Isosorbide Mononitrate
Brand: Monoket (US/EU) / Imdur (US/EU) / Monotrate (IN) / Isomack (BD)
Antianginal
Organic nitrate vasodilator
Pharmacokinetics
| Half-life | 5 hours |
| Tmax | 1 h |
| Bioavailability | 100 % (approx) |
| Protein Binding | 4 % |
| Volume of Distribution | 0.6 L/kg (approx) |
| Clearance Route | hepatic |
| Active Metabolites | no |
| Notes | Completely absorbed orally with nearly 100 % bioavailability; not subject to first-pass metabolism; long-acting once- or twice-daily dosing; tolerance may occur without nitrate-free interval. |
⚠️ Safety & Warnings
Severity: Moderate
Adverse Effects:
Headache, hypotension, dizziness, flushing, syncope
Contraindications:
Concurrent phosphodiesterase-5 inhibitor use (sildenafil, tadalafil), severe hypotension, anemia
Precautions:
Ensure nitrate-free period to prevent tolerance; caution in elderly and volume-depleted patients; avoid abrupt withdrawal in chronic users