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Isosorbide mononitrate: Drug information

Isosorbide mononitrate: Drug information
(For additional information see "Isosorbide mononitrate: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: Canada
  • APO-ISMN;
  • Imdur;
  • PMS-ISMN;
  • PRO-ISMN-60
Pharmacologic Category
  • Antianginal Agent;
  • Vasodilator
Dosing: Adult
Angina, prevention

Angina, prevention:

Note: For prevention of recurrent angina, may use in combination with other anti-anginal therapy (eg, beta-blocker) (Ref).

Immediate release: Oral: 20 mg twice daily; administer second dose at least 7 hours after the first dose (eg, 8 AM and 3 PM) to decrease tolerance development; patients with small stature may initiate therapy with 5 mg twice daily and titrate to at least 10 mg twice daily in first 2 to 3 days of therapy.

Extended release: Oral: Initial: 30 to 60 mg once daily in the morning; may titrate after several days to 120 mg once daily; rarely, 240 mg once daily may be required.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: Mild to severe impairment: No dosage adjustment necessary (Ref).

Hemodialysis, intermittent (thrice weekly): Moderately dialyzable (AUC0-8 decreased 30% with a 4-hour dialysis session (Ref)): No supplemental dose or dosage adjustment necessary (Ref).

Peritoneal dialysis: Not significantly dialyzed (Ref): No dosage adjustment necessary (Ref).

Dosing: Hepatic Impairment: Adult

No dosage adjustment necessary.

Dosing: Older Adult

Refer to adult dosing; initiate with lowest recommended dose.

Adverse Reactions (Significant): Considerations
Headaches

The use of nitrates, including isosorbide mononitrate, commonly results in headache; migraine or cluster headache may also occur (Ref). The severity of headaches ranges from mild to severe and, depending on the etiology, may decrease in both frequency and intensity with continued use (Ref); however, some patients require symptomatic treatment of the headache and/or discontinuation of nitrate therapy (Ref).

Mechanism: There are multiple proposed mechanisms. Immediate headaches are thought to be a result of vasodilation caused by nitric oxide release (Ref); whereas migraine may occur as a result of vasodilation, calcitonin gene-related peptide or glutamate release, and/or ion channel function changes associated with cyclic guanosine monophosphate or S-nitrosylation (Ref).

Onset: Rapid; immediate headaches may appear within minutes to hours of administration and last for several hours (Ref); migraine may occur within hours of administration and last for several hours (Ref).

Risk factors:

• Migraine is more common in patients with a prior history or predisposing risk factors for migraine (Ref)

• Higher initial dose and/or rapid dose titration (Ref)

Hypotension and bradycardia

Isosorbide mononitrate administration may result in hypotension or orthostatic hypotension (Ref); paradoxical bradycardia and exacerbation of angina pectoris may also occur. Tolerance may develop to the effect on blood pressure (Ref); however, hypotension can be severe (even at small doses) and require treatment discontinuation (Ref).

Mechanism: Dose-related; related to the pharmacologic action (vasodilation) (Ref).

Onset: Rapid; decrease in blood pressure occurs within hours of administration (Ref).

Risk factors:

• Consumption of ethanol may exacerbate orthostatic hypotension

• Upright position

• Concomitant use of phosphodiesterase-5 inhibitors (eg, sildenafil, tadalafil, vardenafil) (Ref)

• Hypovolemia (Ref)

Intracranial pressure increased

Nitrates, especially use of IV nitrates (eg, nitroprusside, nitroglycerin), may precipitate or aggravate increased intracranial pressure and subsequently may worsen clinical outcomes in patients with neurologic injury (eg, intracranial hemorrhage, traumatic brain injury) (Ref).

Mechanism: Dose-related; related to the pharmacologic action (vasodilation resulting in decreased cerebral blood flow) (Ref).

