Monoket Retard (Isosorbide Mononitrate)

Isosorbide Mononitrate, the active ingredient in Monoket Retard, is a nitrate vasodilator presented as an oral tablet for oral use. It is used for prophylaxis and treatment of chronic stable angina in adults.

GNH USA supplies Monoket Retard as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, pharmacies and clinics worldwide.

Isosorbide Mononitrate is employed in the management of coronary artery disease, particularly angina pectoris.

- Prophylaxis of angina pectoris: reduces the frequency of angina attacks in patients with stable angina. - Treatment of chronic stable angina: improves exercise tolerance and lessens chest‑pain episodes. - Long‑acting nitrate therapy for patients unable to use short‑acting nitrates: provides sustained vasodilation and symptom control.

Isosorbide Mononitrate may cause a range of adverse reactions.

Common Side Effects: - Headache: throbbing pain often occurring shortly after dosing. - Dizziness or light‑headedness: related to blood pressure lowering. - Flushing: warm sensation and reddening of the skin. - Nausea: mild gastrointestinal upset. - 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. - Myocardial infarction: rare but reported in susceptible patients. - Allergic reactions: rash, itching, or swelling. - Stevens‑Johnson syndrome: severe skin reaction. - Methemoglobinemia: abnormal hemoglobin causing cyanosis.

When prescribing or dispensing Isosorbide Mononitrate, several safety considerations apply.

- Dose titration: start with a low dose and increase gradually to minimise hypotension. - Concomitant PDE‑5 inhibitors: avoid use together because of risk of profound hypotension. - Blood pressure monitoring: check for symptomatic hypotension, especially after dose changes. - Renal impairment: consider dose adjustment in patients with reduced renal function. - Pregnancy and lactation: use only if the potential benefit justifies the potential risk to the fetus or infant. - Store at room temperature: keep in the original container, protect from moisture and light.

Isosorbide Mononitrate can interact with several drug classes.

Major Interactions (Avoid): - Phosphodiesterase‑5 inhibitors (e.g., sildenafil, tadalafil): may cause severe hypotension. - Other nitrates (e.g., nitroglycerin, isosorbide dinitrate): additive vasodilatory effect leading to dangerous blood pressure drops. - Antihypertensive agents (e.g., ACE inhibitors, beta‑blockers): may enhance blood‑pressure‑lowering actions.

Moderate Interactions (Monitor Closely): - Alcohol: can increase the risk of hypotension and dizziness. - Diuretics: may cause volume depletion and amplify blood‑pressure reduction. - Azole antifungals (e.g., ketoconazole): may raise nitrate plasma concentrations.