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Imdur (Isosorbide Mononitrate)

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Generic Imdur is an effective medication which helps in the treatment of angina attacks. Generic Imdur acts as nitrates.

Other names for this medication:

Similar Products:
Nitrostat, Nitro-Bid, NitroQuick, Nitro-Dur, Isordil, Ranexa


Also known as:  Isosorbide Mononitrate.


Generic Imdur is a perfect remedy, which helps to treat angina attacks.

Generic Imdur acts as nitrates.

Imdur is also known as Isosorbide Mononitrate.

Generic name of Generic Imdur is Isosorbide Mononitrate.

Brand names of Generic Imdur are Imdur, ISMO, Monoket.


Take Generic Imdur tablets orally with or without food.

Do not crush or chew it.

Take Generic Imdur at the same time with water.

If you want to achieve most effective results do not stop taking Generic Imdur suddenly.


If you overdose Generic Imdur and you don't feel good you should visit your doctor or health care provider immediately. Symptoms of Generic Imdur are difficult or slow breathing, muscle cramps, nausea, vomiting, diarrhea, high temperature, fainting, abnormal heartbeat, changes in vision, flushing, convulsions, severe throbbing migraine, lightheadedness.


Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Imdur are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.


Do not take Generic Imdur if you are allergic to Generic Imdur components.

Do not take Generic Imdur if you're pregnant or you plan to have a baby.

Do not use potassium supplements or salt substitutes.

Be careful using Generic Imdur if you take dihydroergotamine (D.H.E. 45); or any other heart medicines, especially those used to treat high blood pressure or irregular heartbeats.

Be careful using Generic Imdur if you suffer from or have a history of congestive heart failure, have low blood pressure; a stroke, a transient ischemic attack (TIA, or mini-stroke), have anemia; have an allergy to nitrates; have closed-angle glaucoma; migraines, kidney disease; liver disease, heart attack, a serious head injury.

If you want to achieve most effective results without any side effects it is better to avoid alcohol.

Be very careful when you are driving machine.

Do not stop taking Generic Imdur suddenly.

imdur 120 mg

women liked the opportunity to remain at home during the cervical ripening process. Timing and setting were central issues; women hoped that it would hasten labour, while the home was seen as a setting offering freedom, security and reassurance, as opposed to the hospital, seen as constraining. Two women reported problems with IMN but the remainder reported that they would repeat the experience.

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In isolated renal veins of the rabbit, isosorbide dinitrate and isosorbide-5-mononitrate were seven to twenty times more potent as relaxants than in renal arteries which explains their predilection for the capacitance vascular bed in vivo. For sodium nitroprusside (SNP) and nitroglycerin (NTG), the sensitivity was slightly greater in veins at threshold concentrations (EC10), but similar in veins and arteries at higher concentrations (EC50). After 30 min of exposure, the relaxant effect to NTG faded partially in arteries, but not in veins, which may underlie its preference for the capacitance vessels in vivo. In anaesthetized rats, SNP and NTG were infused i.v. or into the femoral artery. The hypotensive response to NTG was the same by either route of infusion, whereas that to SNP was considerably lower on infusion into the femoral artery; a 34% inactivation of SNP on passage through the hind leg was calculated. The result decrease in venous over arterial blood levels of SNP at a somewhat greater sensitivity of veins than of arteries may account for the balanced effect of SNP on resistance and capacitance vessels in vivo.

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A prospective randomized trial.

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Patients with intracranial aneurysms tend toward raised blood pressure and abnormal pulse pressure profiles. The authors have investigated the influence of three antihypertension agents on blood pressure and pulse pressure waveforms in patients with known intracranial aneurysms, with a view to assessing the potential benefits of longterm antihypertension therapy on the progression of unruptured intracranial aneurysms.

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Thirty-nine patients completed the study and were included in the statistical evaluation. Total exercise duration and time to appearance of 1-mm ST depression increased significantly after two weeks of treatment with both drugs compared with placebo. However, the time to onset of chest pain increased significantly only after therapy with controlled-release 5-ISMN. Moreover, controlled-release 5-ISMN produced a more pronounced improvement in total exercise duration than the conventional formulation of 5-ISMN after two weeks of therapy. Adverse events were reported by five (13%) patients receiving controlled-release 5-ISMN and by the same percentage of patients receiving conventional 5-ISMN therapy; most of these events were headache and/or dizziness.

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Dogs were subjected to various durations of ventricular tachypacing (VTP, 220 to 240 bpm) in the presence or absence of oral enalapril 2 mg. kg(-1). d(-1). VTP for 5 weeks induced CHF, local atrial conduction slowing, and interstitial fibrosis and prolonged atrial burst pacing-induced AF. Atrial angiotensin II concentrations and MAPK expression were increased by tachypacing, with substantial changes in phosphorylated forms of c-Jun N-terminal kinase (JNK), extracellular signal-regulated kinase (ERK), and p38-kinase. Enalapril significantly reduced tachypacing-induced changes in atrial angiotensin II concentrations and ERK expression. Enalapril also attenuated the effects of CHF on atrial conduction (conduction heterogeneity index reduced from 3.1+/-0.4 to 1.9+/-0.2 ms/mm, P<0.05), atrial fibrosis (from 11.9+/-1.1% to 7.5+/-0.4%, P<0.01), and mean AF duration (from 651+/-164 to 218+/-75 seconds, P<0.05). Vasodilator therapy of a separate group of VTP dogs with hydralazine and isosorbide mononitrate did not alter CHF-induced fibrosis or AF promotion.

