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Ismo (Generic Isosorbide)

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Why is this medication prescribed?

Ismo is a medication that contains the active ingredient isosorbide mononitrate. It belongs to a class of drugs called nitrates, and it is primarily prescribed for the prevention and treatment of angina pectoris, a condition characterized by chest pain or discomfort due to reduced blood flow to the heart.

Ismo works by dilating (widening) the blood vessels, particularly the veins, which reduces the workload on the heart and improves blood flow to the heart muscle. This helps relieve the symptoms of angina, such as chest pain, tightness, or pressure. Ismo is typically used as a long-term treatment to prevent angina attacks and improve exercise tolerance in individuals with coronary artery disease.

How should this medicine be used?

Ismo (isosorbide mononitrate) is usually available in the form of extended-release tablets. It’s important to follow the instructions provided by your healthcare professional or the specific directions on the medication label. However, I can provide you with general guidelines for using Ismo:

  • Take Ismo exactly as prescribed: Follow your doctor’s instructions regarding the dosage, frequency, and duration of use. Do not take more or less of the medication or take it more frequently than prescribed.
  • Swallow the tablet whole: Do not crush, chew, or break the tablet. Swallow it whole with a glass of water. Breaking or chewing the tablet may lead to too much of the medication being released at once, which can increase the risk of side effects.
  • Take it consistently: Ismo is usually taken once daily, preferably in the morning. It’s important to take it at the same time each day to maintain a consistent level of the medication in your body.
  • Avoid sudden discontinuation: If you need to stop taking Ismo for any reason, consult your doctor. They will likely advise you to gradually reduce the dosage over time to prevent the occurrence of rebound symptoms.
  • Store properly: Keep Ismo at room temperature, away from moisture, heat, and light. Follow any specific storage instructions provided by the manufacturer.

Remember, these are general guidelines, and it’s crucial to follow the specific instructions given by your healthcare provider. If you have any doubts or questions about the proper use of Ismo, it’s best to consult your doctor or pharmacist for clarification.

Other uses for this medicine

Ismo (isosorbide mononitrate) is primarily prescribed for the prevention and treatment of angina pectoris. However, there may be some off-label or investigational uses of Ismo that are not widely recognized or approved. Off-label use refers to the use of a medication for a purpose not specifically approved by regulatory authorities. It’s important to note that off-label use should only be undertaken under the guidance of a healthcare professional who has evaluated the individual’s specific medical condition.

What special precautions should I follow?

As for special precautions when using Ismo, here are some important points to consider:

  • Allergies: Inform your doctor if you have any known allergies to isosorbide mononitrate or other nitrates. Additionally, disclose any other allergies you may have to medications, foods, or other substances.
  • Medical history: Provide your healthcare provider with a comprehensive medical history, particularly if you have a history of low blood pressure, recent heart attack, heart failure, liver disease, or kidney disease. These conditions may affect the use of Ismo or require adjustments to the dosage.
  • Drug interactions: Inform your doctor about all the medications you are currently taking, including prescription drugs, over-the-counter medications, and herbal supplements. Certain medications, such as erectile dysfunction drugs (e.g., sildenafil, tadalafil) or other nitrates, may interact with Ismo and cause potentially dangerous effects.
  • Pregnancy and breastfeeding: If you are pregnant, planning to become pregnant, or breastfeeding, discuss the potential risks and benefits of using Ismo with your doctor. It’s important to weigh the potential benefits against any potential risks to the developing fetus or nursing infant.
  • Grapefruit juice: Avoid consuming grapefruit or grapefruit juice while taking Ismo. Grapefruit can interact with the medication and increase the risk of side effects.
  • Emergency situations: In case of an emergency or before undergoing any surgical procedures, inform the healthcare professionals involved that you are taking Ismo.

It’s crucial to follow your doctor’s instructions and guidance when taking Ismo. They will consider your individual circumstances and provide you with specific precautions and recommendations based on your medical history and current health status.

