Pain in the heart can occur due to multiple reasons. One such reason is a condition called angina. This may show up when cardiac muscles do not get required amounts of oxygen. The pain experienced in the chest can vary from one person to another. However, there are a few common signs which unmistakably are linked to the incidence of angina. Drugs belonging to a family of medications known as nitrates are used to treat angina. Among nitrates, isosorbide mononitrate is widely used in the case management of this condition. This drug may lead to a few side effects; getting to know them is a smart way to minimize discomforts or other possible medical conditions.
Your heart muscles play a crucial role in ensuring proper circulation. Ironically, when these muscles are deprived of needful levels of blood, such a condition can lead to angina. It often has a lot of similarities with abdominal discomforts such as GERD or acid reflux, indigestion, flatulence, bloating, etc. So, an inexplicable pain in the chest needs to be taken seriously and needful medical help is sought before it turns into a serious medical condition.
People who experience angina describe their pain with multiple phrases – the most common among these descriptions is a feeling of fullness, a squeeze in the chest, a burning sensation, high level of pressure, etc. In most people with angina, pain shows up in other upper parts of the body; especially, parts such as neck, shoulders, jaw, upper back area and your arms. You are most likely to experience respiratory problems such as gasping coupled with excessive sweating, feeling dizzy as well as discomforts like nausea.
Intake of isosorbide mononitrate
Vasodilating drugs are generally administered to ease the flow of blood as well as to provide needful supply of oxygen to cardiac muscles. Nitrates belong to the family of drugs called vasodilators, which are widely used in the treatment of congestion of heart as well as angina. These drugs are known for their capabilities to dilate – i.e., expand your veins. This action removes restrictions to the return of blood from your legs and arms. Once the obstacles are removed, a proper flow resumes to your heart and chest pain eases off in due course of time.
Isosorbide mononitrate forms part of “nitrates” genre of drugs. It is widely used in the treatment of angina (pain in the chest). Its use is more common among people living with a cardiac condition called coronary arterial disorder or disease. This drug however is not consumed after the occurrence of a chest pain. Also, it is not to be taken before a physical activity such as having sex, a workout session or other physical work as well as performing exercises. In order to avoid an incidence of pain in chest your physician may recommend other types of medications.
The standard dose of isosorbide mononitrate is two times each day. It is taken orally – the first dose is taken soon after you have woken up in the morning. The second dose is taken in less than eight (8) hours from the time of your first dosage of each day. This drug is taken in a regular manner to enhance its efficacy levels. Also, it is consumed at the same timeslot every day to increase its efficiencies. Intake of isosorbide mononitrate is not to be discontinued without taking needful consent from your treating doctor. Also, a sudden or abrupt stoppage of doses may very likely worsen or can aggravate your current medical condition.
Side effects of isosorbide mononitrate
Like most other drugs, isosorbide mononitrate may trigger a few adverse side effects. Common side effects of the drug include milder discomforts like nausea, feeling dizzy, headaches, being lightheaded and drowsiness. These discomforts may however show up only for a shorter span of time. They may cease over a period of time – i.e., as soon as your body gets used to this drug. A few of the abovementioned side effects is an indication that the drug’s action has commenced. For instance, headaches are a distinct symptom of the start of its curative actions.
You can seek medical support to manage some of these commonly experienced discomforts such as, say, headaches. Your physician may advise intake of over the counter (OTC) drugs such as aspirin or acetaminophen to get relieved from headaches. In order to counter side effects such as feeling dizzy or being lightheaded, you may be advised to shift postures very slowly; especially, when you are changing from a sleeping or sitting position.
Serious side effects and allergic reactions
In very rare instances, a medication plan involving isosorbide mononitrate may trigger a few serious effects such as rapid beating of the heart, erratic pulse rate, passing out or fainting. In such instances, you are advised to take medical help on an emergency basis upon experiencing these serious discomforts.
You need to tell your treating physician and pharmacist about all known allergies and hypersensitivity to isosorbide mononitrate or any of its inactive ingredients. Also, if you have had prior allergic reactions upon taking drugs such as nitro glycerine, isosorbide di-nitrate, etc., you need to tell your doctor about them. These abovementioned drugs are similar to isosorbide mononitrate and hence a prior allergy can reveal possible risks associated with intake. In a few people, the drug has triggered moderately serious allergic reactions such as respiratory problems, an extreme spell of drowsiness, inflammation of body parts – especially oral and facial organs, rashes on skin, etc. As the aforementioned are relatively acute reactions; hence, you are advised to take medical help without delay.
