Mononitrate, a nitrate used for the prophylaxis and long-term treatment of angina pectoris (chest pain due to heart disease). It works by relaxing blood vessels, which reduces the workload on the heart and improves blood flow.
Uses & Indications
Dosage
Adults
Typically 10-20 mg orally, two to three times daily. Doses should be spaced to provide a nitrate-free interval.
Elderly
No specific dosage adjustment required, but caution is advised due to potential for increased sensitivity and co-morbidities.
Renal_impairment
No specific dosage adjustment needed, but use with caution in severe renal impairment.
How to Take
Take the tablet whole with a glass of water, with or without food. Do not chew or crush. This medicine is for preventing angina attacks, not for treating acute attacks.
Mechanism of Action
Isosorbide Mononitrate releases nitric oxide (NO), which activates guanylyl cyclase, leading to an increase in cyclic GMP (cGMP) in vascular smooth muscle. This results in vasodilation, primarily affecting venous capacitance vessels and to a lesser extent, arterial vessels. This reduces both preload and afterload, decreasing myocardial oxygen demand and relieving angina.
Pharmacokinetics
Onset
Within 20-60 minutes.
Excretion
Excreted primarily via the kidneys as glucuronidated metabolites.
Half life
Approximately 4-5 hours.
Absorption
Rapid and complete absorption from the gastrointestinal tract; bioavailability is nearly 100%.
Metabolism
Extensively metabolized in the liver to inactive metabolites. It is not subject to first-pass metabolism.
Side Effects
Contraindications
- Hypersensitivity to isosorbide mononitrate or any component of the formulation
- Acute circulatory failure (shock, vascular collapse)
- Severe hypotension
- Concomitant use of phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
- Severe anemia
- Increased intracranial pressure
Drug Interactions
Alcohol
May enhance hypotensive effects and dizziness.
Tricyclic antidepressants, major tranquilizers
May enhance the hypotensive effect of isosorbide mononitrate.
Phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
Concomitant use is absolutely contraindicated due to the risk of severe, life-threatening hypotension.
Blood pressure lowering drugs (e.g., beta-blockers, calcium channel blockers, diuretics)
May potentiate hypotensive effects.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, persistent throbbing headache, flushing, palpitations, visual disturbances, dizziness, and syncope. Management involves supportive care, elevation of legs, and if necessary, intravenous fluids and vasoconstrictors (e.g., phenylephrine) to maintain blood pressure. Monitor vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is unknown whether isosorbide mononitrate is excreted in human milk; caution should be exercised when administered to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to isosorbide mononitrate or any component of the formulation
- Acute circulatory failure (shock, vascular collapse)
- Severe hypotension
- Concomitant use of phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
- Severe anemia
- Increased intracranial pressure
Drug Interactions
Alcohol
May enhance hypotensive effects and dizziness.
Tricyclic antidepressants, major tranquilizers
May enhance the hypotensive effect of isosorbide mononitrate.
Phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
Concomitant use is absolutely contraindicated due to the risk of severe, life-threatening hypotension.
Blood pressure lowering drugs (e.g., beta-blockers, calcium channel blockers, diuretics)
May potentiate hypotensive effects.
Storage
Store in a cool and dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypotension, persistent throbbing headache, flushing, palpitations, visual disturbances, dizziness, and syncope. Management involves supportive care, elevation of legs, and if necessary, intravenous fluids and vasoconstrictors (e.g., phenylephrine) to maintain blood pressure. Monitor vital signs.
Pregnancy & Lactation
Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. It is unknown whether isosorbide mononitrate is excreted in human milk; caution should be exercised when administered to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months
Availability
Pharmacies nationwide
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Isosorbide mononitrate has been extensively studied in numerous clinical trials demonstrating its efficacy and safety in the prophylaxis and long-term management of angina pectoris. Its role in reducing the frequency and severity of angina attacks is well-established.
Lab Monitoring
- Routine lab monitoring is generally not required for isosorbide mononitrate therapy.
- Blood pressure monitoring, especially during initial therapy or dose titration.
Doctor Notes
- Emphasize the importance of a nitrate-free interval to prevent tolerance.
- Advise patients not to use this medication for acute anginal attacks.
- Counsel patients on potential interactions, especially with phosphodiesterase-5 inhibitors.
Patient Guidelines
- Take exactly as prescribed by your doctor. Do not stop taking it suddenly, as this can lead to withdrawal symptoms.
- This medication is to prevent angina, not to treat sudden attacks. For sudden attacks, use sublingual nitroglycerin as prescribed.
- Avoid activities that require alertness, such as driving or operating machinery, if you experience dizziness or lightheadedness.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
May cause dizziness or lightheadedness, especially at the start of treatment or after a dose increase. Avoid driving or operating machinery until you know how this medicine affects you.
Lifestyle Advice
- Adopt a heart-healthy lifestyle, including a balanced diet low in saturated fats and cholesterol.
- Regular physical activity, as recommended by your doctor.
- Quit smoking, as smoking greatly increases the risk of heart disease.
- Limit alcohol intake.
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