Isonorm 20, manufactured by Lupin Limited, is a medication primarily used for the prevention and treatment of heart-related chest pain.

Name

• Brand Name: Isonorm 20
• Common Name: Isosorbide Mononitrate (20 mg)

Composition

Isonorm 20 Tablet contains Isosorbide Mononitrate (20 mg) as its active ingredient. This ingredient is a powerful vasodilator that works by relaxing and widening blood vessels, especially those of the heart, thereby improving blood flow and oxygen supply to the heart muscle.

Uses

Isonorm 20 is prescribed for the following medical conditions:

• Angina Pectoris (heart-related chest pain): It is used to prevent and treat angina attacks, which occur due to narrowed blood vessels and reduced blood flow to the heart. It is not for the immediate relief of an ongoing angina attack.
• Coronary Artery Disease: For the management of this condition where the heart's blood supply is blocked or interrupted.
• Heart Failure: It helps ease the workload on the heart by widening blood vessels, improving circulation, and assisting the heart in pumping blood more effectively.
• Hypertensive emergency: Helps lower blood pressure quickly by dilating blood vessels, reducing the risk of complications.
• Pulmonary Hypertension: Used to manage high blood pressure affecting the arteries in the lungs and the right side of the heart.

Dosage and Administration

Isonorm 20 Tablet should be taken orally as prescribed by a doctor, usually once daily. It can be taken with or without food, preferably at fixed intervals each day for best results. The tablet should be swallowed whole with a glass of water and not chewed, crushed, or broken. It is crucial to complete the prescribed course of medicine, even if symptoms improve, and not to stop taking it suddenly, as this may increase the risk of chest pain.

Side Effects

Common side effects include:

• Headache, which often subsides after a few days of continuous treatment
• Dizziness
• Nausea and Vomiting
• Flushing (a feeling of warmth and redness in the face and neck)
• Increased sweating
• Blurred vision
• Low blood pressure (hypotension), especially when standing up or moving suddenly (postural hypotension)

Serious side effects, though rare, may include:

• Severe dizziness or fainting
• Irregular or fast heartbeat
• Severe allergic reactions (rash, itching, swelling)
• Bluish discoloration of lips, fingernails, or hands
• Exacerbation of angina pectoris symptoms (worsening chest pain)

Precautions

• Allergies: Do not take if allergic to isosorbide mononitrate or any nitrate-containing medicines.
• Drug Interactions:
  • Avoid concomitant use with phosphodiesterase inhibitors (e.g., sildenafil, tadalafil) used for erectile dysfunction or pulmonary hypertension, as this can lead to a severe and life-threatening drop in blood pressure.
  • Inform your doctor about all medications, including antihypertensives, as some can significantly reduce blood pressure when taken with Isonorm 20.
• Medical Conditions: Use with caution or avoid in patients with:
  • Low blood pressure or shock.
  • Disorders of heart muscles or other heart problems like circulatory collapse, cardiogenic shock, hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, or aortic/mitral valve stenosis.
  • Recent history of heart attack (acute myocardial infarction).
  • Severe anemia (low number of red blood cells).
  • Glaucoma (an eye disease).
  • Liver or kidney disorders.
  • Thyroid disorders, or increased intracranial pressure (head injury/brain hemorrhage).
• Alcohol Consumption: Avoid or limit alcohol while taking Isonorm 20 as it can increase dizziness and other side effects like low blood pressure.
• Pregnancy and Breastfeeding: Consult a doctor before use if pregnant, planning pregnancy, or breastfeeding. It should only be used if clearly necessary and benefits outweigh the risks.
• Driving and Operating Machinery: Isonorm 20 may cause headaches, blurred vision, dizziness, or tiredness. Patients should ensure they are not affected before driving or operating machinery.
• Tolerance: Patients may develop tolerance to Isonorm 20 over time, meaning the same dose may become less effective. Following the prescribed dosing schedule helps avoid this.

Storage

Store Isonorm 20 Tablet below 30°C in its original container, in a cool and dry place, away from direct heat and light. Keep it out of reach of children and pets.

ISONORM 20 by LUPIN LIMITED: Frequently Asked Questions

What is ISONORM 20 used for?