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The purpose of this study is to investigate the penetration effects and mechanism of N-arginine chitosan (ACS). This novel transdermal enhancer with a mimetic structure of cell-penetration peptides was synthesized by introducing hydrophilic arginine groups to the amino-group on chitosan's side chain. The structure of ACS was confirmed by FT-IR, 1H NMR and element analysis. In addition, attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) was used to study the protein conformation and the water content of stratum corneum, and the result suggested that ACS can change the orderly arrangement of the molecules in the stratum corneum, making the stack structure of keratin become loose. And ACS can increase the water content of the stratum corneurn. Inverted fluorescence microscope and flow cytometry were used to examine penetration effect of ACS on Hacat cell. The result confirmed that the uptake of ACS was enhanced with increased substitution degree of arginine by 4-8 folds compared to chitosan. In vitro penetration studies on three electrical types of drugs were carried out using three model drugs of negatively charged aspirin, positively charged terazosin and neutral drug isosorbide mononitrate by the method of Franz diffusion cells. The results showed that ACS has obviously penetration of the negatively charged drug aspirin, and certain penetration of neutral drug issorbide mononitrate, but inhibition of positively charged terazosin. In vivo imaging technology research results show that the ACS can significantly enhance the fluorescence intensity of morin, which is the auto-fluorescence anionic drug. These obtained results suggested that ACS, as a promising transdermal enhancer, can change the structure of the keratinocytes and analog penetrating peptides promote absorption, but have certain selectivity for the drug.

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Nadolol plus isosorbide mononitrate is significantly more effective than nadolol alone in the primary prophylaxis of variceal bleeding in relatively well patients with cirrhosis, and has few side-effects.

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Sustained action Isosorbide-5-mononitrate (IS-5-MN) microcapsules are prepared in order to overcome the tolerance developed in conventional preparations and to increase patient compliance. For this purpose, factorial design experiments are performed and microcapsules of IS-5-MN are formulated by the organic phase separation method using ethylcellulose with two different viscosities (10 and 45 cp) as coating material. The independent variables in the 2 x 3 x 3 factorial design are core: wall ratio, particle size and pH of the medium. The dependent variable, t50 percent is investigated by the second-order polynomial equation to establish the correlation between independent variables. By using the calculated equations, the response-surface graphs, from which various levels of independent variables could be predicted, are obtained. The in vitro release profiles of the formulated microcapsules and the commercially available preparations are obtained by using the rotating basket method. In vitro release is evaluated by zero-order, first-order, Hixson-Crowell and Higuchi release kinetics. The t50 percent values obtained from the Higuchi equation are used as response in the 2 x 3 x 3 factorial design experiments.

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Repeated treadmill exercise tests were used in 20 patients with stable exercise-induced angina in order to comparatively examine various dosage forms of isosorbide-5-mononitrate (IMN) and isosorbide dinitrate (ID) during their single administration. The antianginal effect of conventional IMN tablets (Monisid, Bulgaria) lasted about 5 hours and 1-2 hours longer than that shown by long-acting tablets (Olicard, FRG) and lasted on an average of 12 hours. There was a correlation between the antianginal effect of IMN and its blood concentration. A significant individual variability was observed in the potency of all the dosage forms of IMN and ID under study. The dosage form of IMN had antianginal effects that were similar and even superior to those exhibited by ID.

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This study investigated the pharmacokinetics, safety, and tolerability of aliskiren administered alone or in combination with either the loop diuretic furosemide or an oral extended-release formulation of isosorbide-5-mononitrate (ISMN). In separate studies, 22 healthy subjects (ages 18-45 years) received either ISMN 40 mg or furosemide 20 mg once-daily for 3 days followed by a 3-day washout. Subjects then received aliskiren 300 mg once-daily for 7 days followed by combination therapy for 3 days. Pharmacokinetic assessments were taken at regular intervals over 24 h after dosing on the last day of each treatment period. At steady state, aliskiren AUC(tau) was decreased by 7% (geometric mean ratio [90% CI], 0.93 [0.84, 1.04]), and C(max) by 20% (0.80 [0.65, 0.97]) with furosemide coadministration compared with aliskiren administration alone. Aliskiren coadministration reduced furosemide AUC(tau) by 28% (0.72 [0.64, 0.81]) and C(max) by 49% (0.51 [0.39, 0.66]) compared with furosemide alone. Coadministration of aliskiren and ISMN was associated with only minor changes in the pharmacokinetic parameters of aliskiren (AUC(tau) 1.03 [0.90, 1.18]; C(max) 0.94 [0.69, 1.29]) and ISMN (AUC(tau) 0.88 [0.71, 1.10]; C(max) 0.94 [0.79, 1.13]). Headache and dizziness were the most common adverse events in both studies; dizziness and BP values below normal (SBP < 90 and/or DBP < 50 mmHg) were more frequent with aliskiren and ISMN coadministration than with either agent alone. Coadministration of aliskiren and ISMN had no clinically relevant effect on either aliskiren or ISMN pharmacokinetics. In conclusion, coadministration of aliskiren and furosemide reduced furosemide exposure and had a minor effect on aliskiren pharmacokinetics. The clinical significance of reduced systemic exposure to furosemide during coadministration of aliskiren is uncertain.

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Plasma BNP levels decreased rapidly in patients with an AECOPD after therapy with a diuretic and a vasodilator, and the treatment did not impair their health status.

