Ismox Depot
Ismox helps prevent chest pain (angina) and treats heart failure.
How to Use
Dosage
For 10mg/20mg tablets: Typically, take 1-2 tablets of 10mg or one 20mg tablet in the morning and afternoon; if needed, the dose can be increased to 1 tablet three times daily (60mg total). For 40mg Depot tablets: Typically, take one 40mg tablet in the morning or evening; if needed, the dose can be increased to one 40mg tablet twice daily (80mg total).
Method
Swallow the tablets whole with a glass of water. Do not chew them. You can take them with or without food, but taking them with food may make the effect start slower.
The maximum daily dose for 10mg/20mg tablets is 60mg, and for 40mg Depot tablets, it is 80mg, with specific intervals recommended to maintain effectiveness.
Possible Side Effects
- •Headache (especially at the beginning of treatment, usually goes away after a few days)
- •Low blood pressure (especially when standing up), which can cause fast heart rate, flushing, dizziness, and feeling weak. These usually get better as you continue treatment.
- •Nausea, vomiting
- •Restlessness, confusion, trouble sleeping, vision problems, increased pressure inside the head
- •Fainting and temporary loss of consciousness (which may be linked to slow heart rate due to low blood pressure), irregular heartbeats, worsening chest pain with a big drop in blood pressure, temporary low oxygen in the blood due to blood flow changes
- •Abdominal pain, diarrhea, heartburn
- •Urination problems, increased need to urinate, impotence
- •Increased eye pressure
- •Allergic skin rash, severe skin itching
- •Severe inflammatory skin disease (exfoliative dermatitis)
- •Strong reactions from low blood pressure, including nausea, vomiting, restlessness, paleness, and heavy sweating
- •Methemoglobin formation, especially in patients with specific blood conditions
Important Warnings
- Do not use if you are allergic to isosorbide mononitrate, other ingredients, or organic nitrates.
- Do not use if you have very low blood pressure (systolic blood pressure below 90 mmHg).
- Do not use if you have sudden circulatory collapse or shock.
- Do not use if you have severe heart pump failure (cardiogenic shock), unless your doctor confirms your left ventricle pressure is high enough.
- Do not use if you have an acute heart attack, especially if the pressure in your heart chambers is low or if it's an acute left ventricular attack.
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- Do not use if you have certain heart muscle diseases where the heart's inner part is narrowed, or heart valve issues (like narrowed aortic or mitral valves).
- Do not use if you have very few red blood cells (severe anemia) or if your blood volume is low (hypovolemia).
- Do not take Ismox with medications for erectile dysfunction (like sildenafil, tadalafil, vardenafil, or other PDE5 inhibitors). This combination can dangerously lower your blood pressure. If you have taken such a medicine, you must wait at least 24 hours before taking Ismox.
- Ismox is not for treating sudden chest pain attacks; other fast-acting medicines are used for that.
- If you have glaucoma (high eye pressure), Ismox might increase eye pressure. Discuss this with your doctor.
- Do not stop taking Ismox suddenly, especially if you have used it for several weeks, as this can cause chest pain or heart rhythm problems. Your doctor will tell you how to stop safely.
- Be careful with alcohol, as it can increase Ismox's effect and cause a significant drop in blood pressure.
- Ismox can cause dizziness at the start of treatment due to lowered blood pressure. Be careful when driving or using machines until you know how it affects you. If you don't have side effects, Ismox shouldn't affect your ability.
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)