Isosorbide mononitrate tablets are indicated for the prevention and treatment of angina pectoris due to coronary artery disease.The onset of action of oral isosorbide mononitrate is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.
Allergic reactions to organic nitrates are extremely rare, but they do occur.Isosorbide mononitrate is contraindicated in patients who are allergic to it.
Amplification of the vasodilatory effects of isosorbide mononitrate by sildenafil can result in severe hypotension.
The time course and dose dependence of this interaction have not been studied.
Appropriate supportive care has not been studied, but it seems reasonable to treat this as a nitrate overdose, with elevation of the extremities and with central volume expansion.The benefits of isosorbide mononitrate in patients with acute myocardial infarction or congestive heart failure have not been established.Because the effects of isosorbide mononitrate are difficult to terminate rapidly, this drug is not recommended in these settings.If isosorbide mononitrate is used in these conditions, careful clinical or hemodynamic monitoring must be used to avoid the hazards of hypotension and tachycardia.