Ismo

Isosorbide Mononitrate, the active ingredient in Ismo, is a nitrate vasodilator presented as an oral tablet for oral use. It is used to manage angina pectoris and chronic heart failure in adult patients. It belongs to the anti‑anginal class and works by releasing nitric oxide to dilate blood vessels, thereby reducing cardiac workload effectively.

GNH USA supplies Ismo as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide, with distribution across the EU and other regulated markets.

Isosorbide Mononitrate is used to treat conditions related to coronary artery disease and heart failure by improving myocardial oxygen supply.

- Angina pectoris: reduces the frequency and severity of chest pain episodes. - Chronic heart failure: decreases symptoms such as dyspnea and improves exercise tolerance. - Stable ischemic heart disease: helps relieve anginal symptoms during physical activity.

Common Side Effects: - Headache: mild to moderate throbbing pain, often transient. - Dizziness or light‑headedness: especially on standing. - Flushing: warm sensation and reddening of skin. - Nausea: occasional upset stomach. - Palpitations: awareness of heartbeat. - Hypotension: mild drop in blood pressure.

Serious or Rare Side Effects: - Severe hypotension: marked blood pressure fall requiring medical attention. - Syncope: sudden loss of consciousness. - Tachycardia: rapid heart rate that may be symptomatic. - Allergic reaction: rash, itching, or swelling. - Angioedema: swelling of face, lips, or throat. - Myocardial infarction: rare but serious cardiac event.

Before starting Ismo, patients should be evaluated for cardiovascular status and concomitant medications.

- Blood pressure monitoring: check for hypotension, especially after dose changes. - Orthostatic precautions: rise slowly from sitting or lying positions. - Hepatic impairment: use with caution; dose adjustment may be needed. - Concomitant nitrates or PDE5 inhibitors: avoid due to risk of severe hypotension. - Allergy assessment: discontinue if signs of hypersensitivity appear. - Store at ambient temperature: keep below 25 °C, retain in original packaging, protect from moisture and direct sunlight.

Isosorbide Mononitrate can interact with several drug classes, requiring careful management.

Major Interactions (Avoid): - Other nitrates (e.g., nitroglycerin): additive vasodilatory effect leading to profound hypotension. - Phosphodiesterase‑5 inhibitors (e.g., sildenafil, tadalafil): risk of severe blood pressure fall. - Strong CYP3A4 inhibitors (e.g., ketoconazole): may increase plasma levels.

Moderate Interactions (Monitor Closely): - Antihypertensive agents (beta‑blockers, ACE inhibitors, diuretics): additive blood pressure reduction. - Alcohol: can enhance vasodilatory effects and dizziness. - Antacids containing aluminum or magnesium: may affect absorption. - Azole antifungals (e.g., fluconazole): modest increase in exposure. - Certain antihistamines: may increase risk of headache.