AHFS DRUG INFORMATION ISDN/M

Isosorbide Dinitrate/Mononitrate
Introduction
C6H8N2O8
C6H9NO6
Isosorbide dinitrate and isosorbide mononitrate, organic nitrates, are vasodilating agents.
Uses
Angina
Isosorbide dinitrate and isosorbide mononitrate share the actions of the other nitrates and nitrites.
The drugs are used for the acute relief of angina pectoris, for prophylactic management in
situations likely to provoke angina attacks, and for long-term prophylactic management of
angina pectoris. (For further information on the use of isosorbide dinitrate and isosorbide
mononitrate in the management of stable and unstable angina, see Uses: Angina in the Nitrates
and Nitrites General Statement 24:12.08.)
Congestive Heart Failure
Fixed-combination Therapy with Hydralazine in Self-identified Black Patients
Isosorbide dinitrate is used in fixed combination with hydralazine as an adjunct to standard
therapy for the treatment of congestive heart failure (CHF) in self-identified black patients to
improve survival, decrease rate of hospitalization for worsened heart failure, and improve
patient-reported functional status.336, 337, 338
Other Therapies in the General Population
Isosorbide dinitrate (in combination with cardiac glycosides and diuretics or with hydralazine)
has been used effectively for the treatment of congestive heart failure# or other low cardiac
output states#. (For further information on the use of isosorbide dinitrate in the management of
heart failure, see Uses: Heart Failure and Low-Output Syndromes in the Nitrates and Nitrites
General Statement 24:12.08.)
Diffuse Esophageal Spasm
In a limited number of patients with diffuse esophageal spasm without gastroesophageal reflux#,
isosorbide dinitrate has been used effectively to relieve pain, dysphagia, and spasm.
Dosage and Administration
Administration
Isosorbide Dinitrate
Isosorbide dinitrate is administered sublingually, intrabuccally, or orally. The possibility that
sublingual or intrabuccal nitrates may be inadequately absorbed, with resultant decreased
efficacy, in patients with dry oral mucous membranes (e.g., xerostomia) should be
considered.219, 220 Chewable tablets (no longer commercially available in the US) should be
chewed thoroughly before swallowing. Extended-release preparations should not be chewed. The

patient should be sitting immediately after administration of isosorbide dinitrate sublingually or

as a chewable tablet.
Isosorbide Mononitrate
Isosorbide mononitrate is administered orally.290, 291, 292 Isosorbide mononitrate extendedrelease tablets can be administered as whole or halved tablets, but these should be swallowed
intact and not chewed or crushed. 292 In addition, isosorbide extended-release tablets should be
administered with adequate amounts of fluid (e.g., 120 mL) on arising in the morning.292
Dosage
Dosage of isosorbide dinitrate and isosorbide mononitrate must be carefully adjusted according
to the patient's requirements and response and the smallest effective dosage should be used.
When isosorbide dinitrate is used in fixed combination with hydralazine, the cautions,
precautions, and contraindications associated with hydralazine must be considered in addition to
those associated with isosorbide dinitrate (see Cautions and Precautions and Contraindications in
the Nitrates and Nitrites General Statement 24:12.08).336
Clinical studies of isosorbide dinitrate alone302 or in fixed combination with hydralazine336 did
not include sufficient numbers of patients 65 years of age and older to determine whether
geriatric patients respond differently than younger patients.302, 336 Although other clinical
experience has not revealed age-related differences in response or tolerance, drug dosage
generally should be titrated carefully in geriatric patients, usually initiating therapy at the low
end of the dosage range.302, 336 The greater frequency of decreased hepatic, renal, and/or
cardiac function and of concomitant disease and drug therapy observed in the elderly also should
be considered.302, 336 Elimination of isosorbide dinitrate and its metabolites may occur more
slowly in geriatric patients than in younger adults.336
Clinical studies of isosorbide mononitrate did not include sufficient numbers of patients 65 years
of age and older to determine whether geriatric patients respond differently than younger
patients.325 Other clinical experience has not identified any differences in responses between
geriatric and younger patients.325 One manufacturer of isosorbide mononitrate states that if
isosorbide mononitrate is used in geriatric patients, dosage of the drug should be selected with
caution, usually initiating therapy at the low end of the dosage range, although age, renal,
hepatic, and cardiovascular dysfunction do not appear to have a significant effect on the
clearance of the drug.325
Angina
Acute Symptomatic Relief and Prophylactic Management. For the acute relief of angina
pectoris or for prophylactic management in situations likely to provoke angina attacks in patients
who fail to respond to nitroglycerin lingual or sublingual preparations, 2.5-5 mg of isosorbide
dinitrate is administered sublingually, intrabuccally, or as a chewable tablet (no longer
commercially available in the US). If relief is not attained after a single dose during an acute
attack, additional doses may be given at 5- to 10-minute intervals; no more than 3 doses should
be given in a 15- to 30- minute period.

