In the event of marked hypotension and/or shock, volume replacement should be given; in exceptional cases, norepinephrine and/or dopamine can be infused as circulatory therapy.Administration of epinephrine and related substances is contraindicated.For methaemoglobinaemia, the following antidote is available:Methylene blue: Up to 50 ml of a 1% methylene blue solution IV.Pharmacotherapeutic group: isosorbide mononitrate, ATC code: C01DA14Isosorbide mononitrate provides long-term nitrate treatment of angina pectoris and heart failure in a form with complete biological availability due to lack of any significant hepatic first-pass metabolism. In order to avoid any attenuation or loss of effect, high continuous dosing regimens should be avoided.Administration of isosorbide-5-nitrate may produce transient hypoxaemia as a result of redistribution of blood flow with a relative increase in perfusion of poorly ventilated areas of the lung. Use in pregnancy is not recommended unless considered essential by the patient's physician.There is no information on excretion of isosorbide-5-mononitrate in breast milk. sildenafil, tadalafil, vardenafil) have been shown to potentiate the hypotensive effects of nitrates and their co-administration with nitrates or nitric oxide donors is therefore contraindicated (see section 4.5).Severe cerebrovascular insufficiency or hypotension are relative contraindications to the use of Isosorbide Mononitrate Tablets 10 mg.Isosorbide Mononitrate Tablets 10 mg should be used with caution in patients who have a recent history of myocardial infarction, or who are suffering from closed-angle glaucoma, hypothyroidism, hypothermia, malnutrition and sever liver or renal disease.Symptoms of circulatory collapse may arise after first dose in patients with labile circulation and in patients already taking ACE inhibitors.This product may give rise to postural hypotension and syncope in some patients. The drug is eliminated solely by the liver and therefore can be used in renal insufficiency.Also contains: crospovidone, lactose, magnesium stearate, maize starch, microcrystalline cellulose (E460), povidone.The product containers are rigid injection moulded polypropylene or injection blow-moulded polyethylene containers with polyfoam wad and snap-on polyethylene lids; in case any supply difficulties should arise the alternative is amber glass containers with screw caps, with polyfoam wad or cotton wool.The product may also be supplied in blister packs in cartons:a) Carton: Printed carton manufactured from white folding box board.b) Blister pack: (i) 250µm white rigid PVC.
The incidence of headache diminishes gradually or disappears after 1-3 weeks and optimum dosage of isosorbide mononitrate may be achieved.At the At the start of therapy or when the dosage is increased, hypotension and/or light headedness in the upright position are commonly observed (i.e in 1-10% of patients).

A rise in intracranial pressure with confusion and neurological deficits can sometimes occur. This effect may be increased by alcohol.A very common (>10% of patients) adverse reaction to Isosorbide Mononitrate Tablets is throbbing headache. Monitor blood pressure and pulse.
4.5 Interaction with other medicinal products and other forms of interaction6.6 Special precautions for disposal and other handling9. Both dosage and frequency should be tapered gradually (see section 4.4).Dosage requirements may be reduced especially when hepatic or renal function is impaired. 1 hour following oral dosing.Isosorbide-5-mononitrate is completely bioavailable after oral doses and is not subjected to pre-systemic elimination processes.Isosorbide-5-mononitrate is eliminated from the plasma with half-life of about 5.1 hours.

The optimum dosage is best determined by continuous haemodynamic monitoring. Date of first authorisation/renewal of the authorisationStart typing to retrieve search suggestions.

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