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Nitrovasodilators have been found to relax vascular smooth muscle by stimulating soluble guanylate cyclase and thus by increasing the formation of cyclic GMP (cGMP). This nucleotide is responsible for relaxation, most likely by decreasing cytosolic free Ca2+ by one or several mechanisms. Repeated administration of organic nitrates causes tolerance development characterized by a diminished relaxing effect and an attenuated rise in cGMP. Experiments in isolated circular strips from bovine coronary arteries were performed in order to study the mechanism of tolerance development. It was found that after nitroglycerin (NG) pretreatment the response of the coronary strips to NG was less sensitive with respect to relaxation and increases in cGMP. These strips were also cross-tolerant against isosorbide-5-mononitrate, which by itself caused only little tolerance. With NG, the degree of tolerance development depended on the time and the concentration of NG pre-exposure. NG was found to stimulate guanylate cyclase (GC) in coronary supernatant provided that cysteine was added to the incubation medium. As in the intact strips, activation of GC by NG was attenuated when supernatants were preincubated with NG. It was found that addition of cysteine during incubation lessened the degree of desensitization but did not prevent it completely. Similarly, in coronary strips, tolerance development was lower when N-acetylcysteine was present during pre-exposure of the strips with NG. Considerably more effective in preventing tolerance development by about 50% was L-2-oxothiazolidine-4-carboxylate (OTC), a substance that easily penetrates into the cell and is transformed into cysteine by 5-oxo-prolinase.(ABSTRACT TRUNCATED AT 250 WORDS)

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Oral isosorbide-5-mononitrate (ISMN) (50 mg once daily) or placebo was administered to 136 patients (NYHA Class 2-3) treated for heart failure, all receiving captopril and most also furosemide. Endpoints were treadmill exercise time at 12 weeks by modified Naughton protocol (primary), with an additional 12-week follow-up period. Secondary endpoints included left ventricular dimensions, ejection fraction, cardiothoracic ratio, functional class, quality of life, hospitalizations and plasma norepinephrine and atrial natriuretic peptide in a four-center substudy.

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In a double-blind, randomized, crossover study, the duration of effects of single oral doses of 20 and 40 mg isosorbide-5-mononitrate (IS-5MN) and matching placebo were studied in 12 male patients with angina pectoris. Plasma IS-5MN concentrations (mean +/- SD) 2 and 6 hours after administration were 300 +/- 60 and 144 +/- 43 ng/ml after 20 mg IS-5MN and 551 +/- 191 and 376 +/- 129 ng/ml after 40 mg IS-5MN. Exercise time to the onset of angina 2 and 6 hours after administration increased after 20 mg IS-5MN (5.88 +/- 1.85; P less than 0.001 and 5.08 +/- 1.97 minutes; P less than 0.002) and 40 mg IS-5MN (6.17 +/- 1.88; P less than 0.001 and 5.78 +/- 1.72 minutes; P less than 0.001) in comparison to placebo (4.57 +/- 1.22 and 4.15 +/- 1.22 minutes). Similarly, total exercise duration increased at 2 (P less than 0.001) and 6 hours (P less than 0.002) after both doses of IS-5MN. Compared with placebo, ECG ST segment depression during exercise was less (P less than 0.05) 2 hours after both doses of IS-5MN. Thus single oral doses of 20 and 40 mg IS-5MN exert antianginal and anti-ischemic effects for at least up to 6 hours.

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The hemodynamic response of isosorbide-5-mononitrate (IS-5-MN) to the addition of the widely used therapy of diuretic drugs and the maximally tolerated dose of enalapril for heart failure was assessed in 8 patients with congestive heart failure (CHF) (New York Heart Association class II and III). The diuretic therapy was furosemide, 40 to 80 mg/day, with or without amiloride, 5 to 10 mg/day. The dose of enalapril was 5 to 20 mg/day. Four hours after the administration of the morning dose of enalapril, a Swan-Ganz catheter was positioned in the pulmonary artery. Patients received increasing doses of IS-5-MN to produce a satisfactory decrease in pulmonary capillary wedge pressure. Two of the first 3 patients studied had a large reduction in blood pressure when given 10 mg of IS-5-MN. Subsequent patients were therefore given an initial dose of 5 mg, the total dose being 5 to 20 mg over 2 hours. Results at baseline and 1 hour after the final dose of IS-5-MN are expressed as mean +/- standard deviation. Both pulmonary artery systolic and diastolic pressures decreased significantly (p less than 0.05) by 12.2 +/- 8.9/4.2 +/- 5.2 mm Hg, from 47.2 +/- 16.0/21.6 +/- 6.0 mm Hg to 35.0 +/- 15.2/17.4 +/- 9.3 mm Hg. Pulmonary capillary wedge pressure decreased by 8.6 +/- 4.4 mm Hg, from 22.1 +/- 5.4 to 13.6 +/- 7.5 mm Hg (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

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High dose imdur has hepato-protective effects in CMS rat models.

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Economic evaluation was conducted alongside a randomised placebo controlled trial (the IMOP trial).