For the prophylactic management in situations likely to provoke angina attacks in patients who
fail to respond to sublingual nitroglycerin, 2.5-5 mg of isosorbide dinitrate should be placed
under the tongue approximately 15 minutes prior to engaging in such activities.200
Since the onset of action of extended-release preparations containing isosorbide dinitrate or any
preparation containing isosorbide mononitrate is not sufficiently rapid to be efficacious in
aborting an acute anginal episode, such preparations are not indicated for use in the management
of acute relief of angina or in the prophylactic management in situations likely to provoke angina
attacks.224, 290, 291, 292
Long-term Prophylactic Management. For long-term prophylactic management of angina
pectoris, the usual initial dosage of oral isosorbide dinitrate conventional tablets (e. g., Isordil
Titradose,) is 5-20 mg administered 2 or 3 times daily.302 The usual recommended
maintenance dosage is 10-40 mg 2 or 3 times daily, although some patients may require higher
dosages.302 Some clinicians recommend that such dosages be administered at 7 a.m., 12 p.m.,
and 5 p.m. in most patients with chronic stable angina or at 7 a.m. and 12 p.m. in patients with
less severe symptoms of angina in order to allow for a nitrate-free interval of 10-14 hours.302
Patients who arise earlier than 7 a.m. may need to adjust this schedule since early morning
angina is common.324 There is some evidence that less frequent administration of isosorbide
dinitrate in patients with angina pectoris may reduce the development of tolerance to the drug's
antianginal effects (see Cautions: Tolerance and Dependence, in the Nitrates and Nitrites General
Statement). In addition, the manufacturer of isosorbide dinitrate extended-release capsules
(Dilatrate-SR) states that results of the only multiple-dose study performed using an extendedrelease preparation of isosorbide dinitrate indicate that when these extended-release capsules
were given twice daily (6 hours apart), the antianginal efficacy of the drug after 4 weeks of
therapy was comparable to that of placebo.224 This manufacturer also states that an interdosing
interval sufficient to avoid tolerance with these extended-release capsules is not known, but it
must exceed 18 hours.224 The maximum daily dosages of Dilatrate should not exceed 160 mg
(4 capsules).224
Alternatively, conventional or extended-release tablets of isosorbide mononitrate may be used for
long-term prophylactic management of angina.290, 291, 292 The usual initial dosage of
conventional isosorbide mononitrate tablets (e.g., Ismo, Monoket) is 20 mg twice daily, with
the 2 doses administered 7 hours apart. 290, 291 Patients of particularly small stature may
receive initial dosages of 5 mg (administered as one-half of a 10-mg tablet) twice daily, but since
such a lower dosage is only effective (as determined by exercise tolerance) on the first day of
therapy, the dosage should be increased to at least 10 mg twice daily by the second or third day
of therapy.291 The recommended initial dosage of the extended-release isosorbide mononitrate
tablets (e.g., Imdur) is 30 (administered as a single 30-mg tablet or as one-half of a 60-mg
tablet) or 60 mg (administered as a single 60-mg tablet) once daily.292 Dosage may be increased
to 120 mg (administered as a single 120-mg tablet or as two 60-mg tablets) once daily after
several days of therapy; dosages of 240 mg of these extended-release tablets are rarely
needed.292
Congestive Heart Failure
Fixed-combination Therapy with Hydralazine in Self-identified Black Patients. For the
adjunctive treatment of congestive heart failure (CHF) in self-identified black patients, the

