Isosorbide mononitrate
Isosorbide mononitrate.svg
Clinical data
Trade namesMonoket, Imdur, others
License data
Routes of
By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
Protein binding<5%
Elimination half-life5 hours
ExcretionKidney (93%)
  • 8-nitrooxy-2,6-dioxabicyclo[3.3.0]octan-4-ol
CAS Number
PubChem CID
CompTox Dashboard (EPA)
ECHA InfoCard100.036.527 Edit this at Wikidata
Chemical and physical data
Molar mass191.139 g·mol−1
3D model (JSmol)
  • [O-][N+](=O)O[C@H]1[C@H]2OC[C@H](O)[C@H]2OC1
  • InChI=1S/C6H9NO6/c8-3-1-11-6-4(13-7(9)10)2-12-5(3)6/h3-6,8H,1-2H2/t3-,4+,5+,6+/m0/s1 checkY

Isosorbide mononitrate, sold under many brand names, is a medication used for heart-related chest pain (angina), heart failure and esophageal spasms.[2] It can be used both to treat and to prevent heart-related chest pain; however, it is generally less preferred than beta blockers or calcium channel blockers.[2] It is taken by mouth.[2]

Common side effects include headache, low blood pressure with standing, blurry vision, and skin flushing.[2] Serious side effects may include low blood pressure especially if also exposed to PDE5 inhibitors such as sildenafil.[2] Use is not recommended in pregnancy.[3] It is believed to work by relaxing smooth muscle within blood vessels.[2]

It was patented in 1971 and approved for medical use in 1981.[4] It is available as a generic medication.[3] In 2020, isosorbide was the 114th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[5][6]

Medical uses

Isosorbide mononitrate is a nitrate-class drug used for the prevention of angina pectoris.[7] The sublingual patch has an onset of five minutes and a duration of action of one hour. The oral, slow release tablet has an onset of thirty minutes, and a duration of 8 hours.

Adverse effects

The following adverse effects have been reported in studies with isosorbide mononitrate:

Very common: Headache predominates (up to 30%) necessitating withdrawal of 2 to 3% of patients, but the incidence reduces rapidly as treatment continues.[7]

Common: Tiredness, sleep disturbances (6%) and gastrointestinal disturbances (6%) have been reported during clinical trials with isosorbide mononitrate modified-release tablets, but at a frequency no greater than for placebo. Hypotension (4 to 5%), poor appetite (2.5%), nausea (1%)[7]

Adverse effects associated with the clinical use of the drug are as expected with all nitrate preparations. They occur mainly in the early stages of treatment.[7]

Hypotension (4%) with symptoms such as dizziness and nausea (1%) have been reported. In general, these symptoms disappear during long-term treatment.[7]

Other reactions that have been reported with isosorbide mononitrate-modified release tablets include tachycardia, vomiting, diarrhoea, vertigo, and heartburn.[7]


Brand names

It is sold in the US by Lannett Company, under the trade name Monoket,[7][8] and was also sold in the US under the name Imdur,[9] and marketed in the UK under the trade names: Isotard, Monosorb, Chemydur. In India, this drug is available under the brand names of Ismo, Imdur, Isonorm, Monotrate, Solotrate, and Monit. In Russia it is occasionally used under the brand names Monocinque and Pektrol. In Australia, this drug is available under the brand name Duride.[citation needed]


  1. ^ "Isosorbide mononitrate Use During Pregnancy". 28 February 2020. Retrieved 14 April 2020.
  2. ^ a b c d e f "Isosorbide Dinitrate/Mononitrate Monograph for Professionals". American Society of Health-System Pharmacists. Retrieved 3 March 2019.
  3. ^ a b British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. pp. 219–220. ISBN 9780857113382.
  4. ^ Fischer J, Ganellin CR (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 454. ISBN 9783527607495.
  5. ^ "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
  6. ^ "Isosorbide - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
  7. ^ a b c d e f g h i "Monoket- isosorbide mononitrate tablet". DailyMed. 3 February 2015. Retrieved 14 April 2020.
  8. ^ "Monoket: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 14 April 2020.
  9. ^ "Imdur: FDA-Approved Drugs". U.S. Food and Drug Administration (FDA). Retrieved 14 April 2020.