Monotrate

• Prevention and treatment of angina pectoris due to coronary artery disease

Adult Dose (Oral):

• Tablet: 20 mg 2 times daily (morning and 7 hours apart); maintenance: 20-120 mg daily (1-6 tablets)
• Sustained Release Capsule: 50 mg once daily
• Elderly: Initiate at lower doses

Child Dose: Safety and efficacy not established

Common Side Effects:

• Headache
• Dizziness
• Increased heart rate
• Flushing (sense of warmth in the face, ears, neck and trunk)
• Orthostatic hypotension (sudden lowering of blood pressure on standing)
• Hypotension

Use in Pregnancy: Category B; animal studies show no evidence of fetal harm; no adequate human studies; use only if clearly needed.

Precautions:

• Isosorbide Mononitrate may decrease alertness, affect vision or make you feel sleepy and dizzy; do not drive if symptoms occur
• Avoid alcohol (may increase dizziness)
• Headaches usually go away after a few days; inform doctor if persists
• May develop tolerance over time; follow prescribed dosing schedule
• Do not take erectile dysfunction medications (sildenafil, tadalafil) as they may cause low blood pressure
• Severe hypotension, particularly with upright posture, may occur with even small doses

Overdose: Severe hypotension, dizziness, headache, flushing, nausea, diarrhea; symptomatic treatment; gastric lavage; for hypotension, place patient in supine position and give IV fluids.