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Nervous system: Dizziness (4% to 11%), headache (13% to 57%) (table 1)

Isosorbide Mononitrate: Adverse Reaction: Headache

Drug (Isosorbide Mononitrate)

Placebo

Dose

Dosage Form

Number of Patients (Isosorbide Mononitrate)

Number of Patients (Placebo)

57%

15%

240 mg once daily

ER tablets

65

96

51%

15%

60 mg once daily

ER tablets

102

96

42%

15%

120 mg once daily

ER tablets

65

96

38%

15%

30 mg once daily

ER tablets

60

96

35%

6%

20 mg twice daily

IR tablets

159

160

17%

6%

5 mg twice daily

IR tablets

54

160

13%

6%

10 mg twice daily

IR tablets

52

160

1% to 10%:

Cardiovascular: Abnormal heart sounds (≤5%), acute myocardial infarction (≤5%), atrial arrhythmia (≤5%), atrial fibrillation (≤5%), bradycardia (≤5%), bundle branch block (≤5%), cardiac arrhythmia (≤5%), chest pain (2%), ECG abnormality (Q wave: ≤5%), edema (≤5%), exacerbation of angina pectoris (≤5%), extrasystoles (≤5%), flushing (2%), heart failure (≤5%), heart murmur (≤5%), hypertension (≤5%), hypotension (≤5%), intermittent claudication (≤5%), palpitations (≤5%), tachycardia (≤5%), varicose veins (≤5%), ventricular tachycardia (≤5%)

Dermatologic: Abnormal hair texture (≤5%), acne vulgaris (≤5%), cutaneous nodule (≤5%), diaphoresis (≤5%), leg ulcer (≤5%), pruritus (2%), skin rash (≤2%)

Endocrine & metabolic: Decreased libido (≤5%), hot flash (≤5%), hyperuricemia (≤5%), hypokalemia (≤5%)

Gastrointestinal: Abdominal pain (2%), constipation (≤5%), diarrhea (2%), dyspepsia (≤5%), flatulence (≤5%), gastric ulcer (≤5%), gastric ulcer with hemorrhage (≤5%), gastritis (≤5%), glossitis (≤5%), hemorrhoids (≤5%), loose stools (≤5%), melena (≤5%), nausea (3%), vomiting (≤5%), xerostomia (≤5%)

Genitourinary: Atrophic vaginitis (≤5%), impotence (≤5%), mastalgia (≤5%), urinary tract infection (≤5%)

Hematologic & oncologic: Hypochromic anemia (≤5%), purpuric disease (≤5%), thrombocytopenia (≤5%)

Hepatic: Increased serum alanine aminotransferase (≤5%), increased serum aspartate aminotransferase (≤5%)

Hypersensitivity: Hypersensitivity reaction (2%)

Infection: Bacterial infection (≤5%), candidiasis (≤5%), viral infection (≤5%)

Nervous system: Anxiety (≤5%), asthenia (≤5%), confusion (≤5%), depression (≤5%), drowsiness (≤5%), emotional lability (2%), fatigue (4%), hypoesthesia (≤5%), insomnia (≤5%), lack of concentration (≤5%), malaise (≤5%), migraine (≤5%), myasthenia (≤5%), nervousness (≤5%), neuritis (≤5%), nightmares (≤5%), pain (4%), paresis (≤5%), paresthesia (≤5%), rigors (≤5%), tremor (≤5%), vertigo (≤5%)

Neuromuscular & skeletal: Arthralgia (≤5%), back pain (≤5%), musculoskeletal pain (≤5%), myalgia (≤5%), myositis (≤5%), shoulder stiffness (frozen shoulder: ≤5%), tendinopathy (≤5%), torticollis (≤5%)

Ophthalmic: Blepharoptosis (≤5%), conjunctivitis (≤5%), photophobia (≤5%), visual disturbance (≤5%)

Otic: Otalgia (≤5%), perforated tympanic membrane (≤5%), tinnitus (≤5%)

Renal: Nephrolithiasis (≤5%), polyuria (≤5%)

Respiratory: Bronchitis (≤5%), bronchospasm (≤5%), cough (≤5%), dyspnea (≤5%), flu-like symptoms (≤5%), increased bronchial secretions (≤5%), increased cough (2%), nasal congestion (≤5%), pharyngitis (≤5%), pneumonia (≤5%), pulmonary infiltrates (≤5%), rales (≤5%), rhinitis (≤5%), sinusitis (≤5%), upper respiratory infection (1% to 4%)

Miscellaneous: Fever (≤5%)

<1%:

