Monoket

Monoket is a nitrate that widens blood vessels, helping blood flow more easily and making it easier for the heart to pump.

Monoket is used to prevent angina attacks (chest pain).

Monoket will not treat an angina attack that has already started.

Monoket may also be used for other purposes that are not listed in this medication guide.

Follow all directions on your prescription label. Your doctor may change your dose from time to time. Do not take this medicine in larger or smaller amounts or for longer than recommended. If you take too much Monoket, it may not work as well to control your condition.

Try to rest or stay seated when you take this medicine (it may cause dizziness or fainting).

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Not all brands and forms of isosorbide mononitrate are taken the same number of times each day. You may only need to take the medicine once daily, in the morning after getting out of bed. You may also need a second dose later in the day.

Follow your doctor's dosing instructions very carefully. If your doctor changes your brand, strength, or type of isosorbide mononitrate, your dosage needs may change. Ask your pharmacist if you have any questions about the new type of isosorbide mononitrate you receive at the pharmacy.

You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. Prolonged illness can lead to a serious electrolyte imbalance, which can make it dangerous for you to use Monoket.

Use Monoket regularly to prevent an angina attack. Get your prescription refilled before you run out of medicine completely.

You should not stop using Monoket suddenly or you could have a severe attack of angina. Keep this medicine on hand at all times. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

You should not take erectile dysfunction medicine (Viagra, Cialis, Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil, vardenafil) while you are taking Monoket. Taking these medicines together can cause a sudden and serious drop in blood pressure.

Seek emergency medical help if you have early signs of a heart attack (chest pain or pressure, pain spreading to your jaw or shoulder, sweating, feeling unwell).

You should not use Monoket if:

• you are allergic to Monoket, isosorbide dinitrate, or nitroglycerin; or
• you have early signs of a heart attack (chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating).

You should not take erectile dysfunction medicine (Viagra, Cialis, Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil, vardenafil) while you are taking Monoket. Taking these medicines together can cause a sudden and serious decrease in blood pressure.

To make sure Monoket is safe for you, tell your doctor if you have:

• congestive heart failure;
• kidney disease; or
• low blood pressure.

It is not known whether Monoket will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether isosorbide mononitrate passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Monoket may cause serious side effects. Call your doctor right away if you have:

• a light-headed feeling, as if you might pass out;
• worsening angina pain;
• fast or slow heart rate; or
• pounding heartbeats or fluttering in your chest.

Monoket can cause severe headaches. These headaches may gradually become less severe as you continue to use nitroglycerin. Do not stop taking Monoket to avoid headaches. Ask your doctor before using any headache pain medication.

Common side effects of Monoket may include:

• headache; or
• flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. Do not take extra medicine to make up for the missed dose.

Seek emergency medical help or call the Poison Help line at 1-800-222-1222. An overdose of Monoket can be deadly.

Symptoms of an overdose may include a severe throbbing headache, fever, confusion, severe dizziness, fast or pounding heartbeats, vision problems, nausea, vomiting, stomach pain, bloody diarrhea, trouble breathing, sweating, cold or clammy skin, fainting, and seizures (convulsions).

Monoket may affect your thinking or reactions. Be cautious if you drive or do anything that requires alertness. Avoid standing up too quickly from a sitting or lying position, as it may cause dizziness. Get up slowly and steady yourself to avoid falling.

Avoid drinking alcohol. Alcohol may increase some side effects of isosorbide mononitrate (dizziness, drowsiness, feeling light-headed, or fainting).

Taking Monoket with certain other medicines can lead to very low blood pressure. This includes medicines for erectile dysfunction or pulmonary arterial hypertension. Serious, life-threatening side effects may happen.

Tell your doctor about all the medicines you are currently taking and any that you start or stop, especially:

• avanafil (Stendra);
• a diuretic or "water pill";
• nitroglycerin;
• riociguat (Adempas);
• sildenafil (Viagra, Revatio);
• tadalafil (Cialis, Adcirca); or
• vardenafil (Levitra, Staxyn).

This list is not complete. Other drugs may interact with isosorbide mononitrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are included in this medication guide.