Monosan - peripheral vasodilator; antianginal agent.
Release form and composition
The drug is available in the form of tablets: round, flat, white in color, with a risk on one side (10 pieces in a blister, in a cardboard bundle 3 blisters).
The active ingredient of Monosan is isosorbid-5-mononitrate: in 1 tablet 20 or 40 mg.
Auxiliary components: granulated lactose, magnesium stearate, talc, corn starch, microcrystalline cellulose.
Indications for use
Monosan is used in combination therapy in the following conditions:
- Pulmonary heart;
- Pulmonary hypertension;
- Chronic heart failure.
Also, the drug is prescribed for the prevention of strokes in patients with coronary heart disease.
- Toxic pulmonary edema;
- Heart tamponade;
- Arterial hypovolemia and arterial hypotension (diastolic blood pressure below 60 mm Hg, systolic blood pressure below 100 mm Hg, central venous pressure below 4-5 mm Hg);
- Acute myocardial infarction (accompanied by severe arterial hypotension);
- Left ventricular failure with low diastolic pressure;
- Vascular collapse;
- Angle-closure glaucoma;
- Diseases accompanied by increased intracranial pressure (including traumatic brain injury and hemorrhagic stroke);
- Age up to 18 years;
- Hypersensitivity to the components of the drug or other nitrates.
Relative (special care should be taken because of the risk of complications):
- Mitral and / or aortic stenosis;
- The tendency to orthostatic disorders of vascular regulation;
- Constrictive pericarditis;
- Severe anemia;
- Hypertrophic cardiomyopathy;
- Liver failure;
- Severe renal failure;
- Elderly age.
Dosing and Administration
Monosan is taken orally, swallowing the pill whole and squeezed with a sufficient amount of liquid after a meal.
The required dose is determined individually depending on the severity of the disease.
At the beginning of treatment prescribed 10-20 mg 1-3 times a day. In case of insufficiency of the therapeutic effect, in 3-5 days the dose is increased to 40-60 mg with the same frequency of administration.
The maximum permissible daily dose is 80 mg.
- Allergic reactions: rash on the skin; rarely, exfoliative dermatitis;
- Cardiovascular system: dizziness, "nitrate" headache, sensation of heat, transient flushing of the skin of the face, marked reduction in blood pressure, tachycardia; rarely - orthostatic collapse, paradoxical intensification of angina attacks;
- The digestive system: a slight burning sensation of the tongue, dry mouth, nausea, vomiting;
- Central nervous system: blurred vision, drowsiness, slow reaction (especially at the beginning of treatment), stiffness; rarely, brain ischemia;
- Other: tolerance (including cross to other nitrates).
Monosan is not intended to relieve angina attacks.
Treatment should be under the control of blood pressure and heart rate.
Patients with arterial hypotension should be prescribed Monosan in combination with drugs that have a positive inotropic effect.
In the case of frequent use of the drug and / or in high doses there is a risk of tolerance. In this case, after 3-6 weeks of regular use, it is recommended to take a break for 24-48 hours or 3-5 days, replacing Monosan with another antianginal drug for this time.
Do not abruptly cancel the drug, the dose should be reduced gradually.
The drug can reduce the speed of psychophysical reactions, therefore, during treatment, it is necessary to proceed with caution to potentially dangerous types of work and to drive vehicles.
Possible interaction reactions in the case of simultaneous use of Monosan with other drugs:
- Dihydroergotamine: increasing its concentration in the blood plasma;
- Barbiturates: increased biotransformation and a decrease in the concentration of isosorbide mononitrate in the blood;
- Antipsychotics (neuroleptics), tricyclic antidepressants, peripheral vasodilators, antihypertensive drugs, beta-blockers, slow calcium channel blockers, quinidine, procainamide, dihydroergotamine, sildenafil, ethanol: increased hypotensive effect;
- Slow calcium channel blockers (for example, nifedipine, verapamil), propranolol, amiodarone, acetylsalicylic acid: increased anti-anginal effect;
- Beta-adrenostimulators, alpha-blockers: a decrease in the severity of antianginal effect (which is fraught with the development of tachycardia and an excessive decrease in blood pressure);
- M-holinoblokatory (atropine): the risk of increased intraocular pressure;
- Adsorbents, enveloping and astringents: a decrease in the absorption of isosorbide mononitrate from the gastrointestinal tract.
Terms and conditions of storage
Store at a temperature of 15-25 ° C out of the reach of children, protected from light and moisture.
Shelf life - 4 years.