Dermatologic: Pallor

Endocrine & metabolic: Increased thirst, weight loss

Gastrointestinal: Anorexia, bitter taste

Genitourinary: Prostatic disease

Nervous system: Cerebrovascular accident, restlessness

Neuromuscular & skeletal: Muscle cramps, neck pain

Ophthalmic: Amblyopia

Respiratory: Asthma

Postmarketing:

Cardiovascular: Orthostatic hypotension (Mussi 2009), syncope (Mussi 2009)

Nervous system: Cluster headache (Bagdy 2010)

Contraindications

Hypersensitivity to isosorbide mononitrate, other nitrates or nitrites, or any component of the formulation; concurrent use with phosphodiesterase-5 (PDE-5) inhibitors (sildenafil, tadalafil, or vardenafil) or riociguat.

Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Canadian labeling: Additional contraindications (not in US labeling): Acute circulatory failure associated with marked hypotension (shock and states of collapse); postural hypotension; myocardial insufficiency due to obstruction (eg, in the presence of aortic or mitral stenosis or of constrictive pericarditis); increased intracranial pressure; severe anemia.

Warnings/Precautions

Concerns related to adverse effects:

• CNS depression: May cause CNS depression, which may impair physical or mental abilities; patients must be cautioned about performing tasks that require mental alertness (eg, operating machinery or driving).

Disease-related concerns:

• Cardiovascular disease: Not recommended for use in patients with acute myocardial infarction (MI) or heart failure (has not been studied). Use with caution in volume depletion and moderate hypotension, and with extreme caution with inferior wall MI and suspected right ventricular infarctions. The Canadian labeling contraindicates use in acute circulatory failure associated with marked hypotension, postural hypotension, and myocardial insufficiency due to obstruction (eg, in the presence of aortic or mitral stenosis or of constrictive pericarditis).

• Hypertrophic cardiomyopathy with left ventricular outflow tract obstruction: Avoid use in patients with hypertrophic cardiomyopathy with left ventricular outflow tract obstruction; nitrates may reduce preload, exacerbating obstruction and cause hypotension or syncope and/or worsening of heart failure (AHA/ACC [Ommen 2021]).

Concurrent drug therapy issues:

• PDE-5 inhibitors: Avoid concurrent use with PDE-5 inhibitors (eg, sildenafil, tadalafil, vardenafil). When nitrate administration becomes medically necessary, may administer nitrates only if 24 hours have elapsed after use of sildenafil or vardenafil (48 hours after tadalafil use) (O’Connor 2010).

Dosage forms related issues:

• Extended-release tablets: Empty matrix "ghosts" (tablets) may pass in patients via colostomy or in the stool; this is of no concern.

Other warnings/precautions:

• Appropriate use: Extended-release: Not intended for the immediate relief of acute attacks of angina pectoris.

• Tolerance: Appropriate dosing intervals are needed to minimize tolerance development. Tolerance can only be overcome by short periods of nitrate absence from the body. Dose escalation does not overcome this effect.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Generic: 10 mg, 20 mg

Tablet Extended Release 24 Hour, Oral:

Generic: 30 mg, 60 mg, 120 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablet, 24-hour (Isosorbide Mononitrate ER Oral)

30 mg (per each): $0.52 - $3.35

60 mg (per each): $0.54 - $4.28

120 mg (per each): $0.76 - $8.80

Tablets (Isosorbide Mononitrate Oral)

10 mg (per each): $0.85

20 mg (per each): $0.89

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet Extended Release 24 Hour, Oral:

Imdur: 60 mg

Generic: 60 mg

Administration: Adult

Do not administer around-the-clock. IR tablet should be scheduled twice daily with doses 7 hours apart (8 AM and 3 PM); administer ER tablet once daily in the morning upon rising with a half-glassful of fluid. Do not chew or crush ER tablets; may be divided in half. Due to insoluble matrix embedding, ER tablets that are scored may be split (Ref).

Bariatric surgery: Tablet, extended release: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Scored tablets may be cut in half. Alternatively, may switch to IR formulation.

Use: Labeled Indications

Angina pectoris, prevention: Treatment (immediate-release only) and prevention of angina pectoris caused by coronary artery disease. Note: The onset of action of oral isosorbide mononitrate is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.

