From the Guidelines
Imdur (isosorbide mononitrate) is primarily used to prevent and treat angina pectoris, which is chest pain caused by reduced blood flow to the heart muscle. This medication belongs to a class of drugs called nitrates that work by relaxing and widening blood vessels, allowing more blood and oxygen to reach the heart.
Key Points
- Imdur is typically prescribed as a long-acting preventive treatment rather than for immediate relief of acute angina attacks.
- Common dosing starts at 30-60 mg once daily, with possible increases up to 120 mg daily based on individual response.
- The extended-release formulation is designed to be taken once daily, usually in the morning.
- Patients should swallow the tablets whole without crushing or chewing them to maintain the extended-release properties.
- To prevent nitrate tolerance, doctors often recommend a nitrate-free period of 10-14 hours each day, typically overnight.
- Side effects may include headache, dizziness, and lightheadedness, especially when starting treatment.
- Patients should avoid alcohol and medications like sildenafil (Viagra) while taking Imdur due to the risk of dangerous drops in blood pressure. According to the most recent guidelines, long-acting nitrates or CCBs can be prescribed for the relief of symptoms when β-blockers are contraindicated or cause unacceptable side effects in patients with stable angina 1. Additionally, long-acting nitrates or CCBs in combination with β-blockers should be prescribed for relief of symptoms when initial therapy with β-blockers is unsuccessful in patients with stable angina 1. It's also important to note that nitrates should not be used with phosphodiesterase inhibitors of the sildenafil type 1. In the context of vasospastic angina, Imdur (isosorbide mononitrate) may be used as a second-line treatment, with a typical dose of 10 mg BID 1. Overall, Imdur is an effective medication for preventing and treating angina pectoris, and its use should be guided by the most recent clinical guidelines and individual patient needs.
From the FDA Drug Label
Isosorbide mononitrate extended-release tablets are indicated for the prevention of angina pectoris due to coronary artery disease. The main use of Imdur (isosorbide mononitrate) is for the prevention of angina pectoris due to coronary artery disease 2.
- It is not used to abort an acute anginal episode due to its slow onset of action.
From the Research
Imdur Usage
Imdur, also known as isosorbide mononitrate, is used for the treatment of:
- Chronic stable angina pectoris 3, 4, 5, 6
- Angina patients on chronic beta-blockade, where it has been shown to increase the anti-anginal effect when used in combination with beta-blockers 5
Key Benefits
The key benefits of using Imdur include:
- Effective antianginal prophylaxis for up to 12 hours 3
- No evidence of classical tolerance to Imdur 30 to 240 mg/day 3
- Well tolerated, with the most frequently reported adverse event being headache, which is usually mild to moderate and improves with long-term therapy 3, 4, 6
- Improved patient compliance due to once-daily administration 3
Comparative Efficacy
Imdur has been compared to other treatments, including:
- Isosorbide dinitrate, where Imdur 60 mg once daily was more effective than isosorbide dinitrate 30 mg 4 times daily and similar to or better than isosorbide dinitrate 20 mg 3 times daily 3
- Diltiazem, where Imdur 60 mg once daily had similar efficacy to diltiazem 60 mg 3 times daily 4
- Other sustained-release isosorbide 5-mononitrate preparations, where Imdur 60 mg once daily was at least as effective 3