recommended initial dosage of the fixed-combination preparation is 20 mg of isosorbide dinitrate

and 37.5 mg of hydralazine hydrochloride (1 tablet of BiDil) 3 times daily.336, 338 The dosage
may be titrated to a maximum tolerated dosage, not to exceed 2 tablets (a total of 40 mg of
isosorbide dinitrate and 75 mg of hydralazine hydrochloride) 3 times daily.336, 338 Although
rapid titration (over 3-5 days) of dosage can be undertaken, slower titration may be needed in
some patients who experience adverse effects.336 In patients who experience intolerable adverse
effects, the dosage may be decreased to as little as one-half of the fixed-combination tablet 3
times daily; however, an attempt should be made to titrate the dosage up once the adverse effects
subside.336 The manufacturer states that there is no adequate clinical experience with
hydralazine or isosorbide dinitrate as separate agentsb or dosages of the drugs other than those
used in the A-HeFT trial (see Uses: Heart Failure and Low-output Syndromes in the Nitrates and
Nitrites General Statement 24:12.08) for the treatment of congestive heart failure.336
Other Therapies in the General Population. Isosorbide dinitrate conventional tablets (up to
160 mg daily) have been used in combination with hydralazine hydrochloride (up to 300 mg
daily) and conventional therapy (e.g., diuretics, cardiac glycosides) for the treatment of
congestive heart failure#.255, 256, 257 In clinical studies, initial oral dosages of 80 mg of
isosorbide dinitrate (administered as one-half of a 40 mg conventional tablet 4 times daily) daily
were administered in combination with oral dosages of 150 mg of hydralazine hydrochloride
(administered as a single 37.5 mg tablet 4 times daily) daily for 2 weeks.256 If initial dosages
were tolerated, daily dosages were increased to 160 mg of isosorbide dinitrate and 300 mg of
hydralazine hydrochloride; patients were maintained at such dosages for at least 2 years.256
Diffuse Esophageal Spasm
In a limited number of patients with diffuse esophageal spasm without gastroesophageal reflux#,
10-30 mg of isosorbide dinitrate has been given orally 4 times daily.
Pharmacokinetics
Absorption
Isosorbide dinitrate is readily (and almost completely) absorbed from the GI tract and oral
mucosa, but considerable variations in the bioavailability of the drug (10-90%) have been
reported as a result of extensive first-pass metabolism in the liver.224, 294, 302 The
bioavailability of isosorbide dinitrate, as unchanged drug, following oral administration of
conventional tablets (25%) generally appears to be about half that following sublingual
administration (40-50%);20, 200, 226, 228 however, in one study, systemic bioavailability of the
drug was similar (about 29%) for both oral conventional tablets and sublingual tablets.221 It has
been suggested that the reduced bioavailability of sublingual tablets of isosorbide dinitrate may
result from swallowing a portion of the drug dissolved from such tablets, possibly because
absorption of the drug is slow relative to the time that a sublingual dose might reasonably be
retained in the mouth.310, 311 Although multiple-dose studies of isosorbide dinitrate sublingual
tablets have not been conducted, multiple-dose studies of isosorbide dinitrate oral conventional
tablets indicate that progressive increases in bioavailability may occur during chronic
therapy.200, 224, 225, 302
Although some evidence suggests that systemic bioavailability of isosorbide dinitrate from
extended-release oral tablets is similar but slightly less than that from conventional oral