What special dietary instructions should I follow?

there are no specific dietary restrictions for Ismo, there are some general guidelines that can help optimize its effectiveness. It’s always best to consult with your healthcare provider or pharmacist for personalized advice, as they are familiar with your specific medical history and needs. That being said, here are some general recommendations:

  • Avoid grapefruit and grapefruit juice: Grapefruit can interfere with the metabolism of certain medications, including Ismo. It can increase the levels of the drug in your body, potentially leading to an increased risk of side effects. Therefore, it’s advisable to avoid consuming grapefruit or grapefruit juice while taking Ismo.
  • Maintain a balanced diet: Following a well-balanced diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats is generally beneficial for overall health. While there are no specific dietary restrictions with Ismo, a healthy diet can support cardiovascular health and complement the effects of the medication.
  • Limit alcohol intake: Alcohol can interact with Ismo and enhance its effects, leading to increased dizziness, lightheadedness, or fainting. It’s advisable to limit alcohol consumption while taking Ismo or to avoid it altogether. If you have any questions about alcohol consumption with Ismo, consult your healthcare provider.

What should I do if I forget a dose?

Regarding a missed dose, if you forget to take a dose of Ismo, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up. Taking extra doses can increase the risk of side effects. If you’re unsure about what to do, it’s always best to consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Ismo, also known as isosorbide mononitrate, is a medication commonly used to prevent angina (chest pain) in people with coronary artery disease. While Ismo is generally well-tolerated, it can cause some side effects. These side effects can vary in severity and may include:

  • Headache: This is the most common side effect of Ismo. The headache may be mild to moderate and can improve over time as your body adjusts to the medication.
  • Dizziness or lightheadedness: Ismo can cause a drop in blood pressure, leading to dizziness or lightheadedness. It’s important to rise slowly from a sitting or lying position to minimize this effect.
  • Flushing or warmth: Ismo can cause your skin to feel warm or flushed, often in the face and neck area. This effect is due to the dilation of blood vessels.
  • Nausea or vomiting: Some individuals may experience gastrointestinal symptoms such as nausea or vomiting while taking Ismo. Taking the medication with food may help reduce these effects.
  • Low blood pressure: Ismo can cause a decrease in blood pressure, resulting in symptoms like lightheadedness, fainting, or feeling weak. It is important to monitor your blood pressure regularly while taking this medication.
  • Rapid heartbeat: Ismo may cause an increase in heart rate, known as tachycardia, in some individuals. If you experience a significantly increased or irregular heartbeat, it’s important to consult your healthcare provider.
  • Allergic reactions: Although rare, some individuals may experience allergic reactions to Ismo, including rash, itching, swelling, or difficulty breathing. Seek immediate medical attention if you develop any signs of an allergic reaction.

What should I know about storage and disposal of this medication?

When it comes to the storage and disposal of Ismo (isosorbide mononitrate), here are some important considerations:


  • Keep Ismo in its original container or packaging to protect it from light and moisture.
  • Store the medication at room temperature, away from heat sources and direct sunlight.
  • Avoid exposing Ismo to extreme temperatures, such as freezing or excessive heat.


  • Do not flush Ismo down the toilet or pour it into a drain unless instructed to do so by specific disposal instructions or local regulations.
  • Consult your healthcare provider, pharmacist, or local waste disposal authorities for guidance on proper disposal methods. They can provide information about medication take-back programs or other disposal options available in your area.
  • If no specific disposal instructions are available, you can mix Ismo with an undesirable substance, like used coffee grounds or cat litter, and place it in a sealed plastic bag before disposing of it in the regular trash. This helps prevent accidental ingestion by pets or children.

In case of emergency/overdose

In case of emergency or a potential overdose, it is important to take the following steps:

  • Contact emergency services (such as the local emergency number) immediately.
  • Inform them about the situation, including the name of the medication (Isosorbide mononitrate/Ismo) and the dosage taken.
  • If possible, provide information about the person’s age, weight, and any known medical conditions.
  • Follow any instructions provided by the emergency services and healthcare professionals.

What other information should I know?

  • Ismo should be taken exactly as prescribed by your healthcare provider. Do not exceed the recommended dose or change the dosing schedule without consulting your doctor.
  • Inform your healthcare provider about any other medications, supplements, or herbal products you are taking, as they can interact with Ismo and affect its effectiveness or increase the risk of side effects.
  • Ismo may cause dizziness or lightheadedness. Avoid activities that require alertness, such as driving or operating heavy machinery, until you know how the medication affects you.
  • If you miss a dose, take it as soon as you remember. If it is close to the time for your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one.

Remember, it’s essential to follow your healthcare provider’s instructions and ask any specific questions you may have about Ismo. They can provide personalized guidance based on your individual medical history and condition.

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