Ismox
Ismox helps prevent chest pain (angina) and treats heart failure by relaxing blood vessels and making it easier for your heart to pump blood.
How to Use
Dosage
For Ismox 10 mg or 20 mg tablets: Take 1 to 2 tablets of 10 mg or one 20 mg tablet in the morning and afternoon. If your doctor says so, you can take one 20 mg tablet three times a day (total 60 mg). For Ismox Depot 40 mg tablets: Take one 40 mg tablet in the morning or evening. If your doctor says so, you can take one 40 mg tablet twice a day (total 80 mg).
Method
Swallow tablets whole with plenty of liquid (e.g., a glass of water). They can be taken with or without food; taking with food may slow down the effect slightly.
Do not take more than 60 mg of Ismox 10 mg or 20 mg tablets in a day, and make sure there's at least 12 hours between doses. For Ismox Depot 40 mg tablets, do not take more than 80 mg in a day, and if taking two doses, the second dose must be at least 6 hours after the first.
Possible Side Effects
- •Headache (especially at the start of treatment, usually goes away after a few days).
- •Low blood pressure, especially when standing up, which may cause fast heart rate, redness, dizziness, and feeling weak. These usually lessen as treatment continues.
- •Feeling sick (nausea), vomiting.
- •Restlessness, confusion, sleeplessness, blurred vision, increased pressure inside the skull.
- •Fainting and temporary loss of consciousness, irregular heartbeats, worsening chest pain (angina pectoris) with a strong drop in blood pressure, temporary lack of oxygen in the blood due to blood flow changes.
- •Stomach pain, diarrhea, heartburn.
- •Problems urinating, increased need to urinate, impotence, increased pressure in the eye.
- •Allergic rash, severe skin itching, severe inflammatory skin disease (exfoliative dermatitis).
- •Severe reactions due to blood pressure drop, including nausea, vomiting, restlessness, paleness, and excessive sweating.
- •Formation of methemoglobin (a blood disorder), especially in patients with a lack of methemoglobin reductase or abnormal hemoglobin structure.
Important Warnings
- Do not use Ismox if you are allergic to isosorbide mononitrate, other nitrates, or any other ingredients in the medicine.
- Do not use Ismox if you have very low blood pressure (systolic blood pressure below 90 mmHg), sudden circulatory collapse, or shock.
- Do not use Ismox if you have severe heart problems like certain types of heart pump failure, acute heart attack (myocardial infarction) that hasn't been corrected, severe anemia, or low blood volume.
- Never take Ismox with certain medicines for erectile dysfunction (like sildenafil, tadalafil, vardenafil) as this can cause a dangerous drop in blood pressure. If you have taken such a medicine, wait at least 24 hours before taking Ismox.
- If you are pregnant, breastfeeding, or planning a pregnancy, talk to your doctor or pharmacist before using Ismox.
Show 3 more warnings
- Be careful when driving or using machines, especially at the start of treatment, as Ismox can cause dizziness due to a drop in blood pressure.
- Alcohol can make Ismox's effect stronger and cause a very low blood pressure.
- Do not stop taking Ismox suddenly if you have been using it for several weeks, as this can lead to chest pain or irregular heartbeats. Your doctor will advise you on how to stop 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)