tablets,20 other evidence suggests that considerable variability exists for various extendedrelease preparations223, 232, 233 and that some preparations may be substantially less
bioavailable than conventional tablets.223, 233 Because pharmacologic effects of the drug also
depend on serum concentrations of active metabolites (e.g., isosorbide-5-mononitrate,
isosorbide-2-mononitrate), comparisons should extend beyond systemic bioavailability of
unchanged drug alone.222, 229, 230, 232, 233 Unfortunately, many studies do not specify20,
222, 224, 225, 232 or provide incomplete data222, 232 on these metabolites. In addition,
although most studies have employed single doses, the pharmacokinetics and/or bioavailability
of the drug may be affected substantially during multiple dosing because the metabolites may
decrease the metabolic clearance of isosorbide dinitrate; therefore, predictions based on singledose studies are uncertain.200, 222, 223, 224, 225, 231, 233
Although food may decrease substantially mean peak plasma concentrations of isosorbide
dinitrate, total bioavailability of the drug does not seem to be affected.299, 311
Considerable interindividual variations (approximately 5- to 11-fold) in peak plasma
concentrations attained have been reported with a specific oral dose of isosorbide dinitrate.222
Following administration of isosorbide dinitrate as sublingual or conventional oral tablets, peak
plasma isosorbide dinitrate concentrations are reached in 10-15 or 60 minutes, respectively.200,
302 Elevated blood concentrations of isosorbide dinitrate have been observed in patients with
cirrhosis.336
Isosorbide mononitrate also is readily absorbed from the GI tract.291, 294, 295 Because
isosorbide mononitrate, unlike isosorbide dinitrate, does not undergo first-pass hepatic
metabolism, the bioavailability of isosorbide mononitrate conventional or extended-release
tablets is approximately 100 or 77-80%, respectively.290, 291, 292, 294, 295, 296, 297, 298
In general, food was found to delay the rate but not the extent of absorption (less than 10%) of
conventional or extended-release isosorbide mononitrate tablets. 292, 295, 298, 299, 300, 301
Following oral administration of conventional or extended-release isosorbide mononitrate
tablets, peak plasma concentrations of isosorbide mononitrate are achieved within 0.5-1 or about
3-4.5 hours, respectively.292 In one study, following oral administration of a 40-mg conventional
isosorbide mononitrate tablet in fasted healthy individuals, mean peak plasma concentrations of
about 930 ng/mL were achieved within about 1 hour.299 In addition, in another study, following
oral administration of a 60- or 120-mg extended-release tablet of isosorbide mononitrate in
healthy individuals, peak plasma concentrations of about 557 or 1151 ng/mL were achieved
within about 3 hours, respectively.295, 296, 297, 298, 300
Following oral administration of a single 40-mg dose of isosorbide dinitrate given in fixed
combination with 75 mg of hydralazine hydrochloride (2 tablets of BiDil) in a limited number
of healthy adults, peak plasma isosorbide concentrations of 76 ng/mL per 65 kg were reached in
1 hour.336 The effect of food on the bioavailability of isosorbide dinitrate when administered in
fixed combination with hydralazine hydrochloride is not known.336
Although optimal therapeutic plasma concentrations have not been determined, it has been
suggested that the therapeutic plasma concentration of isosorbide mononitrate (both for the
management of angina and congestive heart failure) is 100 ng/mL.303, 304, 305 In addition,

