Introduction About ISONITRATE 60 SR TABLET

ISONITRATE 60 SR TABLET contains Isosorbide Mononitrate which belongs to the group of medicines called Nitrate vasodilators. It is used to manage angina pectoris, which is a type of chest pain caused when your heart muscle does not get enough blood supply. The pain is severe and crushing and it is characterized by feeling of pressure and suffocation, behind breastbone.   

Your doctor may advise you to follow lifestyle changes such as diet changes (taking foods low in fat, salt or sugar) and do regular mild exercises to achieve better results during management with this medicine.              

ISONITRATE 60 SR TABLET is not recommended for use in patients with heart problems such as constrictive pericarditis, cardiac tamponade, heart attack, aortic stenosis, mitral stenosis, hypertrophic cardiomyopathy, very low blood pressure and close angle glaucoma.   

Before taking ISONITRATE 60 SR TABLET, inform your doctor if you have a history of liver or kidney problems, hypothyroidism and low body temperature (hypothermia). ISONITRATE 60 SR TABLET is not recommended for use during the first three months of pregnancy and it is not recommended for use in breast-feeding women unless clearly advised by the doctor.

ISONITRATE 60 SR TABLET is not recommended for use in children and should be used with caution in elderly patients. The common side effects of taking ISONITRATE 60 SR TABLET are headache, dizziness and nausea. Consult your doctor if any of the side effects worsen.

Uses Of ISONITRATE 60 SR TABLET

• Manage angina pectoris (chest pain)  

How ISONITRATE 60 SR TABLET Works

ISONITRATE 60 SR TABLET helps to relax the blood vessels and muscles of the heart, which causes the space inside the blood vessels to widen. This helps to ease the flow of blood in the blood vessels of the heart and provides relief from the pain associated with blockage of vessels as seen in angina.   

How to use ISONITRATE 60 SR TABLET

Take ISONITRATE 60 SR TABLET as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of ISONITRATE 60 SR TABLET for you depending upon your age, body weight and disease condition.  

Side Effects Of ISONITRATE 60 SR TABLET

How To Manage Side Effects

Diarrhea

Drink lot of fluids such as water to keep yourself hydrated. Avoid eating high-fat or spicy foods. Consult your doctor if the symptom gets worse.

Headache

Drink ample amount of water and avoid skipping meals. Get adequate rest. Try to be relaxed and stress free. Apply pain relieving balm on your forehead if necessary. Consult your doctor if the symptom does not improve.

Nausea And Vomiting

Take ISONITRATE 60 SR TABLET with or just after meals. Stick to simple meals. Avoid eating oily, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve.

Warning & Precautions

Pregnancy

Contraindicated

ISONITRATE 60 SR TABLET is not recommended for use during the first three months of pregnancy. If you are pregnant or planning to get pregnant, consult your doctor before taking it.    

Breastfeeding

Monitoring required

ISONITRATE 60 SR TABLET is not recommended for use in breast-feeding women unless considered clearly necessary. Consult your doctor before taking it.   

Driving and Using Machines

Use with Caution

Do not drive or operate any machines if you experience dizziness after taking ISONITRATE 60 SR TABLET.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking ISONITRATE 60 SR TABLET.

Kidney

Use with Caution

ISONITRATE 60 SR TABLET should be used with caution in patients with kidney problems. Consult your doctor before taking it.

Liver

Use with Caution

ISONITRATE 60 SR TABLET should be used with caution in patients with liver problems. Consult your doctor before taking it.  

Allergy

Contraindicated

Do not take ISONITRATE 60 SR TABLET if you are allergic to isosorbide mononitrate or other ingredients of this medicine.

Heart Disease

Consult your doctor

ISONITRATE 60 SR TABLET is not recommended for use in patients with constrictive pericarditis (inflammation of the lining around the heart), cardiac tamponade (where the fluid around the heart puts pressure on the heart), heart attack, aortic stenosis (narrowing of the main artery coming from the heart), mitral stenosis (narrowing of the mitral valve on the left side the heart), hypertrophic cardiomyopathy (condition in which the heart muscle becomes abnormally thick). It should be used with caution in patients with serious damage to the heart. Consult your doctor before taking it.