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Techniques of thermal and isothermal stress testing (IST) were used to evaluate the compatibility of isosorbide mononitrate (IMN) with selected excipients used in the development of extended release formulations. In the first phase of the study, differential scanning calorimeter (DSC) was used as a tool to detect any interaction. In the next phase, excipients defined in the prototype formula were tested for their compatibility with IMN using IST. Based on the results, cellulose acetate and MCC were found to show interaction with IMN. Results of IST demonstrated incompatibility between IMN and cellulose acetate. All the excipients defined in the prototype formula were found to be compatible with IMN. Using the excipients that were found to be compatible with IMN, formulations were optimized. The optimized formulation was found to be stable after 3 months of storage at accelerated stability conditions (40 degrees C and 75% RH). In conclusion, tools of DSC, and IST were successfully employed to evaluate the compatibility of IMN with selected excipients.

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University teaching hospital.

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Eighty women who were age 13 to 23 weeks' gestation were randomly assigned to receive per vaginam either IMN 40 mg (group 1, 40 women) or placebo (group 2, 40 women) in addition to gemeprost 1 mg up to 3 times daily 3 hours apart for 2 days. Analysis of variance, a chi 2 test, and a multivariate analysis were performed.

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Our findings indicate that bupivacaine may induce the electrocardiographic and arrhythmic manifestations of the Brugada syndrome in silent carriers of SCN5A mutations. The data have important implications in the management of patients who develop ST segment elevation when under the influence of anesthetics such as bupivacaine.

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Patients with chronic-stable-angina treated with a long-acting nitrate demonstrate improvement in myocardial perfusion defect extent and severity in an extended period by means of both visual and quantitative analysis of sequential exercise testing to the same rate-pressure product end point.

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Vaginally administered nitric oxide donors such as isosorbide mononitrate have been used to ripen the uterine cervix in pregnancy. The pharmacokinetics of isosorbide mononitrate following vaginal administration are unknown. Serum levels of isosorbide mononitrate were determined at baseline and 60, 180 and 360 minutes after vaginal administration of 20 or 40 mg isosorbide mononitrate to pregnant women scheduled for induction of labour at term. Serum levels of isosorbide mononitrate continued to rise up to 360 minutes after isosorbide mononitrate insertion, with mean (SD) final levels of 337 (94) microg/L following isosorbide mononitrate 40 mg and 144 (47) microg/L following isosorbide mononitrate 20 mg, P < 0.01.

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imdur 5 mg 2016-03-05

A three-layered, pH-independent pulsatile release pellets system containing isosorbide-5-mononitrate (ISMN) was studied. The process of the heart disease such as angina has a close relationship to the chronobiology, which gives rise to the need of a pulsatile drug deliver system for the anti-anginal drug. In this study, pellets containing ISMN were firstly prepared as the core, and then layered with a swelling layer followed by an water-insoluble control layer. The core pellets were formulated with microcrystalline cellulose (MCC) and lactose, and were prepared by extrusion-spheronization. The preparation was optimized by Box-Behnken experimental design, when taking the MCC/lactose ratio as swell as the operating conditions of extrusion-spheronization as variables. The experimental results demonstrated the relationships between formulation, operation and properties of the product, and meanwhile provided optimized values for the parameters. The core pellets were coated by a buy imdur fluidized bed coater, and pellets with various coating types and coating levels were studied by in vitro dissolution tests. The effects of both swelling layer and control layer on the lag time and the drug release time were studied, in order to predetermine the lag time and release time. The pellets were also evaluated in vivo by studying the pharmacokinetics after oral administration in beagle dogs. The pellets achieved a lag time of 4.1 h in vivo, which had a good consistency with the in vitro results, and the relative bioavailability was nearly 100% comparing to the normal tablets.

imdur dose conversion 2017-12-02

Mitochondrial aldehyde dehydrogenase (ALDH-2) was recently identified to be essential for the bioactivation of glyceryl trinitrate (GTN). Here we assessed whether other organic nitrates are bioactivated by a similar mechanism. The ALDH-2 inhibitor benomyl reduced the vasodilator potency, but not the efficacy, of GTN, pentaerythritol tetranitrate (PETN), and pentaerythritol trinitrate in phenylephrine-constricted rat aorta, whereas vasodilator responses to isosorbide dinitrate, isosorbide-5-mononitrate, pentaerythritol dinitrate, pentaerythritol mononitrate, and the endothelium-dependent vasodilator acetylcholine were not affected. Likewise, benomyl decreased GTN- and PETN-elicited phosphorylation of the cGMP-activated protein kinase substrate vasodilator-stimulated phosphoprotein (VASP) but not that elicited by other nitrates. The vasodilator potency of organic nitrates correlated with their potency to inhibit ALDH-2 dehydrogenase activity in mitochondria from rat heart and increase mitochondrial superoxide formation, as detected by chemiluminescence. In contrast, mitochondrial ALDH-2 esterase activity was not affected by PETN and its metabolites buy imdur , whereas it was inhibited by benomyl, GTN applied in vitro and in vivo, and some sulfhydryl oxidants. The bioactivation-related metabolism of GTN to glyceryl-1,2-dinitrate by isolated RAW macrophages was reduced by the ALDH-2 inhibitors benomyl and daidzin, as well as by GTN at concentrations >1 microM. We conclude that mitochondrial ALDH-2, specifically its esterase activity, is required for the bioactivation of the organic nitrates with high vasodilator potency, such as GTN and PETN, but not for the less potent nitrates. It is interesting that ALDH-2 esterase activity was inhibited by GTN only, not by the other nitrates tested. This difference might explain why GTN elicits mitochondrial superoxide formation and nitrate tolerance with the highest potency.

imdur tablets 2017-10-14

The present study demonstrated an independent inverse association between NIH and SXscore. The buy imdur NIH could provide important predictive information about coronary artery lesion complexity in patients with stable CAD.

