Monofast

Take orally with or without food. Swallow the tablet whole with a glass of water. Do not chew or crush.

Isosorbide Mononitrate is an organic nitrate that acts as a vasodilator. It is metabolized to nitric oxide (NO) which activates guanylyl cyclase, increasing cyclic GMP (cGMP) in smooth muscle cells. This leads to dephosphorylation of the myosin light chain and subsequent relaxation of vascular smooth muscle, resulting in venodilation and arterial dilation. Venodilation reduces preload (end-diastolic volume), and arterial dilation reduces afterload (systemic vascular resistance), both of which decrease myocardial oxygen demand. It also redistributes coronary blood flow to ischemic areas of the myocardium.

• Hypersensitivity to isosorbide mononitrate or any other nitrates
• Acute circulatory failure (shock, vascular collapse)
• Severe hypotension (systolic blood pressure less than 90 mmHg)
• Cardiogenic shock
• Hypertrophic obstructive cardiomyopathy
• Constrictive pericarditis
• Cardiac tamponade
• Severe anaemia
• Closed-angle glaucoma
• Concomitant use with phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil)

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

Symptoms of overdose include severe hypotension, persistent throbbing headache, flushing, palpitations, visual disturbances, dizziness, syncope, nausea, vomiting, diarrhoea, and methaemoglobinaemia (rare). Management involves supportive care, elevation of legs, intravenous fluids, and if necessary, alpha-adrenergic agonists (e.g., phenylephrine) to reverse hypotension. For severe methaemoglobinaemia, methylene blue may be administered.

Pregnancy Category C. Use only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is unknown whether isosorbide mononitrate is excreted in human milk. Exercise caution when administered to a nursing mother.

• Hypersensitivity to isosorbide mononitrate or any other nitrates
• Acute circulatory failure (shock, vascular collapse)
• Severe hypotension (systolic blood pressure less than 90 mmHg)
• Cardiogenic shock
• Hypertrophic obstructive cardiomyopathy
• Constrictive pericarditis
• Cardiac tamponade
• Severe anaemia
• Closed-angle glaucoma
• Concomitant use with phosphodiesterase-5 (PDE5) inhibitors (e.g., sildenafil, tadalafil)

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

Symptoms of overdose include severe hypotension, persistent throbbing headache, flushing, palpitations, visual disturbances, dizziness, syncope, nausea, vomiting, diarrhoea, and methaemoglobinaemia (rare). Management involves supportive care, elevation of legs, intravenous fluids, and if necessary, alpha-adrenergic agonists (e.g., phenylephrine) to reverse hypotension. For severe methaemoglobinaemia, methylene blue may be administered.

Pregnancy Category C. Use only if clearly needed and the potential benefits outweigh the potential risks to the fetus. It is unknown whether isosorbide mononitrate is excreted in human milk. Exercise caution when administered to a nursing mother.