Isosorbide mononitrate


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Isosorbide mononitrate
Accession Number
DB01020  (APRD00528)
Small Molecule

Isosorbide mononitrate is a drug used principally in the treatment of angina pectoris and acts by dilating the blood vessels so as to reduce the blood pressure. It is sold by AstraZeneca under the trade name Imdur.

Isosorbide mononitrate is used to for the the prophylactic treatment of angina pectoris; that is, it is taken in order to prevent or at least reduce the occurrence of angina. Research on Isosorbide mononitrate as a cervical ripener to reduce time at hospital to birth is supportive.

Isosorbide mononitrate is an active metabolite of isosorbide dinitrate and exerts qualitatively similar effects. Isosorbide mononitrate reduces the workload of the heart by producing venous and arterial dilation. By reducing the end diastolic pressure and volume, isosorbide mononitrate lowers intramural pressure, hence leading to an improvement in the subendocardial blood flow. The net effect when administering isosorbide mononitrate is therefore a reduced workload for the heart and an improvement in the oxygen supply/demand balance of the myocardium.

The adverse reactions which follow have been reported in studies with isosorbide mononitrate: Very common. Up to 30% of patients experience headaches and 2-3 % of patients withdraw treatment for this reason, but the incidence reduces rapidly as treatment continues . Common. 6% of patients experience tiredness, sleep disturbances, and gastrointestinal disturbances. 4-5% of patients experience hypotension, 2.5% experience poor appetite, and 1% experience nausea. Patients experience similar adverse effects as they would for all nitrate treatments and their incidence is most common early in treatment. These symptoms generally disappear during long-term treatment. Other reactions that have been reported with isosorbide mononitrate modified release tablets include tachycardia, vomiting, diarrhoea, vertigo and heartburn

  • IS 5-MN
  • IS-5-MN
  • IS-5MN
  • ISMN
  • Iso-5-mononitrate
  • Isosorbide 5-mononitrate
  • Isosorbide 5-nitrate
  • Isosorbide mononitrate
  • Isosorbide-5-mononitrate
  • Isosorbidi mononitras
  • Mononitrate d'isosorbide
  • Mononitrato de isosorbida
  • Monosorbitrate
External IDs
AHR-4698 / BM 22.145 / BM-22.145 / BM-22145
Active Moieties
Product Images
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
ImdurTablet, extended release60 mgOralMda Inc.1994-12-31Not applicableCanada
ImdurTablet120 mg/1OralSchering Corporation2003-09-012006-11-30Us
ImdurTablet60 mg/1OralSchering Corporation2003-09-012006-10-31Us
ImdurTablet30 mg/1OralSchering Corporation2003-09-012006-10-31Us
IsmnTablet, extended releaseOralSivem Pharmaceuticals Ulc2015-10-082017-06-27Canada
IsmoTablet, film coated20 mg/1OralReddy Pharmaceuticals, LLC2007-03-31Not applicableUs
Ismo Tab 20mgTabletOralWyeth Ayerst Canada Inc.1994-12-312002-06-10Canada
MonoketTablet10 mg/1OralUcb Inc1993-06-302012-07-11Us
MonoketTablet20 mg/1OralKremers Urban1993-06-30Not applicableUs
MonoketTablet10 mg/1OralKremers Urban1993-06-30Not applicableUs
Additional Data Available
  • Application Number
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  • Product Code
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Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
Apo-ismnTablet, extended releaseOralApotex Corporation2006-03-03Not applicableCanada
Dom-ismnTablet, extended releaseOralDominion PharmacalNot applicableNot applicableCanada
ImdurTablet, extended release120 mg/1OralSchering Corporation2006-01-052017-04-06Us
ImdurTablet, extended release30 mg/1OralPhysicians Total Care, Inc.2009-12-022012-06-30Us
ImdurTablet, extended release60 mg/1OralSchering Corporation2006-01-052017-04-06Us
ImdurTablet, extended release30 mg/1OralSchering Corporation2006-01-052017-04-06Us
ImdurTablet, extended release60 mg/1OralPhysicians Total Care, Inc.1997-01-032012-06-30Us
Isorsorbide MononitrateTablet, film coated, extended release60 mg/1OralActavis Pharma Company2005-05-042006-07-30Us
Isorsorbide MononitrateTablet, film coated, extended release30 mg/1OralActavis Pharma Company2005-05-042006-07-30Us
IsosorbideTablet, film coated, extended release30 mg/1Oralbryant ranch prepack2006-03-30Not applicableUs
Additional Data Available
  • Application Number
    Application Number

