Does Imdur (isosorbide mononitrate) affect heart rate in patients with angina (chest pain)?

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From the Guidelines

Imdur (isosorbide mononitrate) is an effective medication for managing angina (chest pain) in patients with coronary artery disease, and it typically does not significantly affect heart rate. It primarily works by dilating blood vessels, improving blood flow to the heart muscle, and reducing the workload on the heart. This action helps prevent or relieve chest pain episodes. When taking Imdur, patients should be aware of potential side effects including headaches (especially when starting treatment), dizziness, and lightheadedness due to blood pressure lowering. To avoid tolerance development, physicians typically prescribe Imdur with a nitrate-free interval (usually overnight) 1. For optimal management of chest pain, Imdur is often used as part of a comprehensive treatment plan that may include other medications like beta-blockers or calcium channel blockers, as recommended by recent guidelines 1. Some key points to consider when using Imdur include:

  • It is not primarily considered a blood pressure medication, but it can lower blood pressure as a side effect.
  • It belongs to the nitrate class of medications and works by relaxing and widening blood vessels.
  • Patients should take Imdur exactly as prescribed, usually once daily in the morning, and should not stop taking it suddenly without consulting their healthcare provider.
  • The combination of Imdur with other medications, such as beta-blockers or calcium channel blockers, should be individualized based on the patient's specific condition and response to treatment, as suggested by recent studies 1. Overall, Imdur is a useful medication for managing angina, but it should be used under the guidance of a healthcare provider and as part of a comprehensive treatment plan.

From the Research

Imdur's Effect on Heart Rate

  • There is no direct evidence in the provided studies that Imdur affects heart rate.
  • The studies focus on the antianginal and anti-ischaemic effects of Imdur, as well as its efficacy in managing chest pain and angina pectoris 2, 3, 4.

Imdur as a Blood Pressure Pill

  • Imdur is not specifically mentioned as a blood pressure pill, but rather as a treatment for chronic stable angina pectoris and chest pain 2, 3, 4.
  • The primary drugs utilized in the treatment of angina pectoris include organic nitrates, beta-adrenoceptor antagonists, Ca2+ antagonists, and the antithrombotic agents aspirin and heparin 5.
  • Imdur, which contains isosorbide-5-mononitrate, is a type of organic nitrate that provides relief from angina pain and improves exercise tolerance primarily through its ability to decrease oxygen demand 5.

Efficacy of Imdur in Managing Chest Pain

  • Imdur has been shown to be effective in managing chest pain and angina pectoris, with significant antianginal and anti-ischaemic effects compared to placebo 2, 3, 4.
  • The efficacy of Imdur is maintained during long-term treatment, without the development of tolerance, and it is well tolerated with minimal side effects 2, 3, 4.
  • Imdur can be used in combination with other medications, such as beta-blockers, to provide additional antianginal protection 3, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Clinical experience with Imdur in angina pectoris. A review.

European journal of clinical pharmacology, 1990

Research

Pharmacologic therapy of angina pectoris.

The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society, 1995

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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