evidence from clinical studies of isosorbide dinitrate and isosorbide mononitrate have shown that
dosing regimens that result in plasma isosorbide mononitrate concentrations that fall below 100
ng/L prior to the administration of the next dose may be associated with a lower risk of
developing tolerance.304
The approximate onset and duration of action of various dosage forms of isosorbide dinitrate
(ISDN) and isosorbide mononitrate (ISMN) are shown in Table 1 and Table 2.
Table 1. Antianginal Effects
Dosage Form Onset Duration sublingual ISDN within 3 min200, 225 2 h200, 225 chewable
ISDN within 3 min225 2-2.5 h225 oral ISDN 1 h225 up to 8 h225 oral ISMN 1 h290, 291 5-7
h290, 291 extended-release ISDN 1 h224 8 h224 extended-release ISMN 1 h298 12 h298
HEMODYNAMIC EFFECTS
Dosage Form Onset Duration sublingual ISDN within 15-30 min 1.5-4 h chewable ISDN 5 min
2-3 h oral ISDN within 20-60 min 4-6 h oral ISMN 10-30 min314 at least 6 h314 extendedrelease ISDN within 2 h313 up to 12 h313 extended-release ISMN 20-30 min314 at least 6 h314
The onset and duration of action following intrabuccal administration are probably similar to
those after sublingual administration of isosorbide dinitrate; however, no studies are available.
Distribution
Distribution of isosorbide dinitrate or isosorbide mononitrate into human body tissues and fluids
has not been fully characterized.294, 302, 303, 304 Once absorbed, isosorbide dinitrate is widely
distributed into body tissues and fluids including smooth muscle cells of blood vessels with the
apparent volume of distribution reported to be 2-4 L/kg in adults.294, 302, 303, 304 Under
steady-state conditions, substantial accumulation (relative to simultaneous plasma
concentrations) of isosorbide dinitrate may occur in the pectoral muscle and saphenous vein
walls.336 Following IV administration, isosorbide mononitrate is distributed into total body
water in about 9 minutes with an apparent volume of distribution of approximately 0.6-0.7 L/kg
in adults. 290, 291, 292 Isosorbide mononitrate also is distributed into blood cells and saliva.290,
291, 292, 312
Isosorbide dinitrate and isosorbide mononitrate are approximately 28 and 4-5% bound to plasma
proteins, respectively.290, 291, 292, 303
Although isosorbide dinitrate reportedly was detected in milk,303 it currently is not known if
isosorbide dinitrate and isosorbide mononitrate are distributed into milk in humans.200, 224,
290, 291, 292, 302
Elimination
The elimination half-life of isosorbide dinitrate is approximately 1 hour200, 224, 225, 302, 336
(although a longer half-life [about 2 hours] has been reported when administered in fixed
combination with hydralazine hydrochloride).336 Isosorbide mononitrate has an elimination
half-life of about 5 hours.290, 291, 292

Isosorbide dinitrate is metabolized (denitrated) extensively; about 15-25 and 75-85% of a dose is
metabolized to isosorbide-2-mononitrate and isosorbide-5-mononitrate (referred to simply as
isosorbide mononitrate), respectively.200, 224, 290, 291, 292, 302 Both metabolites are
pharmacologically active, especially the isosorbide mononitrate.200, 224, 290, 291, 292, 302
Isosorbide mononitrate is metabolized principally in the liver, but unlike isosorbide dinitrate, it
does not undergo first-pass metabolism.290, 291, 292 About 50% of a dose of isosorbide
mononitrate undergoes denitration to form isosorbide, followed by partial dehydration to form
sorbitol.200, 224, 291, 292, 302 Isosorbide mononitrate also appears to undergo glucuronidation
to form the 5-mononitrate glucuronide.291, 292, 302 These metabolites apparently do not have
pharmacologic activity.291, 292
After a single oral dose of isosorbide dinitrate, 80-100% of the amount is excreted in urine
within 24 hours, chiefly as metabolites. Isosorbide mononitrate also is excreted mainly in the
urine; compounds recovered in urine after isosorbide mononitrate administration have included
isosorbide, sorbitol, and conjugates; only 2% of a dose is excreted as unchanged drug.291 About
96% of an administered dose of isosorbide mononitrate is excreted in urine and about 1% in
feces within 5 days; most excretion (about 93%) occurs within 48 hours.200 224, 290, 291, 292
The plasma clearance of isosorbide dinitrate reportedly is 2-4 L/minute.200, 224, 225, 302 Since
plasma clearance exceeds hepatic blood flow, it appears that the drug also is metabolized at
extrahepatic sites.200, 224, 302
Renal clearance of isosorbide mononitrate accounts only for about 4% of total body
clearance.292 Plasma clearance of isosorbide mononitrate does not appear to be affected by age,
cardiac disease, or renal or hepatic impairment.290, 291 Isosorbide mononitrate is substantially
removed by hemodialysis.291, 315
Chemistry and Stability
Chemistry
Isosorbide is commercially available as dinitrate200, 224, 225, 302 and mononitrate290, 291,
292 organic salts. Organic nitrates (e.g., isosorbide dinitrate, isosorbide mononitrate) are
powerful explosives that are rendered nonexplosive by the addition of an inert excipient such as
lactose.
Isosorbide Dinitrate
Isosorbide dinitrate occurs as a white to off-white,302 crystalline powder.336 Isosorbide dinitrate
is sparingly soluble in water302 and freely soluble in alcohol.302, 336 The drug is diluted with
lactose, mannitol, or other suitable inert excipients to permit safe handling. Diluted isosorbide
dinitrate occurs as an ivory-white, odorless powder.
Isosorbide dinitrate is commercially available as conventional tablets (e.g., Sorbitrate225 and
Isordil Titradose),302 extended-release capsules (e.g., Dilatrate-SR),224 extended-release
tablets, and sublingual-intrabuccal (e.g., Isordil)200 tablets. The commercially available
extended-release capsules of isosorbide dinitrate (Dilatrate-SR) contain the drug in a
microdialysis membrane delivery system that slowly releases the drug.224