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  • Product Code
    Product Code

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International/Other Brands
Chemydur / Corangin / Dilatrate / Duride / Elantan / Etimonis / Imodur / Imtrate / Ismexin / Ismox / Isomon / Isomonit / Isonorm / Medocor / Monicor / Monit / Mono Corax / Mono Mack / Monocedocard / Monoclair / Monocord / Monodur Durules / Monolong / Monomax / Mononit / Monopront / Monosorb / Monosordil / Monotrate / Nitramin / Olicard / Olicardin / Orasorbil / Pertil / Plodin / Promocard / Sigacora / Solotrate / Sorbimon / Turimonit / Uniket / Vasdilat
CAS number
Average: 191.1388
Monoisotopic: 191.042987025
Chemical Formula
InChI Key
(3R,3aS,6S,6aR)-6-hydroxy-hexahydrofuro[3,2-b]furan-3-yl nitrate



For the prevention of angina pectoris due to coronary artery disease and the treatment of acute and chronic angina pectoris, hypertension, and myocardial infarction.

Associated Conditions

Isosorbide-5-mononitrate, the long-acting metabolite of isosorbide dinitrate, is used as a vasodilatory agent in the management of angina pectoris. By dilating the vessels, it lowers the blood pressure and reduces the left ventricular preload and afterload, therefore, leads to a reduction of myocardial oxygen requirement.

Mechanism of action

Similar to other nitrites and organic nitrates, Isosorbide Mononitrate is converted to nitric oxide (NO), an active intermediate compound which activates the enzyme guanylate cyclase (Atrial natriuretic peptide receptor A). This stimulates the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP) which then activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, eventually resulting in the dephosphorylation of the myosin light chain of the smooth muscle fiber. The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation.

AGuanylate cyclase soluble subunit alpha-2
Additional Data Available
Adverse Effects

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Additional Data Available

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Blackbox Warnings

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Volume of distribution
  • 0.6 to 0.7 L/kg
Protein binding




Route of elimination

Isosorbide mononitrate is primarily metabolized by the liver, but unlike oral isosorbide dinitrate, it is not subject to first-pass metabolism. Isosorbide mononitrate is cleared by denitration to isosorbide and glucuronidation as the mononitrate, with 96% of the administered dose excreted in the urine within 5 days and only about 1% eliminated in the feces. At least six different compounds have been detected in urine, with about 2% of the dose excreted as the unchanged drug and at least five metabolites.

Half life

5 hours

  • 120–122 mL/min [Single dose of 60 mg PO]
  • 151–187 mL/min [Single dose of extended-release tablet 60 mg PO]
  • 132-151 mL/min [Multiple doses of extended release tablet 60 mg PO]
  • 119-140 mL/min [Multiple doses of extended release tablet 120 mg PO]

Symptoms of overdose include vasodilatation, venous pooling, reduced cardiac output, and hypotension. There are no data suggesting what dose of isosorbide mononitrate is likely to be life-threatening in humans. In rats and mice, there is significant lethality at doses of 2000 mg/kg and 3000 mg/kg, respectively.