ISONORM 20 Tablet is primarily used to prevent angina pectoris, a type of heart-related chest pain caused by coronary artery disease. It is also used to manage coronary heart disease, as a follow-up medication after a heart attack, and to manage pulmonary hypertension (high blood pressure affecting the arteries in the lungs and the right side of the heart). This medicine helps to prevent future chest pain, improve exercise capacity, and enhance daily activities. It is important to note that ISONORM 20 is not for the immediate relief of sudden angina attacks.

How does ISONORM 20 work?

ISONORM 20 contains Isosorbide Mononitrate, which belongs to a class of medications called nitrates. It works by being converted into nitric oxide (NO) in the body. Nitric oxide activates an enzyme that increases cyclic guanosine monophosphate (cGMP) in smooth muscles. This process leads to the relaxation and widening of blood vessels (vasodilation) in the arteries, veins, and cardiac tissue. This vasodilation improves blood flow and oxygen supply to the heart, reduces the workload on the heart, and thus alleviates angina symptoms.

What is the usual dosage of ISONORM 20?

The daily dose of ISONORM 20 should be taken as advised by your doctor. It can be taken with or without food, but it is recommended to take it at the same time each day for optimal benefits. It should be swallowed whole with a glass of water and not chewed or crushed. Your doctor will determine the appropriate dosage and frequency, which may change based on how well the medicine is working. If taken once daily, it's often recommended in the morning. If prescribed twice daily, a 7-hour gap between doses is often suggested to prevent tolerance development.

What are the possible side effects of ISONORM 20?

Common side effects of ISONORM 20 include headache, dizziness, nausea, increased sweating, flushing (warmth and redness on the face and neck), blurred vision, increased or decreased heartbeat, cough, and nasal congestion. Other possible side effects include tinnitus (ringing in the ears), edema, fatigue, flu-like symptoms, malaise, low blood pressure, lack of energy, and sleepiness. Headaches often go away after a few days of continued treatment. If you experience any serious side effects or worsening symptoms, consult your doctor.

Is ISONORM 20 safe during pregnancy or breastfeeding?

Caution is advised when taking ISONORM 20 during pregnancy or breastfeeding. There is limited information on its effect during pregnancy, and it is generally preferred not to use it in pregnant women. While some sources suggest mild effects on breastfeeding women, it may pass into human breast milk, and breastfeeding should be discontinued during treatment with this medicine. It is best to consult your doctor before taking this medicine during these conditions.

Can ISONORM 20 be taken with other medications?

ISONORM 20 can interact with several medications. It should not be taken with medicines for erectile dysfunction or pulmonary hypertension, such as sildenafil and tadalafil, as this can lead to a severe and potentially life-threatening drop in blood pressure. Concomitant use with antihypertensives (e.g., atenolol, verapamil, telmisartan) can also significantly reduce blood pressure, requiring careful monitoring. Psychiatric disorder and migraine medications may also lead to low blood pressure symptoms. Inform your doctor about all medicines, herbals, and supplements you are currently taking to avoid possible interactions.

What precautions should be taken with ISONORM 20?

Avoid consuming alcohol while taking ISONORM 20, as it may increase certain side effects like dizziness, low blood pressure, and flushing. This medicine can cause low blood pressure, dizziness, tiredness, or blurred vision, so it's advised to avoid driving or operating machinery if you experience these effects.

Inform your doctor if you have low blood pressure or conditions that can lead to reduced blood pressure (e.g., shock, thyroid disorder, anemia, increased intracranial pressure), kidney or liver disorders, or glaucoma. You should not stop taking ISONORM 20 suddenly without consulting your doctor, as this can increase the risk of angina attacks. To avoid developing tolerance to the medication, follow the prescribed dosing schedule.

What happens if a dose of ISONORM 20 is missed?

If you forget to take ISONORM 20, take it as soon as you remember. However, if it's nearly time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to compensate for the missed one.

How should ISONORM 20 be stored?

ISONORM 20 Tablet should be stored below 30°C in its original container. Keep it out of the reach of children and pets. Store it in a cool and dry place, away from direct heat and light.