Ismo 20mg

Ismo 20 must not be used I the following conditions:

   — Acute circulatory failure

   — Severe anaemia

   — Marked hypotension

   — Cardiogenic shock

   — Severe hypovolaemia

   — Hypersensitivity to Isosorbide mononitrate, other nitrate compounds, or any ingredients

Ismo tablets may only be taken with caution in the following cases:

   — Aortic or mitral stenosis

   — Hypertrophic obstructive cardiomyopathy, pericardial tamponade, and constrictive pericarditis

   — Susceptibility to orthostatic circulatory dysregulation

   — Disorders associated with increased intracranial pressure

Isosorbide mononitrate is not suitable for treating acute myocardial infarction or angina pectoris. Safety, effectiveness, and dosage of Isosorbide-5-nitrate in children have not been established. Patients with rare hereditary problems of glucose-galactose malabsorption should not take Ismo 20 mg.

Concomitant use of other vasodilators, antihypertensive agents, beta-blockers, ACE inhibitors, diuretics, tricyclic anti-depressants, neuroleptics, calcium antagonists, and alcohol can potentiate the antihypertensive effect of Ismo. This particularly applies to the concomitant use of erectile dysfunction drugs such as sildenafil, tadalafil, and vardenafil.

For special precautionary reasons, the isosorbide mononitrate drug should only be taken during pregnancy on the instructions of a doctor, as there is no adequate report on the use of Ismo 20 mg in pregnant women.  

There is insufficient experience with use in lactating women, and whether the medicine passes into breast milk is unknown. If Ismo is taken during breastfeeding, close monitoring is required for possible drug effects in the infant.

During the initial days of the treatment, a headache may occur, which most resolves after a few days of constant intake. A significant drop in blood pressure with worsening angina pectoris symptoms has been observed. Severe hypotensive responses, including nausea, restlessness, vomiting, pallor, and hyperhidrosis, have been reported for organic nitrates. Please talk to your doctor if any of these become troublesome or if you develop other side effects that persist for longer. 

The standard dose of Ismo 20 mg is one tablet twice daily, which might be increased to one tablet daily if the individual requirement is higher. To prevent or minimize nitrate headaches, it is recommended that the dose is reduced to half a tablet twice daily for the initial two days and then increased to one tablet two times a day for the next two days. Afterwards, the treatment regimen can be maintained at this level or increased, if necessary, to one tablet thrice daily. Treatment with Ismo 20 mg is normally long-term therapy. The tablet should be swallowed uncrushed or unchewed with plenty of water. If needed, one tablet can be taken shortly before going to sleep. It is important to take the drug as instructed by your doctor. The sudden discontinuance of medicine can cause undesirable reactions. So, it is necessary that before stopping the drug intake, you should always consult a physician first.

Generally, this tablet is advised to be taken once a day. Always take the dose as prescribed by the physician. It is very important to consume medicine timely. Various factors are observed before prescribing a drug; thus, your doctor will prescribe the best suitable dose for you. Dosage can be adjusted depending on the patient’s severity of the condition.