Medication Safety Issues
Sound-alike/look-alike issues:

Imdur may be confused with Imuran, Inderal LA, K-Dur

Monoket may be confused with Monopril

Metabolism/Transport Effects

Substrate of CYP3A4 (minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Alcohol (Ethyl): May enhance the vasodilatory effect of Vasodilators (Organic Nitrates). Risk C: Monitor therapy

Dapoxetine: May enhance the orthostatic hypotensive effect of Vasodilators (Organic Nitrates). Risk C: Monitor therapy

Dapsone (Topical): May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Risk C: Monitor therapy

Local Anesthetics: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy

Molsidomine: May enhance the hypotensive effect of Vasodilators (Organic Nitrates). Risk C: Monitor therapy

Nitric Oxide: May enhance the adverse/toxic effect of Methemoglobinemia Associated Agents. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy

Phosphodiesterase 5 Inhibitors: May enhance the vasodilatory effect of Vasodilators (Organic Nitrates). Risk X: Avoid combination

Prilocaine: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Prilocaine. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Management: Monitor patients for signs of methemoglobinemia (e.g., hypoxia, cyanosis) when prilocaine is used in combination with other agents associated with development of methemoglobinemia. Avoid lidocaine/prilocaine in infants receiving such agents. Risk C: Monitor therapy

Rilmenidine: Vasodilators (Organic Nitrates) may enhance the hypotensive effect of Rilmenidine. Risk C: Monitor therapy

Riociguat: Vasodilators (Organic Nitrates) may enhance the hypotensive effect of Riociguat. Risk X: Avoid combination

Rosiglitazone: Vasodilators (Organic Nitrates) may enhance the adverse/toxic effect of Rosiglitazone. Specifically, a greater risk of ischemia and other adverse effects has been associated with this combination in some pooled analyses. Risk C: Monitor therapy

Sodium Nitrite: Methemoglobinemia Associated Agents may enhance the adverse/toxic effect of Sodium Nitrite. Combinations of these agents may increase the likelihood of significant methemoglobinemia. Risk C: Monitor therapy

Pregnancy Considerations

Adverse events have been observed in some animal reproduction studies.

Nitric oxide donors, such as isosorbide, have been evaluated for cervical ripening and induction of labor (Abu-Zaid 2022; Ghosh 2016); however, use of isosorbide mononitrate is not currently recommended for this indication (ACOG 2009; NICE 2021). Nitric oxide donors have also been evaluated for the prevention of preterm birth (Duckitt 2014; Wilson 2022); additional study is needed for this indication and use is not currently recommended (McDougal 2023; WHO 2022).

Breastfeeding Considerations

It is not known if isosorbide mononitrate is present in breast milk.

The manufacturer recommends that caution be exercised when administering isosorbide mononitrate to patients who are breastfeeding.

Monitoring Parameters

Blood pressure, heart rate

Mechanism of Action

Nitroglycerin and other nitrates form free radical nitric oxide. In smooth muscle, nitric oxide activates guanylate cyclase which increases guanosine 3’5’ monophosphate (cGMP) leading to dephosphorylation of myosin light chains and smooth muscle relaxation. Produces a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins. Primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure); may modestly reduce afterload; dilates coronary arteries and improves collateral flow to ischemic regions.

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: 30 to 45 minutes (Thadani 1987)

Duration: Immediate release: ≥6 hours (Thadani 1987); Extended release: ≥12 to 24 hours (Anderson 2007)

Absorption: Rapid and complete

Distribution: Vd: ~0.6 L/kg

Protein binding: <5%

Metabolism: Hepatic

Bioavailability: ~100%

Half-life elimination: 5 to 6 hours (Thadani 1987)