imdur 30 tab 2017-08-02

In this chapter we give a quick review of the rationale for treatment of portal hypertension. The different scenarios for treatment of variceal bleeding will be discussed-that is, primary and secondary prophylaxis of variceal bleeding as well as the treatment of the acute bleeding episode. The role of the pharmacological, endoscopic and derivative treatments in each one of these scenarios will be discussed. Particular attention will be devoted to the potential role of the combination therapy of beta- buy imdur blockers with isosorbide-5-mononitrate for preventing re-bleeding and to the best approach to patients with intolerance or contraindications to beta-blockers. We also give a rational review of the data comparing sclerotherapy against ligation as well as the potential role of the latter on primary prophylaxis.

imdur user reviews 2015-12-17

A specific, sensitive and precise capillary gas chromatographic method using electron-capture detection was developed for the determination of four isomeric vasodilating organic mononitrates, viz. L-isoidide mononitrate (L-IIMN), isosorbide-2-mononitrate (IS-2-MN), isomannide mononitrate (IMMN) and isosorbide-5-mononitrate (IS-5-MN), in rat plasma. With a sample size of 100 microliters of rat plasma, the detection limits were found to be between 0 buy imdur .5 and 2 ng/ml for these mononitrates, and the absolute recovery was found to range from 83 to 90%. The within-day coefficients of variation for the assay of the four isomers were less than 5%, while the between-day coefficients of variation were less than 10%. Because of the short retention times of these isomers in this assay, routine analyses of about sixty plasma samples per day can be carried out. The possibility of in vivo interconversion among these four isomers in rats was investigated after individual administration of each isomer. No interconversion was found based on examination of plasma samples. The gas chromatographic method was applied to the pharmacokinetic studies of these four isomers in rats; at an intravenous dose of 2 mg/kg, the biological half-lives of L-IIMN, IMMN, IS-2-MN and IS-5-MN were found to be 13.2, 25.2, 54.6 and 112 min, respectively.

imdur drug class 2017-01-22

This work examined the effect of the selective a1-inhibitor, doxazosin (CAS 74191-85-8), on the activity of endothelium-derived relaxing factor (EDRF). In vitro, the intact thoracic aortic rings of rabbits were contracted with the a-agonist, phenylephrine, and then relaxed by sequentially increasing concentrations of the EDRF-releasing agent adenosine triphosphate (ATP). In parallel experiments, doxazosin (10(-8) mol/l) was added after the contraction but before the addition of ATP. Doxazosin enhanced the ATP-induced vasodilation by a factor of 3. Control experiments suggested that this was due to the enhanced activity of EDRF, which was related to displacement of phenylephrine from a1-adrenoceptors by doxazosin. Physiologically relevant concentrations of buy imdur 6- or 7-hydroxydoxazosin (5 x 10(-10) mol/l) had no effect on EDRF activity in vitro. In vivo experiments in the rabbit were carried out using bolus, intravenous injections of acetylcholine (ACh), which stimulated EDRF release. Threshold doses of doxazosin (2 x 10(-6) g/kg) enhanced the hypotensive activity of ACh. Prefeeding the rabbits for 4 weeks with a 2% cholesterol diet significantly reduced the sensitivity of the aorta to isosorbide-5-mononitrate, a stable EDRF-analog. However, the impairment in endothelium-dependent relaxation was attenuated in the presence of doxazosin (2 x 10(-9) mol/l). The results that in addition to its known antiplatelet activity, doxazosin enhances EDRF activity.

imdur 30 mg 2016-03-05

A double-blind, multicenter trial was carried out to assess the effectiveness of isosorbide-5-mononitrate in preventing recurrent variceal hemorrhage during the course of endoscopic sclerotherapy. Seventy-six patients with their first bleeding episode from esophageal varices were randomly allocated, after initial control of hemorrhage, to groups receiving either 50 mg/day oral isosorbide-5-mononitrate retard (37 patients) or an identical placebo (39 patients) until variceal eradication. Sclerotherapy was performed at weekly intervals, and varices buy imdur were intra- and para-variceally injected with 1% polidocanol until eradication. If rebleeding occurred, additional sclerotherapy was performed. Four (10.8%) patients rebled in the isosorbide group, compared with 15 (38.4%) in the placebo group (p = 0.01). The total number of rebleeding episodes was also significantly lower in the isosorbide group (5 versus 19, p = 0.043), whereas comparison between major versus minor rebleedings was not significant. The median transfusion requirement per bleeding episode was not significantly different in the two groups, although the cumulative number of blood units transfused was over threefold greater (22 versus 70) in the placebo group. Two (5.4%) deaths occurred among isosorbide-treated patients and nine (17.9%) among placebo patients (NS). The number of sclerotherapy sessions and the time required to obtain variceal eradication were also comparable in the two groups. Finally, the nitrovasodilator was well tolerated, requiring withdrawal for severe headache in only one patient. In conclusion, isosorbide-5-mononitrate reduces the rebleeding rate and the number of rebleeding episodes before variceal eradication in patients treated with sclerotherapy.

imdur drug interactions 2016-01-16

Twenty-one patients received oral propranolol at increasing doses until buy imdur their resting heart rate was reduced by 25%, and 21 patients received oral propranolol (on the same schedule) plus oral Is-5-Mn, 40 mg twice a day.