Use In Pediatrics

Contraindicated

ISONITRATE 60 SR TABLET is not recommended for use in children. Consult your child’s doctor for advice.

Use In Geriatrics

Use with Caution

ISONITRATE 60 SR TABLET should be used with caution in elderly patients. Consult your doctor before taking it.

Interactions

A. Drug-Drug Interactions

Before taking ISONITRATE 60 SR TABLET, inform your doctor if you are taking any of the following medicines:

• medicines used to manage male impotency (Ex. sildenafil, tadalafil, alprostadil)
• medicines used to manage high blood pressure such as calcium channel blockers (Ex. verapamil), angiotensin-converting enzyme (ACE) inhibitors (Ex. captopril, lisinopril), angiotensin II receptor blockers (Ex. azilsartan, candesartan), betablockers (Ex, metoprolol, atenolol) and diuretics (Ex. hydrochlorothiazide)
• aldesleukin (used for the management of cancer)
• benzodiazepines such as temazepam (used to manage insomnia)
• tricyclic antidepressants such as amitriptyline (used to manage depression)
• neuroleptics (Ex. haloperidol, trifluoperazine) (used to manage psychiatric disorders)

Overdosage:
If you or anyone else accidentally take too much of ISONITRATE 60 SR TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdosage are nausea, vomiting, pulsing headache, reddening of the skin, cold perspiration and fast heart beat.

Synopsis

More Information

• Keep ISONITRATE 60 SR TABLET out of reach of children
• Store at room temperature  

FAQs About ISONITRATE 60 SR TABLET

Q: What is ISONITRATE 60 SR TABLET used for?

A: ISONITRATE 60 SR TABLET is used to manage angina pectoris, which is a type of chest pain caused when your heart muscle does not get enough blood supply. The pain is severe and crushing and it is characterized by feeling of pressure and suffocation, behind breastbone. 

Q: Can ISONITRATE 60 SR TABLET be used in elderly patients?

A: Yes, ISONITRATE 60 SR TABLET should be used with caution in elderly patients. Your doctor may adjust the dose of ISONITRATE 60 SR TABLET due to increased risk of side effects in elderly individuals. Consult your doctor before taking it.

Q: Is ISONITRATE 60 SR TABLET safe to use during pregnancy?

A: ISONITRATE 60 SR TABLET is not recommended for use during the first three months of pregnancy. If you are pregnant or planning to get pregnant, consult your doctor before taking ISONITRATE 60 SR TABLET.  

Q: What are the common side effects of ISONITRATE 60 SR TABLET?

A: The common side effects of taking ISONITRATE 60 SR TABLET are headache, faster heartbeat, dizziness, low blood pressure and nausea. Consult your doctor if any of the side effects worsen.

Q: Is ISONITRATE 60 SR TABLET safe to use in patients with liver problems?

A: ISONITRATE 60 SR TABLET should be used with caution in patients with liver problems. Your doctor may monitor your liver function test before and during management with this medicine to manage the risk of any unusual effects. Consult your doctor before taking ISONITRATE 60 SR TABLET.

References

1. KD. Tripathi. Antianginal and Other Anti-ischaemic Drugs. Essentials of Medical Pharmacology. Seventh edition. 2013. Page 539-588

2. Gunasekara, N.S. and Noble, S. Isosorbide 5-Mononitrate, Drugs. [Revised in October 2012] [Accessed on 20th July 2022] https://link.springer.com/article/10.2165/00003495-199957020-00016

3. Walker, J.M., Curry, P.V.L., Bailey, A.E. and Steare, S.E. A comparison of nifedipine once daily (Adalat LA), isosorbide mononitrate once daily and isosorbide dinitrate twice daily in patients with chronic stable angina. International journal of cardiology. [Accessed on 20th July 2022] https://www.sciencedirect.com/science/article/abs/pii/0167527395025316

4. Milpharm Limited. Electronic Medicines Compendium (EMC). [Revised in August 2021] [Accessed on 20th July 2022] https://www.medicines.org.uk/emc/files/pil.549.pdf

Useful Diagnostic Tests

• Electrocardiogram (ECG)
• Chest x-ray
• Echocardiogram