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Imdur (isosorbide mononitrate) 

Indications 

• Angina Pectoris (Chest Pain) 
• Used to prevent angina (chest pain) due to coronary artery disease by relaxing and widening blood vessels, which improves blood flow to the heart. 
• Heart Failure 
• Helps manage symptoms of heart failure by reducing the heart’s workload and improving blood flow. 
• Post-Heart Attack Treatment 
• Assists in the recovery process after a heart attack by ensuring better blood circulation and reducing the heart’s oxygen demand. 

Dosage and Administration 

• Take Imdur exactly as prescribed by your healthcare provider. 
• Swallow the extended-release tablet whole with a glass of water. 
• Take the medication at the same time each day to maintain a stable level in your bloodstream. 
• Take the medication with or without food, according to your preference or as advised by your doctor. 
• Do not crush, chew, or break the extended-release tablets. 
• Do not skip doses. If you forget a dose, take it as soon as you remember. If it’s close to the next dose, skip the missed dose. 
• Do not take two doses at the same time to make up for a missed dose. 
• Avoid alcohol consumption, as it can increase certain side effects. 

Mechanism of Action 

Imdur (isosorbide mononitrate) is a nitrate that works by relaxing and widening blood vessels. This improves blood flow and reduces the oxygen demand of the heart, which helps to prevent angina (chest pain). It achieves this by releasing nitric oxide, which relaxes the smooth muscles in the vessel walls. 

Contraindications 

• Allergic Reactions: Do not use if you are allergic to isosorbide mononitrate or any other nitrates. 
• Severe Anemia: Avoid use in patients with severe anemia (low red blood cell count). 
• Recent Heart Attack: Not recommended for patients who have recently had a heart attack without doctor’s advice. 
• Low Blood Pressure: Do not use if you have very low blood pressure (hypotension). 
• Use of PDE-5 Inhibitors: Contraindicated in patients taking medications for erectile dysfunction (like sildenafil, tadalafil) due to severe risk of low blood pressure. 

Side Effects 

Common Side Effects: 

• Headache 
• Dizziness 
• Lightheadedness 
• Flushing (warmth, redness, or tingling) 
• Nausea 

Serious Side Effects: 

• Severe dizziness or fainting 
• Irregular heartbeat 
• Allergic reactions (rash, itching/swelling, severe dizziness, trouble breathing) 
• Chest pain that is new or worsening 

Precautions 

• Regular Monitoring: Regularly monitor your blood pressure and heart rate as advised by your doctor. 
• Inform About Other Medications: Inform your healthcare provider about all other medications you are taking, including over-the-counter drugs and supplements. 
• Avoid Sudden Position Changes: Move slowly when rising from a sitting or lying position to prevent dizziness. 
• Hydration: Stay adequately hydrated but follow your doctor’s advice regarding fluid intake. 
• Driving and Operating Machinery: Be cautious when driving or operating machinery until you know how Imdur affects you, as it can cause dizziness. 

Storage Instructions 

• Store at room temperature between 20°C to 25°C (68°F to 77°F). 
• Keep in a dry place away from moisture and direct sunlight. 
• Keep the tablets in their original packaging until it’s time to take them. 
• Store out of the reach of children and pets. 
• Do not use the tablets beyond their expiration date. Dispose of any expired medication properly. 

References 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/075155Orig1s034lbl.pdf