Ismox
Ismox is a medicine that helps prevent chest pain (angina pectoris) and treats heart failure by widening blood vessels.
How to Use
Dosage
Ismox 10 mg or 20 mg tablets: Usually 1-2 tablets of 10 mg each or one 20 mg tablet, taken in the morning and afternoon. Ismox Depot 40 mg prolonged-release tablets: Usually one 40 mg tablet, taken in the morning or evening.
Method
Swallow tablets whole with a glass of water. You can take them with or without food, but taking them with food might make them work a bit slower.
For Ismox 10 mg or 20 mg tablets, the maximum is 60 mg per day (one 20 mg tablet three times a day, with at least 12 hours between doses to avoid the medicine becoming less effective). For Ismox Depot 40 mg prolonged-release tablets, the maximum is 80 mg per day (one 40 mg tablet twice a day, with the second dose no later than 6 hours after the first. To reduce the chance of the medicine becoming less effective, it's best to take it only once a day or ensure a 'nitrate-free' period).
Possible Side Effects
- •Headache (especially at the start of treatment, often goes away after a few days)
- •Low blood pressure (especially when standing), fast heartbeat, flushing, dizziness, and a feeling of weakness (these symptoms usually get better as you continue treatment)
- •Nausea
- •Vomiting
- •Feeling restless
- •Confusion
- •Trouble sleeping
- •Blurry vision
- •Increased pressure inside your head
- •Fainting or temporary loss of consciousness
- •Irregular heartbeat
- •Worsening chest pain
- •A severe drop in blood pressure
- •Temporary lack of oxygen in your blood
- •Stomach pain
- •Diarrhea
- •Heartburn
- •Problems with urination
- •Increased need to pee
- •Impotence
- •Increased pressure in the eye
- •Allergic skin rash
- •Severe skin itching
- •A severe inflammatory skin disease
- •Severe reactions due to blood pressure drop, including nausea, vomiting, restlessness, pale skin, and heavy sweating
- •Methemoglobin formation (a blood disorder where hemoglobin doesn't carry oxygen well), especially in certain patients with specific blood conditions
Important Warnings
- Do not use if you are allergic to isosorbide mononitrate, other nitrate medicines, or any other ingredient in this medicine.
- Do not use if you have very low blood pressure (systolic < 90 mmHg), sudden circulatory collapse, or shock.
- Do not use if you have severe heart pump failure (cardiogenic shock), an acute heart attack, acute left ventricular infarction, certain heart muscle diseases where the heart is narrowed, or certain heart valve defects.
- Do not use if you have severe anemia (very few red blood cells) or if your body has too little blood (hypovolemia).
- Do not take Ismox with certain medicines for erectile dysfunction (like sildenafil). Taking them together can cause a dangerous drop in blood pressure. If you have taken such a medicine, wait at least 24 hours before taking Ismox.
Show 4 more warnings
- Be careful with alcohol, as it can make Ismox work too strongly and cause your blood pressure to drop too much.
- Ismox can make you feel dizzy, especially when you first start taking it, because your blood pressure might drop. Be careful when driving or using machines. If you don't experience side effects, your ability to drive or use machines should not be affected.
- If you are pregnant, breastfeeding, or planning a pregnancy, talk to your doctor or pharmacist before using this medicine.
- If you have used Ismox for several weeks, do not stop taking it suddenly, as this could cause chest pain or irregular heartbeats. Your doctor will tell you how to stop the treatment safely.
Use in Elderly Patients
Suitable for older adults. Consider reduced blood pressure and the risk of fainting due to orthostatic hypotonia. Need for long-acting product should be assessed regularly. (updated 19.5.2025)