![]() ![]() Isosorbide mononitrate may also have a direct dilatory effect on the coronary arteries. High plasma concentrations also dilate the arteries reducing systemic vascular resistance and arterial pressure leading to a reduction in cardiac afterload. Low plasma concentrations lead to venous dilatation, resulting in peripheral pooling of blood, decreased venous return and reduction in left ventricular end-diastolic pressure (preload). The effect of the treatment is dependent on the dose. The principal pharmacological action of isosorbide mononitrate, an active metabolite of isosorbide dinitrate, is relaxation of vascular smooth muscle, producing vasodilation of both arteries and veins with the latter effect predominating. Pharmacotherapeutic group: Vasodilators used in cardiovascular disease (organic nitrates). Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: or search for MHRA Yellow Card in thr Google Play or Apple App Store. It allows continued monitoring of the benefit/risk balance of the medicinal product. ![]() Reporting suspected adverse reactions after authorisation of the medicinal products is important. Musculoskeletal and connective tissue disorders These symptoms generally disappear during continued treatment. Hypotension, with symptoms such as dizziness and nausea with syncope in isolated cases, has occasionally been reported. Headache may occur when treatment is initiated, but usually disappears after 1-2 weeks of treatment. Most of the adverse reactions are pharmacodynamically mediated and dose dependent. The adverse reactions which follow have been reported in studies with isosorbide mononitrate. ![]()
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