Isosorbide Mononitrate
Isosorbide mononitrate is the major active metabolite of isosorbide dinitrate.290, 291, 292
Isosorbide mononitrate occurs as a white, crystalline, odorless powder, and is freely soluble in
water and alcohol.292
The drug is commercially available as conventional (e.g., Monoket, Ismo) or extended-release
(e.g., Imdur) tablets. The commercially available extended-release isosorbide mononitrate
tablets contain the drug in an insoluble matrix designed for extended release.295, 296, 297, 298,
307, 308 Isosorbide mononitrate also may be available as extended-release capsules (not
commercially available in the US) that contain 30% of the drug in an immediate-release layer
and the remaining 70% in controlled-release coated pellets.307, 309
Stability
Isosorbide Dinitrate
Isosorbide dinitrate tablets should be stored in tight, light-resistant containers at room
temperature (25C) and should not be exposed to extremes in temperature. Commercially
available fixed-combination tablets of isosorbide dinitrate and hydralazine hydrochloride should
be stored in tight, light-resistant containers at a controlled room temperature of 25C but may be
exposed to temperatures ranging from 15-30C.336
Isosorbide Mononitrate
Some isosorbide mononitrate extended-release (Imdur) and conventional tablets (Ismo) should
be stored in tight, light-resistant containers at 20-25C; however, other conventional tablets of
isosorbide mononitrate (e.g., Monoket) should be stored in tight, light-resistant containers at 1530C.290, 292, 293
Additional Information
For further information on chemistry and stability, pharmacology, pharmacokinetics, uses,
cautions, drug interactions, laboratory test interferences, and dosage and administration of
isosorbide dinitrate, see the Nitrates and Nitrites General Statement 24:12.08.
Preparations
* available generically
Isosorbide Dinitrate
Routes Dosage Forms Strengths Brand Names Manufacturer Oral Capsules, 40 mg DilatrateSR Schwarz extended- release Tablets 5 mg* Isordil Titradose (scored) Biovail Isosorbide
Dinitrate Tablets Par, Sandoz, Teva, West-Ward 10 mg* Isosorbide Dinitrate Tablets Par,
Sandoz, Teva, West-Ward 20 mg* Isosorbide Dinitrate Tablets Par, Sandoz, Teva, West-Ward
30 mg* Isosorbide Dinitrate Tablets Par 40 mg* Isordil Titradose (scored) Biovail Tablets,
40 mg* Isosorbide Dinitrate Tablets ER Inwood extended- release Sublingual Tablets 2.5 mg*
Isosorbide Dinitrate Tablets West-Ward (Intrabuccal) 5 mg* Isosorbide Dinitrate Tablets
West-Ward
* available generically

