Imdur (Isosorbide Mononitrate). Imdur sustained release

Drug Information: Indications, Side Effects, Warnings

Category:  Cardiovascular Diseases

Generic Imdur is used for preventing angina (chest pain) caused by heart disease.

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Pharmacological group:order pills Imdur
Nitrates and similar tools

Nosological classification (ICD-10):
I20 angina [angina pectoris]
I25 Chronic ischemic heart disease
I25.2 Transferred last myocardial infarction
I27 Other forms of cardiopulmonary diseases
I50.0 Congestive heart failure


The main active ingredient: isosorbide mononitrate

Characteristics of matter:

The main active metabolite of isosorbide dinitrate. White crystalline solid, is odorless, stable in air and in a solution with a melting point of about 90 ° C. Easily soluble in water, ethanol, methanol, chloroform, ethyl acetate and dichloromethane.


Pharmacological action — antianginalnoe, vasodilator.

The drug:
— Increases nitric oxide in the endothelium
— Stimulates guanylate cyclase and cGMP formation
— Reduces the concentration of calcium in the smooth muscle cells
— Lowers the tone of the vascular wall and causes vasodilation.
— The drug acts on the venous vessels — reduces venous return to the heart.
— Expanding the arterioles reduces peripheral vascular resistance, systolic and mean arterial pressure.
— The drug reduces myocardial oxygen demand.
— Directly dilates coronary arteries
— Improves coronary blood flow, promotes its redistribution in the ischemic area
— Reduces the pressure in the pulmonary arteries
— Reduces end-diastolic volume of the left ventricle
— Reduced systolic wall stress ventricle.
— Increases exercise tolerance in patients with coronary artery disease
— Reduces the frequency and duration of episodes of silent ischemia (according to daily monitoring of ECG)
— Reduces the pressure in the pulmonary circulation.
The drug improves the quality of life in patients with coronary heart disease, reduces the number of angina attacks and nitroglycerin consumption. In heart failure, myocardial preparation promotes discharge by reducing preload. The drug lowers blood pressure in the portal vein and inhibits platelet function.

Generic Imdur contributes to the relative redistribution of blood flow in the direction of areas with reduced lung ventilation (poorly ventilated alveolar region). As a result, this may be a transient decrease in the content of oxygen in arterial blood (hypoxemia).

Indications for use:

Coronary artery disease (long-term care), angina and vasospastic (preventing attacks), post-MI angina, chronic heart failure (combination therapy), pulmonary hypertension.


— Hypersensitivity, acute myocardial infarction with reduced left ventricular filling pressure.
— Do not use the drug if you have conditions such as: acute left ventricular failure, cardiogenic shock, circulatory collapse, severe hypotension (Sad less than 90 mm Hg)
— Hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade
— If you have intracranial hemorrhage, cranial hypertension, severe anemia, glaucoma, pregnancy (I term), and breast-feeding.


Restrictions apply to:

Acute myocardial infarction, unstable angina, acute coronary syndrome, children’s age (safety and efficacy in children has not been studied).

Pregnancy and breast-feeding:

Use of the drug during pregnancy is possible only in cases where the expected benefit exceeds the possible negative effects on the fetus.

Category effects on the fetus by FDA — C.

At the time of treatment should stop breastfeeding.

Side effects:

From the nervous system and sensory organs: «nitrate» headache, weakness, agitation.

Cardio-vascular system and blood (blood, hemostasis):


— transient reddening skin;

-gipotenziya, including orthostatic (accompanied by reflex tachycardia, confusion, dizziness, paleness, etc.);
— With severe arterial hypotension, possibly increasing symptoms of angina (paradoxical effect of nitrates) and / or severe paradoxical bradycardia, collapse, syncope; methemoglobinemia (long-term treatment).

From the digestive tract: dry mouth, nausea, vomiting.

Allergic reactions: burning and itching, exfoliative dermatitis.

Other: sweating, transient hypoxemia, increased levels of catecholamines and vanillin-succinic acid in the urine.


Symptoms: orthostatic hypotension, sensation of squeezing the head, throbbing headache, severe sweating, cold skin, covered with sticky sweat, or erythematous, palpitations, bradycardia, conduction disturbances (blockade), shortness of breath, Kussmaul breathing, bloody diarrhea, vomiting, dizziness, confusion, syncope, coma, fever, paralysis, visual disturbances.
Treatment: gastric lavage, administration of infusion solutions, the purpose of ascorbic acid at a dose of 1 g orally (or methylthioninium chloride (methylene blue) / in 50 ml of 1% solution), toluidine blue — 2-4 mg / kg body weight / in quickly, if necessary — again in a dose of 2 mg / kg with intervals of 1 hour, oxygen, hemodialysis, exchange transfusion.


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