Ismo Retard (isosorbide mononitrate)

How does it work?

Ismo Retard tablets contain the active ingredient isosorbide mononitrate, which is a type of medicine called a nitrate. It is used to help the heart work more easily.

Isosorbide mononitrate works by being converted in the body to a chemical called nitric oxide. This chemical is made naturally by the body and has the effect of making the veins and arteries relax and widen (dilate). When the blood vessels dilate in this way there is more space inside them and hence less resistance. This makes it easier for the heart to pump blood around the body.

Widening the veins also decreases the volume of blood that returns to the heart with each heartbeat. This makes it easier for the heart to pump that blood out again.

As a result of both these actions, the heart does not need as much energy to pump the blood around the body and therefore needs less oxygen.

Isosorbide mononitrate also widens the arteries within the heart itself, which increases the blood and oxygen supply to the heart muscle.

The pain of angina is caused by too little oxygen reaching the heart when its workload increases, such as during exercise. Isosorbide mononitrate improves the oxygen supply to the heart, as well as decreasing the amount of oxygen that the heart needs by making it easier for the heart to pump blood around the body. It can therefore be used to treat angina.

Ismo Retard tablets are modified release tablets that are taken on a regular basis to help prevent angina attacks. The tablets are designed to release the medicine slowly as it passes through the gut. They are taken once a day, usually in the morning, to provide steady blood levels of the medicine throughout the day. The tablets must be swallowed whole and not chewed or crushed, as this would damage the modified release action.

What is it used for?

Prevention of angina attacks.

Warning!

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.

If you think that this medicine has become less effective at preventing 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 Retard 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.

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