Time to peak, plasma: 30 to 60 minutes

Excretion: Predominantly urine (2% as unchanged drug); feces (1%)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Apo Ismn | Elantan | Imdur | Ismo | Mono mack | Monoclair | Monotrate;
  • (AR) Argentina: Cilatron | Cilatron ap | Isosorbide 5-mononitrato gen med | Medocor | Medocor ap | Misordil | Monoket | Monotrin;
  • (AT) Austria: Elantan | Ismn | Isomonat | Isosorbidmononitrat 1a pharma gmbh | Isosorbidmononitrat genericon pharma | Isosorbidmononitrat hexal pharma | Mono-mack | Monoket | Myocardon mono | Olicardin;
  • (AU) Australia: Apo isosorbide mononitrate | Arsorb | Cm isosorb mononit | Duride | Genrx isosorbide mononitrate | Imdur | Imtrate | Isobide mr | Isomonit | Isosorbide an | Isosorbide mononitrate-bc | Isosorbide pfizer | Isosorbide ps | Monodur | Tw isosorb mononit;
  • (BD) Bangladesh: A-Card | Angifix | Esmo | Imocard | Iso | Monate | Monis | Monit | Moniten | Monocard | Monocinque | Monocontin | Monotrate | Pentacard | Unicard;
  • (BE) Belgium: Pentacard | Promocard;
  • (BG) Bulgaria: Isosorbe | Monisid | Monodilat | Neosorbid | Olicard;
  • (BR) Brazil: Cincordil | Coronar | Lfm mononitrato de isossorbida | Monocordil | Mononitrato de isossorbida | Mononitrato de isossorbida biolab gen | Vexell;
  • (CH) Switzerland: Ismo;
  • (CL) Chile: Ismo | Medocor | Mono Pack;
  • (CN) China: Ai di mo ni | Ai fu ning | Ai si mo | Chen gong zaijia | Danxiao | De mai ning | Detrilin | Elantan | Etimonis | Imdur | Is 5 mono | Ismo | Isomonit | Jin xin tai | Kai wei fu | Li wei | Li zhu xin le | Lu nan xin kang | Mono mack | Monotrate | Pentacard | Rui de ming | Shan su | Shu bi lai te | Suo ni te | Xin kang | Xin le | Xin tai | Ya xu | Yi bei te | Yi mai qing | Yi suo man | Yi xin jian | Zai cheng | Zai jia;
  • (CO) Colombia: Cardalol | Cincordil | Imodur | Monis;
  • (CZ) Czech Republic: Elantan | Imdur | Ismn al | Isomonat | Isostenase | Mono mack | Monosan | Monosor | Monostenase | Monotab | Olicard | Sorbimon;
  • (DE) Germany: Coleb | Coleb-duriles | Conpin | Corangin | Duramonitat | Elan | Elantan | Is 5 mono | Ismanton | Ismn | Ismn 1a pharma | Ismn abz | Ismn al | Ismn basics | Ismn klast | Ismn Sandoz | Ismn stada | Ismn Temmler | Ismn von CT | Ismo | Ismonoreal | Isomon | Isomonit | Isosorbid mononitrate | Moni biochemie | Moni sanorania | Monit Puren | Mono | Mono 5 Wolff | Mono 5-Wolff | Mono acis | Mono mack | Mono Maycor | Mono sigma | Mono wolff | Mono-corax | Monobeta | Monoclair | Monolong | Mononitrat | Monopur | Monostenase | Olicard | Orasorbil | Sigacora | Turimonit;
  • (DK) Denmark: Farmidur;
  • (DO) Dominican Republic: Angicor | Elantan | Ismo | Isocard | Isonitril | Medocor | Medocor ap | Mono Pack | Monobide | Monobide AP | Monocinque | Nitricor | Pectocor;
  • (EC) Ecuador: Elantan | Ismo | Medocor | Monobide | Monomack;
  • (EE) Estonia: Effox | Elantan | Imdur | Is 5 mono-ratiopharm | Ismn stada | Isomonit | Isosorbide mononitrate vitabalans | Mono mack | Monolong | Monosan | Olicard;
  • (EG) Egypt: Angiofox | Cardioguard m | Corangin | Effox | Imdur | Ismn | Ismn stada | Ismo | Isosorbide | Mono mack | Mono mak depot | Monocard;