imdur cost 2017-12-19

Male Wistar rats (n= 69 in total) were treated with ISMN (75 mg/kg/day) or placebo for 7 days. Endothelin (ET) expression was determined by immunohistochemistry in aortic sections. Isosorbide-5-mononitrate infusion caused significant endothelial dysfunction but no tolerance to ISMN itself, whereas ROS formation and nicotinamide adenine dinucleotidephosphate (NADPH) oxidase activity in the aorta, heart, and whole blood were increased. Isosorbide-5-mononitrate up-regulated the expression of NADPH subunits and caused uncoupling of the endothelial nitric oxide synthase (eNOS) likely due to a down-regulation of the tetrahydrobiopterin-synthesizing enzyme GTP-cyclohydrolase-1 and to S-glutathionylation of eNOS. The adverse effects of ISMN were improved in gp91phox knockout mice and normalized by bosentan in vivo/ex vivo treatment and suppressed by apocynin. In addition, a strong increase in the expression of ET within the endothelial cell buy imdur layer and the adventitia was observed.

imdur er dosage 2015-07-10

Nitrovasodilators have been found to relax vascular smooth muscle by stimulating soluble guanylate cyclase and thus by increasing the formation of cyclic GMP (cGMP). This nucleotide is responsible for relaxation, most likely by decreasing cytosolic free Ca2+ by one or several mechanisms. Repeated administration of organic nitrates causes tolerance development characterized by a diminished relaxing effect and an attenuated rise in cGMP. Experiments in isolated circular strips from bovine coronary arteries were performed in order to study the mechanism of tolerance development. It was found that after nitroglycerin (NG) pretreatment the buy imdur response of the coronary strips to NG was less sensitive with respect to relaxation and increases in cGMP. These strips were also cross-tolerant against isosorbide-5-mononitrate, which by itself caused only little tolerance. With NG, the degree of tolerance development depended on the time and the concentration of NG pre-exposure. NG was found to stimulate guanylate cyclase (GC) in coronary supernatant provided that cysteine was added to the incubation medium. As in the intact strips, activation of GC by NG was attenuated when supernatants were preincubated with NG. It was found that addition of cysteine during incubation lessened the degree of desensitization but did not prevent it completely. Similarly, in coronary strips, tolerance development was lower when N-acetylcysteine was present during pre-exposure of the strips with NG. Considerably more effective in preventing tolerance development by about 50% was L-2-oxothiazolidine-4-carboxylate (OTC), a substance that easily penetrates into the cell and is transformed into cysteine by 5-oxo-prolinase.(ABSTRACT TRUNCATED AT 250 WORDS)

imdur generic equivalent 2015-02-05

The authors evaluated the influence of three alternative methods of treatment of coronary artery disease (CAD) and stable exertional stenocardia accompanied by arterial hypertension on systolic and diastolic left ventricular (LV) function. The three methods were: conventional therapy with monocinque, chronotherapy with monocinque, and therapy with a combination of monocinque and melatonin. All the 65 patients aged 44 to 69 years underwent echoCG with Vivid 7 ultrasound scanner (USA) before and after the treatment. The study showed that chronotherapy with monocinque had the most favorable effect on LV diastolic function, which manifested by an increase in peak E from 0.47 +/- 0.02 to 0.53 +/- 0.02 m/s (p = 0.006) and peak E/peak A ratio from 0.77 +/- -0.05 to 0.93 +/- 0.05 (P = 0.002), as well as a decrease in peak A from 0.65 +/- 0.03 to 0.56 +/- 0.03 m/s (p = 0.05). Complex treatment with monocinque and melatonin improved systolic and diastolic LV function better than did conventional therapy. The favorable influence on myocardial contractility manifested by a reduction in end systolic LV size from 3.66 +/- 0.04 to 3.42 +/- 0.02 cm (p < 0.001), end diastolic LV volume from 126.7 +/- 1.3 to 118.4 +/- 1.1 ml (p < 0.001), and end systolic LV volume from 55.1 +/- 1.0 to 47.0 +/- 0.8 ml (p < 0.001), as well as an increase in ejection fraction from 56.5 +/- 0.9 to 60.3 +/- 0.8% (p = 0.003) and shortening fraction from 27.9 +/- 1.3 to 33.0 +/- 0.4% (p = 0.001). The normalizing effect on LV diastolic function manifested by an increase in peak E from 0.46 +/- 0.02 to 0.54 +/- 0.02 m/sec (p = 0.009) and peak E/peak A ratio from 0.68 +/- 0.05 to buy imdur 0.82 +/- 0.05 (p = 0.002).

imdur generic cost 2015-04-23

The present comparative pharmacokinetic study performed to establish the relative bioavailability for buy imdur an isosorbide dinitrate (ISDN) retard preparation (Sorbidilat-retard) included 6 healthy, male and female volunteers. In a randomised cross-over scheme the volunteers received a capsule Sorbidilat retard forte and a tablet of a standard preparation which contained as well 40 mg isosorbide dinitrate as retard formulation. Blood samples were taken over a period of 24 h and isosorbide dinitrate, 5-isosorbide mononitrate and 2-isosorbide mononitrate measured in the serum by means of gas chromatography with electron-capture detection. The resorption rate for all three substances revealed only minor differences between Sorbidilat and the standard preparation. However, the slightly retarded absorption for the compound from Sorbidilat with a longer period of invasion led to a higher maximal concentration and to higher serum levels of ISDN and the mononitrates over the whole period of observation. The relative bioavailability for all three substances ISDN, 5-isosorbide mononitrate and 2-isosorbide mononitrate, was estimated from the areas under the plasma concentration-time curves and was 2 to 2.5 fold higher for the Sorbidilat preparation than for the standard preparation.

