Ismo (isosorbide mononitrate)

- This medicine should not be used to treat an angina attack, as it does not work quickly enough. It should be taken regularly, as prescribed, to prevent angina attacks, and you should keep your glyceryl trinitrate (GTN) sublingual tablets or spray with you at all times to use if you do have an angina attack.
- This medicine may cause dizziness and so may affect your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how this medicine affects you and you are sure it won't affect your performance.
- Drinking alcohol may enhance some of the side effects of this medicine, such as feeling faint or dizzy.
- With long-term continuous use the body can start to become tolerant to this medicine, which means it may seem less effective. To avoid this problem, it is important that there is a period of time in every 24 hours when the amount of medicine in your blood is allowed to drop. This is acheived by not spacing your doses evenly throughout the day. For example, if you are taking this medicine twice a day, you could take your first tablet in the morning and your second about eight hours later, rather than 12 hours later. Ask your doctor or pharmacist for advice on when is best for you to take your tablets. This will depend on when your angina is usually worse.
- If you think that this medicine has become less effective at preventing your angina attacks you should consult your doctor or pharmacist.
- You should not suddenly stop taking this medicine, as this could cause your angina to get worse. If treatment with this medicine is stopped, this should be done gradually, following the instructions given by your doctor.

Use with caution in

- Severely decreased kidney function.
- Severely decreased liver function.
- People who have recently had a heart attack.
- Underactive thyroid gland .
- People with low levels of oxygen in their blood, eg due to lung disease.
- Dangerously low body temperature (hypothermia).
- Malnutrition.

Not to be used in

- Allergy to nitrates.
- Low blood pressure (hypotension).
- Low volume of circulating blood (hypovolaemia).
- Inflammation of the sac surrounding the heart that stops the heart from beating properly (constrictive pericarditis).
- Fluid in the sac surrounding the heart that prevents the heart beating properly (cardiac tamponade).
- Narrowing of the main artery coming from the heart (aortic stenosis).
- Narrowing of one of the valves in the heart.
- Heart disease in which the muscle of the heart grows abnormally (hypertrophic obstructive cardiomyopathy).
- Head injury.
- Bleeding in the brain (cerebral haemorrhage).
- Severe anaemia.
- Closed angle glaucoma.
- Lactase insufficiency, galactosaemia or glucose/galactose malabsorption syndrome. (Ismo tablets contain lactose).
- This medicine is not recommended for use in children.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The safety of this medicine for use during pregnancy has not been established. It should only be used during pregnancy if the benefits to the mother outweigh any risks to the developing baby. Seek medical advice from your doctor.
- It is not known if this medicine passes into breast milk. It should only be used by breastfeeding mothers if the benefits to the mother outweigh any risks to the nursing infant. Seek medical advice from your doctor.

Label warnings

- This medication is to be swallowed whole, not chewed.

The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care or attention by a qualified practitioner. The materials in this web site cannot and should not be used as a basis for diagnosis or choice of treatment. Conditions for use © Copyright 1998 - 2008 NetDoctor.co.uk - All rights reserved