  • (ES) Spain: Cardionil | Cardiovas | Coronur | Dolak | Isonitril | Mononitr isosorb normon | Mononitr isosorb ratiopharm | Olicard | Percorina | Pertil | Titrane | Uniket;
  • (FI) Finland: Imdur | Isangina | Ismexin | Ismox | Isosor | Monoket | Monomack | Ormox | Ormox od;
  • (FR) France: Monicor lp;
  • (GB) United Kingdom: Angeze | Angitate | Carmil | Carmil xl | Chemydur | Cibral | Dynamin | Dynamin xl | Elantan | Eumon | Imdur | Imo la | Isib | Ismo | Isodur | Isomel | Isosorb mono | Isosorbide mononitrate cox | Isotard | Ketanodur | Mcr | Medomil | Modisal | Monit | Mono Cedocard | Monodur | Monomax | Monomil | Monomil xl | Monosorb | Nyzamac sr | Phasonit la50 | Relosorb XL | Tardisc xl | Trangina xl | Xismox | Zemon;
  • (GR) Greece: Angioval | G dil | Imdur | Isomon | Monoginal | Monoket | Monorythm | Monosordil | Nitramin | Nitrilan | Procardol;
  • (HK) Hong Kong: Apo Ismn | Coxine | Elantan | Imdex | Imdur | Ismo | Mono mack | Monocinque;
  • (HR) Croatia: Cardox | ISMN Genericon | ISMN Jadran | Isocard | Olicard;
  • (HU) Hungary: Cardisorb | Ismn-aliud | Ismn-alkaloida | Isospan | Mono mack | Olicard | Rangin | Sorbimon;
  • (ID) Indonesia: Cardismo | Elantan | Imdur | Imocard | Ismo | Isomonit | Monecto | Mono mack | Pentacard;
  • (IE) Ireland: Elantan | Imdur | Isomel | Isomonit | Sormon;
  • (IL) Israel: Monocord | Monolong | Mononit;
  • (IN) India: 5-mono | Angicor | Angifree | Angimon | Anginex | Angison | Angitab | Angitrit | Angivas | Difurate | Difutrate | Ihd | Imdur | Imnit | Insocalm | Isbid | Ismo | Isobax OD | Isocor | Isomeg | Isomin | Isonorm | Isotec | Monet | Monex | Monicor | Monit | Monit-od | Monn | Mono isordil | Monobid | Monocontin | Monomen | Monopark | Monosorbitrate | Monotrace | Monotrate | Natriem | Nican-CR | Nitrofirst | Nitrofix | Nitrovas | Olvisol | Solotrate | Sorb | Sormo | Synotrate | Vasodil | Vasonit | Vasotrate;
  • (IT) Italy: Duronitrin | Elan | Ismo | Isosorbide | Isosorbide eg | Isosorbide Mononitrato | Isosorbide mononitrato mylan generics | Isosorbide Sandoz | Kiton | Leicester | Monocinque | Monoket | Nitrex | Vasdilat;
  • (JO) Jordan: Elantan | Ismo | Mono mack;
  • (JP) Japan: Airocool | Aislar | Banreel | Cardis | Isomonit | Isonitoll | Itorol | Soprerole | Soprerole yamakawa | Taisirol;
  • (KE) Kenya: Imdur | Monicor | Mono mak | Monocontin | Monotrate;
  • (KR) Korea, Republic of: Caso | Elantan | Eloton | Elroton | Elroton sr | Erantan | Imdur | Ismo | Isobid | Isoby retard | Isonite | Isotril | Monomax | Monosol;
  • (KW) Kuwait: Imdur | Monomack;
  • (LB) Lebanon: Elantan | Mono mack | Monocinque;
  • (LT) Lithuania: Elantan | Imdur | Is 5 mono | Ismn | Isomonit | Isosorbide mononitrate vitabalans | Monisid | Mono mack | Monolong | Mononit | Monosan | Olicard;
  • (LU) Luxembourg: Elantan | Imdur | Isomonit | Mono mack;
  • (LV) Latvia: Cardionil | Effox | Elantan | Imdur | Is 5 mono | Ismn | Isomonit | Isosorbide mononitrate vitabalans | Monisid | Mono mack | Monolong | Mononit | Monosan | Olicard;
  • (MA) Morocco: Corangin | Mononitril;
  • (MX) Mexico: Elantan | Elantan retard | Imdur | Isosorbida | Kenbrid | Mono mack | Monocorat | Monocorat depot | Monomack;