Affected organisms
  • Humans and other mammals
Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline7,8-Dichloro-1,2,3,4-tetrahydroisoquinoline may increase the orthostatic hypotensive activities of Isosorbide Mononitrate.
AbacavirIsosorbide mononitrate may decrease the excretion rate of Abacavir which could result in a higher serum level.
AcarboseAcarbose may decrease the excretion rate of Isosorbide mononitrate which could result in a higher serum level.
AcebutololThe therapeutic efficacy of Acebutolol can be increased when used in combination with Isosorbide mononitrate.
AceclofenacAceclofenac may decrease the excretion rate of Isosorbide mononitrate which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Isosorbide mononitrate which could result in a higher serum level.
AcetaminophenThe risk or severity of methemoglobinemia can be increased when Acetaminophen is combined with Isosorbide mononitrate.
AcetazolamideAcetazolamide may increase the excretion rate of Isosorbide mononitrate which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Isosorbide mononitrate which could result in a higher serum level.
AclidiniumIsosorbide mononitrate may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Additional Data Available
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Food Interactions
  • Take without regard to meals.


General References
Not Available
External Links
Human Metabolome Database
KEGG Compound
PubChem Compound
PubChem Substance
Therapeutic Targets Database
RxList Drug Page Drug Page
ATC Codes
C01DA14 — Isosorbide mononitrate
AHFS Codes
  • 24:12.08 — Nitrates and Nitrites
FDA label
Download (217 KB)
Download (66.5 KB)

Clinical Trials

Clinical Trials
1CompletedNot AvailableHealthy Volunteers2
1CompletedDiagnosticHigh Blood Pressure (Hypertension)1
1CompletedTreatmentHealthy Volunteers1
1CompletedTreatmentHigh Blood Pressure (Hypertension)1
1Not Yet RecruitingTreatmentAnal Fissures1
1, 2Active Not RecruitingSupportive CareInduction of Labour1
2CompletedPreventionCerebral Small Vessels Disease / Cognitive Impairments / Stroke1
2CompletedTreatmentHeart Failure / Preserved Ejection Fraction1
2RecruitingTreatmentCervical Ripening1
2RecruitingTreatmentHigh Blood Pressure (Hypertension) / Kidney Injury / Proteinuria1
2RecruitingTreatmentInduction of Labour1
2RecruitingTreatmentMissed Abortion1
2WithdrawnTreatmentHigh Blood Pressure (Hypertension)1
2, 3CompletedTreatmentIsolated (Idiopathic) Oligohydramnios1
2, 3RecruitingPreventionCerebral Small Vessels Disease / Stroke, Lacunar1
3RecruitingSupportive CareInduction of Labor Affected Fetus / Newborn1
3RecruitingSupportive CareInduction of Labor Affected Fetus / Newborn / Rupture of Membranes Prior to Onset of Labor1
3Unknown StatusTreatmentStable Angina (SA)1
4Active Not RecruitingTreatmentAcute Heart Failure (AHF)1
4CompletedPreventionGastrointestinal Hemorrhage / Liver Cirrhosis / Portal Hypertension1
4CompletedPreventionVariceal Rebleeding1
4CompletedTreatmentSecond Trimester Abortions1
4Not Yet RecruitingTreatmentCoronary Artery Disease2
Not AvailableCompletedTreatmentMigraine1
Not AvailableCompletedTreatmentType 2 Diabetes Mellitus1
Not AvailableNot Yet RecruitingTreatmentIUD Insertion Complication1
Not AvailableRecruitingPreventionPreeclampsia / Premature Labour1
Not AvailableWithdrawnNot AvailableCoronary Heart Disease (CHD)1


