Isosorbide mononitrate is a medication used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery disease). It belongs to a class of drugs known as nitrates and works by relaxing and widening blood vessels, which helps increase the blood flow to the heart. This, in turn, reduces the workload on the heart and relieves chest pain.

Mechanism of Action

Isosorbide mononitrate is a nitrate drug that acts as a vasodilator. It is converted into nitric oxide (NO) in the body, which then activates guanylate cyclase, leading to an increase in cyclic guanosine monophosphate (cGMP) levels. Elevated cGMP levels cause smooth muscle relaxation, leading to vasodilation of veins and arteries. This vasodilation reduces cardiac preload and afterload, thereby decreasing myocardial oxygen demand.


Isosorbide mononitrate is primarily indicated for the prevention of angina pectoris due to coronary artery disease. It is not intended for immediate relief of angina attacks.

Dosage and Administration

The dosage of isosorbide mononitrate varies depending on the individual’s condition and response to treatment. It is typically taken orally with or without food as directed by a healthcare professional. The medication should be swallowed whole and not chewed or crushed.

Side Effects

Common side effects of isosorbide mononitrate may include headache, dizziness, lightheadedness, nausea, and flushing as blood vessels widen. In some cases, individuals may experience more serious side effects such as fainting, fast/irregular heartbeat, or severe dizziness.

Contraindications and Precautions

Isosorbide mononitrate is contraindicated in patients who are allergic to nitrates or nitrites. It should also be used with caution in individuals with hypotension (low blood pressure), severe anemia, increased intracranial pressure, or those taking medications for erectile dysfunction that contain sildenafil, tadalafil, or vardenafil.

Drug Interactions

Isosorbide mononitrate may interact with other medications such as phosphodiesterase-5 inhibitors (e.g., sildenafil), riociguat, certain drugs for high blood pressure, and others. These interactions can lead to potentially serious effects and should be discussed with a healthcare provider.

Pregnancy and Lactation

The use of isosorbide mononitrate during pregnancy or breastfeeding should be carefully considered based on the potential benefits and risks. It is important for pregnant or nursing individuals to consult their healthcare provider before using this medication.


In case of an overdose of isosorbide mononitrate, immediate medical attention should be sought. Overdose symptoms may include severe throbbing headache, confusion, fever, rapid breathing, and fainting.


Isosorbide mononitrate should be stored at room temperature away from light and moisture. It should be kept out of reach of children and pets.

In conclusion, isosorbide mononitrate is a vasodilator medication used for the prevention of angina pectoris due to coronary artery disease. Its mechanism of action involves the release of nitric oxide leading to vasodilation. While generally well-tolerated, it has potential side effects and interactions that need to be considered when prescribing or using this medication.

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