Ismo Retard 40mg Tablet 7'S

INTRODUCTION

ISMO RETARD 40MG contains Isosorbide-5-mononitrate which belongs to the group of medicines called nitrate vasodilators. It is used to prevent angina pectoris. Angina pectoris is defined as a sudden, sharp, severe pain originating from the apex of heart and radiating to the left shoulder. The pain is severe and crushing, and it is characterized by feeling of pressure and suffocation, behind breastbone. It can also help to control certain types of heart failure.

Isosorbide-5-mononitrate works by relaxing the blood vessels of the heart and this reduces the strain on the heart making it easier to pump blood. Along with the treatment, your doctor might ask you to make certain lifestyle changes such as quitting alcohol and smoking, improve your sleep at night, eating a healthy diet and manage weight.

The most common side effect of taking this medicine is headache. This is common, particularly at the start of treatment and normally subsides after few days. This medicine may make you feel dizzy or light-headed. Avoid travelling or driving while you experience these symptoms. Others side effects includes nausea, vomiting and hypotension. Before taking this medicine, inform your doctor if you have any liver, kidney or heart disease, hypothyroidism or glaucoma.

USES OF ISMO RETARD 40MG

• Prevents angina pectoris

HOW ISMO RETARD 40MG WORKS

After administration, isosorbide-5-mononitrate is converted into free radical nitric oxide which activates the enzyme guanylate cyclase. Activation of this enzyme is followed by synthesis of cyclic guanosine 3',5'-monophosphate (cyclic GMP) in smooth muscle and other tissues. This process leads to dephosphorylation of myosin light chain of smooth muscles, and results in relaxation and increased blood flow in arteries, veins and cardiac tissue (vasodilatation), this in turn decreases cardiac workload and provides relief from anginal symptoms.

DIRECTIONS FOR USE

Take ISMO RETARD 40MG as directed by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose for you depending upon your condition. Continue to take this medicine, as long as your doctor tells you to do so, to obtain better results.

SIDE EFFECTS OF ISMO RETARD 40MG

HOW TO MANAGE SIDE EFFECTS

Nausea or vomiting:

Try taking this medicine with, or just after meal. Stick to simple meals. Do not eat rich or spicy food.

Headache:  

This is common, particularly at the start of treatment and normally subsides after few days. Rest and drink plenty of fluids. Do not drink too much alcohol.

WARNING & PRECAUTIONS

INTERACTIONS

Talk to your doctor, if you are taking,

• medicines used to treat high blood pressure ACE-inhibitors (e.g. captopril, enalapril), angiotensin- II-receptor antagonists (e.g. losartan, valsartan), beta-blockers (e.g. propanolol, atenolol), calcium antagonists (e.g. diltizem, verapamil) and diuretic (e.g. furosemide)
• medicines used to treat male erectile dysfunction (e.g. sildenafil, tadalafil, vardenafil and alprostadil)
• other medicine used to treat angina such as long acting nitrates (isosorbide dinitrate, nitroglycerin)
• neuroleptics (used to treat psychiatric disorders) e.g. risperidone, aripiprazole
• sapropterin (used to lower phenylalanine levels in blood)
• aldesleukin (used to treat cancer)
• riociguat (used to treat pulmonary hypertension)
• tricyclic anti-depressants (used to treat depression) e.g. imipramine, desipramine
• ergotamine (used for migraine)

SYNOPSIS

MORE INFORMATION

Store below 20-25°C and keep out of reach of children.

FAQs ABOUT ISMO RETARD 40MG

Can I crush ISMO RETARD 40MG?

No. Swallow the medicine as whole with a drink of water. Do not crush or chew the medicine.

Can I consume alcohol while taking ISMO RETARD 40MG?

No. Avoid consumption of alcohol while taking this medicine, because it may raise the blood pressure lowering effect of this medicine.

What are the most common side effects of ISMO RETARD 40MG?

The most common side effects of this medicine are headache, nausea, vomiting and hypotension.

REFERENCES

1. KD. Tripathi. Antianginal and Other Anti-ischaemic Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page – 544-545.

2. Thomas Michel and Brian B. Hoffman. Treatment of myocardial ischemia and hypertension. Goodman & Gilman’s: The Pharmacological basics of Therapeutics. 12th Edition. New York McGraw Hill Medical 2011. Page – 747-750 & 752.

3. Gerald G. Briggs and Roger K. Freeman. I. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 2099-2100.

4. Torrent Pharmaceuticals Limited. Bioequivalence Study of Torrent Pharmaceutical Limited's Isosorbide Mononitrate 120 mg ER Tablets Under Fed Conditions.  NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised on August 2011] [Accessed 27th November 2020] https://clinicaltrials.gov/ct2/show/NCT01418547

5. Zheng Tan, Xiaoming Shang, Li li, Luobing tian, Yi ma, Yan peng and Lingxi gao. Clinical study of isosorbide mononitrate treatment for angina pectoris in coronary heart disease. NCBI; PMC US National Library of Medicine, National Institute of Health. February 2013. [Accessed 27th November 2020] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628368/

6. Accord. Electronic Medicines Compendium (EMC); [Revised on June 2020] [Accessed 27th November 2020] https://www.medicines.org.uk/emc/files/pil.5797.pdf

7. Aesica Pharmaceuticals GmbH. Electronic Medicines Compendium (EMC); [Revised on July 2020] [Accessed 27th November 2020] https://www.medicines.org.uk/emc/files/pil.9214.pdf

8. Aesica Pharmaceuticals GmbH. Electronic Medicines Compendium (EMC); [Revised on July 2020] [Accessed 27th November 2020] https://www.medicines.org.uk/emc/files/pil.9215.pdf

9. Ltd Pharma®-Dexcel. Electronic Medicines Compendium (EMC); [Revised on December 2017] [Accessed 27th November 2020] https://www.medicines.org.uk/emc/files/pil.2697.pdf

10. Kremers Urban Pharmaceutical Inc. U.S. Food & Drug Administration. [Revised on July 2014] [Accessed 27th November 2020] https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/075155Orig1s034lbl.pdf

USEFUL DIAGNOSTIC TESTS

• Electrocardiogram (ECG)
• Chest x-ray
• Chest CT
• Coronary CT angiography
• Cardiac MRI
• Coronary angiography
• Echocardiogram