  • (MY) Malaysia: Duride | Elantan | Imdex | Imdur | Ismn | Ismo | Isomonit;
  • (NL) Netherlands: Isosorbide Mononitraat Actavis | Isosorbide Mononitraat Merck | Isosorbide mononitraat retard rph | Isosorbide-5-mononitraat Accord | Isosorbide-5-Mononitraat FLX | Isosorbidemononitraat | Isosorbidemononitraat A | Isosorbidemononitraat Actavis | Isosorbidemononitraat CF | Isosorbidemononitraat Gf | Isosorbidemononitraat Katwijk | Isosorbidemononitraat Merck | Isosorbidemononitraat PCH | Isosorbidemononitraat sandoz | Mono Cedocard | Mono-cedocard | Monocedocard | Promocard;
  • (NO) Norway: Imdur | Ismo | Ismo retard | Isomex | Isosorbid nycomed | Isosorbidmononitrat | Isosorbidmononitrat aliud | Monoket;
  • (NZ) New Zealand: Duride | Imdur | Imtrate | Ismo;
  • (PE) Peru: Elantan | Izonit m | Monomack | Mononit;
  • (PH) Philippines: Angistad | Elantan | Imdur | Ismn natrapharm | Ismo | Isomonit | Isonate | Isorbide | Isormed | Isotrate | Monis | Mono mack | Monobid | Monosorb | Monovas | Montra | Solotrate | Vasotrate;
  • (PK) Pakistan: Alsorbide | Corlet | Elanton | Flo | Imdur | Ismo | Ismo retard | Isomon | Isorate | Isotab | Isotime | Isotrate | Monis | Monit | Mono-card | Monotrate | Savdil | Sequence | Sorbimon | Vasocord;
  • (PL) Poland: Effox | Elantan | Isomonit | Isosorbide mononitrate vitabalans | Izonit | Mono mack | Mono tad | Monocard | Mononit | Olicard;
  • (PR) Puerto Rico: Imdur | Ismo | Isosorbide mononite | Monoket;
  • (PT) Portugal: Amplexol | Imdur | Ismo | Monoket | Mononitrato de isossorbida | Mononitril | Monopront | Orasorbil;
  • (PY) Paraguay: Medocor | Medocor ap | Mni;
  • (RU) Russian Federation: Effox | Effox 20 | Isosorbid mononitrat | Isosorbid mononitrate | Isosorbide mononite | Monisol | Monizol | Mono mack | Mono rom | Monocinque | Monolong | Mononit | Monosan | Olicard | Olicard 60 | Pectrol | Pektrol;
  • (SA) Saudi Arabia: Ismo | Mono mack | Monorem;
  • (SE) Sweden: Fem-mono | Imdur | Ismo | Ismo retard | Isodur | Isomex | Isonova | Isosorbidmononitrat astimex | Isosorbidmononitrat ebb | Isosorbidmononitrat Ivax | Isosorbidmononitrat Merck NM | Isosorbidmononitrat mylan | Monoket;
  • (SG) Singapore: Elantan | Imdex CR | Imdur | Ismo;
  • (SI) Slovenia: Isocard | Mono 5-Wolff | Monosan | Olicard | Plodin;
  • (SK) Slovakia: Imdur | Mono mack | Monosan | Monosor | Monotab | Olicard | Sorbimon;
  • (TH) Thailand: Elantan | Imdex | Imdur | Is 5 mono-ratiopharm | Ismo | Isopen | Mono mack | Monolin | Monotrate | Pentacard | Sorbinate | Vasotrate;
  • (TN) Tunisia: Monicor;
  • (TR) Turkey: Isorat | Monodur | Monodur durules | Monoket;
  • (TW) Taiwan: Corangin | Coxine | Duride | Elantan | Ibimo | Imdur | Insure | Is 5 Mono Ratiopharm | Ismn | Ismo | Isormol | Sordur | Usomono;
  • (UA) Ukraine: Cardix | Isomonit | Isomonit retard | Mononit | Mononitrosid | Monosan | Monotrat | Olicard | Olicard retard | Plodin;
  • (UY) Uruguay: Ismo | Medocor | Mono-Conducil | Monoket;
  • (VE) Venezuela, Bolivarian Republic of: Elantan | Ismo | Monomack | Mononitrato de isosorbide;
  • (VN) Viet Nam: Donox | Imidu;
  • (ZA) South Africa: Angitrate | Elantan | Imdur | Ismo | Monicor;
  • (ZM) Zambia: Monit
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