imdur medication uses 2015-05-10

To avoid the development of nitrate tolerance secondary to relatively constant elevated plasma nitrate concentrations, intermittent nitrate dosing has been advocated. However, a nitrate-free interval may induce a rebound increase in myocardial ischaemia, and thus increase anginal symptoms during the latter portion of the dosing interval. This was suggested by the results of recent studies in which nitroglycerin patches were administered intermittently with a 12 h nitrate-free interval. The present investigation was carried out to determine whether a controlled-release formulation of 60 mg isosorbide-5-mononitrate (5-ISMN) would produce such a rebound phenomenon. Seventy-nine patients, who had participated in four crossover, placebo-controlled studies in which the treatment arms lasted for between 1 and 2 weeks, were reviewed. These studies had assessed the efficacy of this nitrate preparation by exercise testing and each had included exercise testing at the end of each treatment phase, 24 h after the last medication had been administered. There were no differences noted in the time to onset of angina, the time to onset of 1 mm ST segment depression or the total exercise duration between the two treatment phases, indicating an absence of rebound phenomena at the end of the dosing interval. The reason for the absence of buy imdur a detectable pre-dose rebound is unclear, but the plasma concentration profile of 5-ISMN produced by the presently used preparation, resulting in a nitrate-low instead of nitrate-free interval, may have contributed.

imdur generic drugs 2017-03-07

The objective of this study was to determine if the clinical nitrate, Imdur, has a hepato-protective effect in chronic mountain buy imdur sickness (CMS).

imdur 10 mg 2016-01-20

To address the issues of tolerance development and its circumvention during long-term treatment with nitrates, several controlled studies have been performed. In patients with coronary artery disease, during long-term treatment with isosorbide dinitrate (ISDN) in sustained-release form at dosages of 20 mg t.i.d., 40 mg t.i.d. and 60 mg t.i.d., both the rate of anginal attacks and the ischaemic reaction to exercise were unaffected. After a marked acute anti-ischaemic effect to 40 mg ISDN in nonsustained-release form, during chronic administration of the same dose four times daily, in association with continuously-high nitrate plasma concentrations, similarly, there were no significant effects. On use of nitroglycerin (NTG) transdermal patches delivering 10 mg, 15 mg and 30 mg per 24 hours, respectively, renewed patch application after 24 hours was not met with the same marked response observed after initial application. Clearly attenuated effects could be seen within 8 to 12 hours. These results show that tolerance development is incurred when the incrementation in plasma concentration after a repeated nitrate dose is of relatively limited magnitude with respect to baseline values. The observation of rapid reversibility of nitrate tolerance lead to the concept of interval treatment which on daily use incorporates a sufficiently long period without nitrate administration. On use of a nitrate-free treatment interval employing a regimen of 20 mg ISDN nonsustained-release form twice daily in the morning and at midday, 120 mg ISDN sustained-release form once daily or 50 or 100 mg isosorbide 5-mononitrate once daily, maintained effectiveness has been documented, as it has also been shown for treatment with NTG patches delivering 10 mg per 24 hours on incorporation of a 12-hour patch-free interval. The currently available patch system with discontinuous NTG delivery does not incur a complete loss of action but a considerable attenuation Crestor Prescription Cost of its effects indicates the need for further refinements. Thus interval treatment guarantees maintenance of nitrate effects, albeit with the limitation that 24-hour therapeutic coverage is not enabled.

imdur 120 mg 2016-02-17

Bioavailability of Sustained Release and Non Sustained Release Isosorbide-5-Mononitrate. In a randomized, open cross-over study in 18 healthy subjects plasma concentration of isosorbide-5-mononitrate (IS-5-MN) after oral administration was determined over 24 h by gas chromatography. A single dose of three sustained release and two standard preparations was given: (A) a capsule (Elantan), 50 mg; (B) a development tablet, 50 mg and (C) a development capsule, 100 mg; furthermore (D) and (E) non sustained release tablets, 40 and 2 x 20 mg, of two different producers. (D) was considered as reference preparation. Standard preparations (D) and (E) were bioequivalent. But maximum plasma concentrations (cmax) of all sustained release preparations were significantly lower from Cozaar Overdose 13% (C) to 53% (A). Also the moment of maximum plasma concentrations (tmax) occurred significantly later between 2 h 40 min and 3 h 50 min. A significant loss in relative bioavailability was observed for (A) with 82.5% and for (C) with 81.4%. (B) achieved the highest relative bioavailability (93.9%) of the sustained release preparations (n.s.). "Therapeutic concentrations" above 100 ng/ml over 24 h were maintained only by (C). Terminal elimination half-lives were calculated between 5.5 and 6.5 h (mean). Plasma concentration-time curves were simulated in steady state.