Isosorbide Mononitrate
Routes Dosage Forms Strengths Brand Names Manufacturer Oral Tablets 10 mg* Isosorbide
Mononitrate Actavis, Kremers Urban Tablets Monoket (scored) Schwarz 20 mg* Isosorbide
Mononitrate Actavis, Kremers Urban, Tablets West-Ward Monoket (scored) Schwarz Tablets,
30 mg* Imdur (scored) Schering-Plough extended- release Isosorbide Mononitrate Actavis,
Ethex, Kremers Tablets ER Urban, Warrick 60 mg* Imdur (scored) Schering-Plough
Isosorbide Mononitrate Actavis, Ethex, Kremers Tablets ER Urban, Warrick, West-Ward 120
mg* Imdur Schering-Plough Isosorbide Mononitrate Ethex, Kremers Urban, Tablets ER
Warrick Tablets, 20 mg Ismo (with povidone) ESP Pharma extended- release, film-coated
Isosorbide Dinitrate Combinations
Routes Dosage Forms Strengths Brand Names Manufacturer Oral Tablets, film- 20 mg with
Hydralazine BiDil NitroMed coated Hydrochloride 37.5 mg (scored)
Comparative Pricing
Pricing information provided by drugstore.com.
Imdur 120MG TB24 (KEY): 30/$80.12 or 90/$232.59
Imdur 30MG TB24 (KEY): 30/$72.25 or 90/$197.47
Imdur 60MG TB24 (KEY): 30/$72.25 or 90/$207.12
Ismo 20MG TABS (REDDY PHARMACEUTICAL): 60/$101.99 or 180/$299.97
Isosorbide Mononitrate 10MG TABS (ACTAVIS ELIZABETH): 60/$17.99 or 180/$45.99
Isosorbide Mononitrate 20MG TABS (ACTAVIS ELIZABETH): 60/$18.99 or 180/$48.98
Isosorbide Mononitrate CR 120MG TB24 (ETHEX): 30/$19.99 or 90/$46.97
Isosorbide Mononitrate CR 30MG TB24 (WEST-WARD): 30/$15.99 or 90/$35.99
Monoket 10MG TABS (SCHWARZ PHARMA): 60/$69.99 or 180/$197.96
Monoket 20MG TABS (SCHWARZ PHARMA): 60/$97.99 or 180/$274.95
AHFS Drug Information. Copyright, 1959-2008, Selected Revisions March 2006. American
Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.
#

Use is not currently included in the labeling approved by the US Food and Drug
Administration.
References
Please see the general statement for a list of references.

Copyright 2008 by the American Society of Health-System Pharmacists, Inc. All rights
reserved.
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Copyright:
o Copyright 2008 by the American Society of Health-System Pharmacists, Inc.
All rights reserved.

Database Title:
o STAT!Ref Online Electronic Medical Library

Editor:
o Gerald K. McEvoy, Pharm.D.

ISBN:
o 978-1-58528-206-7

ISSN:
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Publication City:
o Bethesda, MD

Publication Year:
o 2008

Publisher:
o American Society of Health-System Pharmacists, Inc.

Title:
o AHFS Drug Information (2008)

Date Posted:
o 11/17/2008 2:49:05 PM PST (GMT -08:00)

Electronic Address:
o http://online.statref.com/document.aspx?fxid=1&docid=462

Date Accessed:
o 11/22/2008 3:18:23 AM PST (GMT -08:00)

Location In Title:
o AHFS DRUG INFORMATION (2008)
24:00 Cardiovascular Drugs
24:12 Vasodilating Agents
24:12.08 Nitrates and Nitrites
Isosorbide Dinitrate/Mononitrate

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