Ismo Retard 40 Mg (Isosorbide Mononitrate)

What is Ismo Retard 40 mg?

Ismo Retard 40 mg is a prolonged-release tablet that contains Isosorbide Mononitrate, a long-acting nitrate. It is primarily used to prevent angina pectoris (chest pain) caused by coronary artery disease. It works by relaxing and dilating blood vessels, improving blood flow to the heart and reducing its oxygen demand.

---

Uses of Ismo Retard 40 mg

Ismo Retard 40 mg is used for:

• Prevention of stable angina (chronic chest pain due to coronary artery disease)

• Long-term treatment of ischemic heart disease

• Adjunctive therapy in chronic congestive heart failure (alongside other heart medications)

Note: It is not used to relieve acute angina attacks (for which fast-acting nitrates like sublingual nitroglycerin are prescribed).

---

Benefits of Ismo Retard 40 mg

• Reduces frequency and severity of angina attacks

• Improves exercise tolerance in patients with heart conditions

• Enhances blood flow to the heart muscle

• Prolonged action due to slow release formulation (once-daily dosing)

---

How Does Ismo Retard 40 mg Work?

It contains isosorbide mononitrate, which acts as a vasodilator. It releases nitric oxide in vascular smooth muscle, stimulating an enzyme that increases cyclic GMP, leading to relaxation of blood vessels. This reduces:

• Preload and afterload on the heart

• Myocardial oxygen demand

• Symptoms of angina

---

How to Take Ismo Retard 40 mg

• Take once daily, preferably in the morning, or as directed by your doctor.

• Swallow the tablet whole with water — do not crush or chew.

• It should be taken at the same time every day to maintain a steady level in the body.

---

Dosage of Ismo Retard 40 mg

• Usual adult dose: 40 mg once daily

• Dosage may be adjusted based on individual response.

• Some patients may be prescribed two tablets per day (80 mg total), spaced apart to maintain a nitrate-free interval (to prevent tolerance).

---

Missed Dose and Overdose

Missed Dose:

• Take the missed dose as soon as you remember.

• Skip it if it’s nearly time for your next dose.

• Do not double the dose.

Overdose Symptoms:

• Low blood pressure

• Rapid heartbeat

• Headache

• Dizziness

• Fainting

Seek immediate medical attention in case of overdose.

---

Available Strengths of Ismo Retard

• Ismo Retard 20 mg

• Ismo Retard 40 mg

Other isosorbide mononitrate formulations (like immediate-release or other brands) may come in:

• 30 mg

• 60 mg

• 120 mg

---

Side Effects of Ismo Retard 40 mg

Common:

• Headache (especially at the start)

• Dizziness

• Nausea

• Fatigue

• Low blood pressure

Serious (rare):

• Fainting

• Rapid heart rate

• Severe hypotension

• Allergic reaction (rash, swelling)

Inform your doctor if any side effects persist or worsen.

---

Drug Interactions

Avoid taking Ismo Retard with:

• PDE5 inhibitors (sildenafil, tadalafil) – can cause severe hypotension

• Other antihypertensives – may enhance blood pressure-lowering effects

• Alcohol – increases risk of dizziness or fainting

• Tricyclic antidepressants – may enhance nitrate effects

Always disclose all medications and supplements you’re using to your doctor.

---

Precautions

• Not recommended if you have severe hypotension, recent heart attack, or severe anemia

• Use with caution in kidney or liver impairment

• May cause dizziness – avoid driving until you know how it affects you

• Pregnancy and breastfeeding – use only if prescribed

• Avoid abrupt discontinuation – may worsen angina

---

Storage Information

• Store at 20–25°C (68–77°F)

• Keep away from moisture, heat, and direct sunlight

• Keep out of reach of children

• Do not use after the expiry date

---

Availability in the US and Australia

• United States: Available under different brand names like Monoket, Imdur. “Ismo Retard” may not be the marketed brand.

• Australia: Available; listed in the Australian Register of Therapeutic Goods (ARTG) as isosorbide mononitrate extended-release tablets under brands like Duride or Ismo Retard.

---

Frequently Asked Questions (FAQs)

Q1. Can I use Ismo Retard 40 mg for a sudden angina attack?

No. It’s for long-term prevention, not for immediate relief. Use sublingual nitroglycerin for acute attacks.

Q2. Why do I get headaches with Ismo Retard?

Headaches are common due to blood vessel dilation. They usually subside with continued use.

Q3. Is it safe to consume alcohol while taking Ismo Retard?

Avoid alcohol, as it may enhance blood pressure-lowering effects and cause dizziness.

Q4. Can I drive after taking Ismo Retard?

Avoid driving if you feel dizzy or lightheaded after taking the tablet.

Q5. Can Ismo Retard be taken with food?

Yes, it can be taken with or without food. Taking it with food may reduce stomach discomfort.