People living with conditions like a drop in blood pressure – i.e., hypotension, need to tell their physician as well as pharmacist about this medical condition. Also, if you have habits like frequent consumption of alcohol or intake of intoxicating drugs such as cannabis (marijuana), you need to inform about such habits. These habits – along with the intake of isosorbide mononitrate – can lead to excessive spells of dizziness. It is for almost the same reasons you need to avoid working with heavy machinery or stay away from performing activities such as driving. In general, you are advised to keep off from doing tasks that need a fairly high level of nimbleness, mental agility and alertness.
Prior health conditions and likely side effects of isosorbide mononitrate
People who are likely to undergo a surgery need to tell their treating the surgeon about intake of this drug. Also, those who will soon undergo a dental procedure or an intervention need to tell their dental surgeon about consumption of isosorbide mononitrate. In general, you need to keep a list of drugs you currently consume to avoid likely risks of interactions; this list needs to be shared with your treating doctor before starting a course of isosorbide mononitrate. In this list, you are advised to include all possible forms of medications – i.e., prescribed drugs, over the counter (OTC) medications, herbal aids, dietary supplements, etc. This list is one proven way to avoid risks of likely interactions with drugs co-administered with isosorbide mononitrate.
Likely interactions with other drugs are a risk that can be avoided. The side effects of such unintended reactions can get serious, at times. Isosorbide mononitrate may interact adversely if co-administered with a few medications taken to treat male impotence or erectile dysfunction; such drugs include tadalafil, sildenafil, etc. A few other drugs taken for the case management of hypertension – especially to treat a build-up of pressure in your lungs may also interact with isosorbide mononitrate; examples of such drugs include riociguat, etc. You need to remember that isosorbide di-nitrate is almost identical to isosorbide mononitrate; hence, taking these two drugs together can lead to a likely overdose.
In general, you need to ask your pharmacist about the other drugs to be avoided while taking isosorbide mononitrate. You also need to stay cautious about intake of cough relieving drugs, cold management drugs or non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen, ibuprofen, etc.
Pregnancy, breastfeeding and intake of isosorbide mononitrate
Physicians administer isosorbide mononitrate to women who are pregnant only if it is an essential need. Hence, those who are already pregnant need to share the status of their pregnancy prior to starting a course of this drug. Similarly, those who are planning to become pregnant also need to tell their treating doctor about such plans before taking it. The effects of isosorbide mononitrate on women who are breastfeeding or nursing an infant remain largely unknown to therapists. Hence, it is a good practice to inform your physician if you are nursing a baby; this information need to be shared well ahead of commencing a mediation plan that involves intake of isosorbide mononitrate.
Likely risks of an overdose of isosorbide mononitrate
A potential risk of an overdose of isosorbide mononitrate can occur when people skip a dose or skip several doses, and in order to make up for the doses forgotten or not-taken, they tend to take double doses or excessive doses of it. Such practices need to be completely avoided. If you have forgotten to take a dose and if your next dose is already coming up, skip the dose you forgot to take.
On the other hand, if you have forgotten to take multiple doses, talk to your doctor or pharmacist to reschedule your medication and dosage plan. In case of an accidental overdose, you may experience signs such as severe episodes of vomiting, sweating profusely, slow down of pulse rate, chills or tremors, discoloration of fingertips or toes, respiratory problems as well as fainting. It is strongly recommended to take medical help on an emergency basis upon experiencing any of the aforesaid side effects.
In sum, the common side effects associated with the intake of isosorbide mononitrate are nausea, headaches, being lightheaded, feeling dizzy and drowsy. These side effects may occur for a shorter time and may disappear once your body gets used to isosorbide mononitrate. Your doctor may prescribe OTC drugs such as acetaminophen for a headache. If you feel very dizzy, you can slow down your movements – especially while changing postures.
You may need to note that the above list does not represent the entire set of side effects or allergies associated with isosorbide mononitrate. Hence, if you experience any new signs, symptoms or allergic reactions, it is a good practice to tell your treating doctor as well as your pharmacist about the discomforts experienced. Those living in the US are advised to get in touch with the emergency helpline numbers of food and drug administration (FDA); you may also contact 911 as soon as you can. If you living in any of the provinces of Canada, you are advised to contact a local poison control center or call the hotline numbers of Health Canada.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
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