Ismo 20 Tablet (Isosorbide Mononitrate 20mg)

INTRODUCTION

ISMO 20MG contains Isosorbide-5-mononitrate which belongs to the group of medicines called nitrate vasodilators. It is used to prevent angina pectoris. Angina pectoris is defined as a sudden, sharp, severe pain originating from the apex of heart and radiating to the left shoulder. The pain is severe and crushing, and it is characterized by feeling of pressure and suffocation, behind breastbone. It can also help to control certain types of heart failure.

Isosorbide-5-mononitrate works by relaxing the blood vessels of the heart and this reduces the strain on the heart making it easier to pump blood. Along with the treatment, your doctor might ask you to make certain lifestyle changes such as quitting alcohol and smoking, improve your sleep at night, eating a healthy diet and manage weight.

The most common side effect of taking this medicine is headache. This is common, particularly at the start of treatment and normally subsides after few days. This medicine may make you feel dizzy or light-headed. Avoid travelling or driving while you experience these symptoms. Others side effects includes nausea, vomiting and hypotension. Before taking this medicine, inform your doctor if you have any liver, kidney or heart disease, hypothyroidism or glaucoma.

USES OF ISMO 20MG

Prevents angina pectoris

HOW ISMO 20MG WORKS

After administration, isosorbide-5-mononitrate is converted into free radical nitric oxide which activates the enzyme guanylate cyclase. Activation of this enzyme is followed by synthesis of cyclic guanosine 3′,5′-monophosphate (cyclic GMP) in smooth muscle and other tissues. This process leads to dephosphorylation of myosin light chain of smooth muscles, and results in relaxation and increased blood flow in arteries, veins and cardiac tissue (vasodilatation), this in turn decreases cardiac workload and provides relief from anginal symptoms.

DIRECTIONS FOR USE

Take ISMO 20MG as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose for you depending upon your condition. Continue to take this medicine, as long as your doctor tells you to do so, to obtain better results.

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SIDE EFFECTS OF ISMO 20MG

SERIOUS
Fainting or collapse
Increased chest pain
COMMON
Headache
Nausea or vomiting
Sleepiness
Hypotension (low blood pressure)
Postural hypotension (decreases in blood pressure when standing up)
Tachycardia (fast heartbeat)
Dizziness or feeling weak

HOW TO MANAGE SIDE EFFECTS

Nausea or vomiting:

Try taking this medicine with, or just after meal. Stick to simple meals. Do not eat rich or spicy food.

Headache:

This is common, particularly at the start of treatment and normally subsides after few days. Rest and drink plenty of fluids. Do not drink too much alcohol.

WARNING & PRECAUTIONS

PREGNANCY
ISMO 20MG should be used with caution in pregnant women. Consult your doctor before taking this medicine.

BREASTFEEDING
ISMO 20MG should be used with caution in breastfeeding women. Consult your doctor before taking this medicine.

DRIVING AND USING MACHINES
Do not drive or operate any machines, because this medicine may make you feel dizzy or light-headed.

ALCOHOL
Avoid consumption of alcohol while taking this medicine, because it may raise the blood pressure lowering effect of this medicine.

KIDNEY
ISMO 20MG should be taken with caution in patients with severe kidney disease. Consult your doctor for advice.

LIVER
ISMO 20MG should be taken with caution in patients with severe liver disease. Consult your doctor for advice.

ALLERGY
Do not take this medicine if you are allergic (hypersensitive) to isosorbide-5-mononitrate.

HEART DISEASE
Do not take this medicine if you are suffering from any heart problems. Discuss the risks and benefits with the doctor.

OTHERS

Do not take this medicine, if you have:

Severe anemia, closed angle glaucoma, raised intracranial pressure, cerebral haemorrhage or severe hypovolemia (decreased blood volume)
Hypothyroidism, hypothermia (low body temperature) or malnourished

INTERACTIONS

Talk to your doctor, if you are taking,

Medicines used to treat high blood pressure ACE-inhibitors (e.g. captopril, enalapril), angiotensin- II-receptor antagonists (e.g. losartan, valsartan), beta-blockers (e.g. propanolol, atenolol), calcium antagonists (e.g. diltizem, verapamil) and diuretic (e.g. furosemide)
Medicines used to treat male erectile dysfunction (e.g. sildenafil, tadalafil, vardenafil and alprostadil)
Other medicine used to treat angina such as long acting nitrates (isosorbide dinitrate, nitroglycerin)
Neuroleptics (used to treat psychiatric disorders) e.g. risperidone, aripiprazole
Sapropterin (used to lower phenylalanine levels in blood)
Aldesleukin (used to treat cancer)
Riociguat (used to treat pulmonary hypertension)
Tricyclic anti-depressants (used to treat depression) e.g. imipramine, desipramine
Ergotamine (used for migraine)