imdur er dose 2015-08-31

Conflicting information existed regarding the relevance of pharmacokinetics in relation to the duration of action of organic nitrates. We examined this question using three geometric isomers of organic mononitrates, L-isoidide mononitrate, isosorbide-2-mononitrate and isosorbide-5-mononitrate, which produce no active metabolites but possess diverse biological half-lives (T1/2). These compounds were given i.v. to rats at doses which were predetermined to produce equal peak effects on pulse pressure. The relationship between percentage change in pulse pressure and plasma mononitrate level could be described by the classical Hill equation, with similar slope but different EC50 values. A duration of action, defined as the time taken for the pulse pressure to change from -30% to -20% from base line, was measured experimentally. Theoretical analysis suggests that a linear relationship should exist between this duration of action and T1/2/slope, and this was indeed observed (r = 0.99, P less than .01, n = 12), affirming the dependency of Bystolic 5mg Tablets pulse pressure pharmacodynamics on the pharmacokinetics of organic mononitrates. Pharmacokinetic modeling of the in vivo time-dependent hemodynamic effects further indicated that the blood compartment data were more consistent with a mechanism of mononitrate action that involves metabolic activation to form nitric oxide and cyclic GMP, rather than direct receptor activation. Using this pharmacodynamic model, the in vivo half-lives of nitric oxide and cGMP were estimated to be 1.6 and 2.0 min, respectively.

imdur missed dose 2016-02-05

Patients with heart failure and a preserved ejection fraction who received Geodon Reviews isosorbide mononitrate were less active and did not have better quality of life or submaximal exercise capacity than did patients who received placebo. (Funded by the National Heart, Lung, and Blood Institute; number, NCT02053493.).

imdur daily dose 2016-11-06

1. BM 12.434 was Diovan 100 Mg compared with a known beta-adrenoceptor-blocking agent, metipranolol, and a combination of metipranolol and isosorbide-5-mononitrate in healthy volunteers. BM 12.434 and metipranolol were given in equi-effective beta-adrenoceptor-blocking doses (reduction of exercise-increased pulse--pressure product). 2. Responses of the cardiovascular system were determined by non-invasive methods. 3. BM 12.434 increased the peripheral resistance less than metipranolol. 4. After BM 12.434, in contrast to metipranolol, both arterial flow and the venous capacity showed significant increase. 5. The combination of isosorbide-5-mononitrate and metipranolol differed from metipranolol alone mainly by the effect on venous capacity, which showed a slight increase. 6. BM 12.434 is a beta-adrenoceptor-blocking agent whose additional actions on the veins and arteries are potentially useful for the treatment of both coronary heart disease and of arterial hypertension.

imdur 60 mg 2016-08-25

A simple and highly sensitive gas-liquid chromatographic method using electron-capture detection has been developed for the simultaneous determination of isosorbide dinitrate (ISDN) and its mononitrate metabolites in rat and human plasma. This method has a limit of quantitation of about 5 ng/ml for the mononitrates and of 1 ng/ml for ISDN using 0.1 ml of plasma, and is thus useful for pharmacokinetic studies of these compounds in small animals, and in humans when the available volume of blood is limited. Using this method, we found the apparent in vitro partitioning ratio of ISDN between erythrocyte and plasma in rat and human blood at 37 degrees C to be 0.22 and 0.13, respectively. In spite of this poor affinity for red blood cells, ISDN degradation Paracetamol Overdose Phases in whole blood was mediated primarily via this blood fraction. Loss of ISDN in blood appeared to proceed exclusively through its mononitrate metabolites, resulting in a 6:1 product ratio of the 5-mononitrate to its 2-isomer. These data suggest that although blood degradation of ISDN and erythrocyte partitioning occur per se, these phenomena do not contribute significantly to the very rapid in vivo clearance of ISDN observed in man and in the rat.

imdur er generic 2015-10-23

The effect of transdermal and oral nitrates on anginal symptoms were compared in a randomized trial of 2,456 out-patients with stable angina pectoris recruited in 206 cardiological centers in Italy. Half of the patients had effort-induced angina, 12% rest angina and 38% "mixed angina". Before enrollment, all of the patients were on stable treatment with oral nitrates either as monotherapy or in combination with other antianginal agents. After a 2-week run-in period on the previous oral nitrate regimen, two thirds of the patients were randomized to receive a nitroglycerin patch 5 mg/24 hours for 2 weeks, the remaining one third continued their previous treatment. The patients subsequently reporting > or = 1 anginal attack/2 weeks were titrated to transdermal nitroglycerin 10 mg/24 hours or to the maximum dose of oral nitrates suggested by the manufacturer for the following 4 weeks; asymptomatic patients continued on the initial dosages. The 2-week anginal attack rate was reduced from 4.9 +/- 5.3 to 1.4 +/- 2.5 in the transdermal nitroglycerin group (-71%), and from 4.5 +/- 4.7 to 1.5 +/- 2.7 (-67%) in the oral nitrate group. The proportion of patients Valtrex Shingles Dosage free of angina increased from 12% to 54% (+343%) with transdermal nitroglycerin and from 15% to 49% with oral nitrates (+218%) (p < 0.05). The reduction in angina frequency was similar during the day and during the night. Nocturnal angina was rare in patients with effort angina. However, about half of the patients with rest and "mixed" angina had had nocturnal episodes, the number of which was significantly reduced by both regimens: nighttime asymptomatic patients increased from 45% to 82% in the rest angina group, and from 50% to 83% in the "mixed" angina group, with no differences between treatments. Withdrawals due to side-effects were rare: 1.5% with transdermal nitroglycerin and 1.3% with oral nitrates. Headache was the most common side-effect and was more frequently reported with oral nitrates. Although the lack of a placebo control precludes an absolute evaluation of efficacy, the results of the present study suggest that both transdermal nitroglycerin and oral nitrates may provide relief of anginal symptoms over 24 hours in the majority of stable angina patients. Nocturnal angina, reported by 50% of the patients with rest and mixed angina, is effectively reduced by the administration of nitrates over 24 hours.