isosorbide mononitrate

CLINICAL USE

Vasodilator:Treatment and prophylaxis of angina Adjunct in congestive heart failure

DOSE IN NORMAL RENAL FUNCTION

20–120 mg/day in divided doses

PHARMACOKINETICS

Molecular weight :191.1

%Protein binding :<4

%Excreted unchanged in urine : 2

Volume of distribution (L/kg) :0.6

half-life – normal/ESRD (hrs) :1.5–5/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in normal renal function

HD :Dialysed. Dose as in normal renal function

HDF/high flux :Dialysed. Dose as in normal renal function

CAV/VVHD :Probably Dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsSildenafil: hypotensive effect significantly enhanced – avoid concomitant useTadalafil: hypotensive effect significantly enhanced – avoid concomitant use

Vardenafil: hypotensive effect significantly enhanced – avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Tolerance may develop. This may be minimised by having nitrate-‘free’ periodsisosorbide mononitrate.

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