  • Schering plough corp
  • Actavis elizabeth llc
  • Brightstone pharma inc
  • Dexcel ltd
  • Elan pharmaceutical research corp
  • Ivax pharmaceuticals inc sub teva pharmaceuticals usa
  • Kremers urban co
  • Kv pharmaceutical co
  • Vintage pharmaceuticals inc
  • West ward pharmaceutical corp
  • Promius pharma llc
  • Teva pharmaceuticals usa inc
  • Schwarz gmbh
  • Actavis Group
  • Advanced Pharmaceutical Services Inc.
  • Alvogen Inc.
  • Apothecon
  • A-S Medication Solutions LLC
  • AstraZeneca Inc.
  • Atlantic Biologicals Corporation
  • Bryant Ranch Prepack
  • Cardinal Health
  • Comprehensive Consultant Services Inc.
  • Dexcel Ltd.
  • Dispensing Solutions
  • Diversified Healthcare Services Inc.
  • Elan Pharmaceuticals Inc.
  • Ethex Corp.
  • Heartland Repack Services LLC
  • Ivax Pharmaceuticals
  • Kaiser Foundation Hospital
  • Lake Erie Medical and Surgical Supply
  • Mckesson Corp.
  • Murfreesboro Pharmaceutical Nursing Supply
  • Neuman Distributors Inc.
  • Nucare Pharmaceuticals Inc.
  • Palmetto Pharmaceuticals Inc.
  • Pharmaceutical Utilization Management Program VA Inc.
  • Physicians Total Care Inc.
  • Prepak Systems Inc.
  • Promius Pharma
  • Remedy Repack
  • Resource Optimization and Innovation LLC
  • Schering Corp.
  • Schwarz Pharma Inc.
  • Southwood Pharmaceuticals
  • Stat Rx Usa
  • Teva Pharmaceutical Industries Ltd.
  • Vangard Labs Inc.
  • West-Ward Pharmaceuticals
Dosage forms
Tablet, extended releaseOral
TabletOral120 mg/1
TabletOral30 mg/1
TabletOral60 mg/1
Tablet, extended releaseOral60 mg
Tablet, film coatedOral20 mg/1
TabletOral10 mg/1
TabletOral20 mg/1
Tablet, coatedOral20 mg/1
Tablet, extended releaseOral120 mg/1
Tablet, extended releaseOral30 mg/1
Tablet, extended releaseOral60 mg/1
Tablet, film coated, extended releaseOral120 mg/1
Tablet, film coated, extended releaseOral30 mg/1
Tablet, film coated, extended releaseOral60 mg/1
Unit descriptionCostUnit
Imdur er 120 mg tablet4.19USD tablet
Imdur 120 mg 24 Hour tablet3.15USD tablet
Imdur 60 mg 24 Hour tablet3.11USD tablet
Imdur er 60 mg tablet2.99USD tablet
Imdur 30 mg 24 Hour tablet2.87USD tablet
Imdur er 30 mg tablet2.85USD tablet
Monoket 20 mg tablet2.65USD tablet
Ismo 20 mg tablet2.1USD tablet
Monoket 10 mg tablet1.75USD tablet
Isosorbide Mononitrate CR 60 mg 24 Hour tablet1.48USD tablet
Isosorbide Mononitrate CR 30 mg 24 Hour tablet1.16USD tablet
Isosorbide Mononitrate 20 mg tablet0.78USD tablet
Isosorbide Mononitrate 10 mg tablet0.74USD tablet
Imdur 60 mg Extended-Release Tablet0.74USD tablet
Isosorbide mn 20 mg tablet0.72USD tablet
Isosorbide mn 10 mg tablet0.71USD tablet
Apo-Ismn 60 mg Extended-Release Tablet0.42USD tablet
Pms-Ismn 60 mg Extended-Release Tablet0.42USD tablet
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Not Available


Experimental Properties
melting point (°C)88-91 °CNot Available
water solubility1.07E+005 mg/LNot Available
logP-0.15SANGSTER (1993)
Predicted Properties
Water Solubility57.0 mg/mLALOGPS
pKa (Strongest Acidic)13.34ChemAxon
pKa (Strongest Basic)-3.5ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count6ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area93.74 Å2ChemAxon
Rotatable Bond Count2ChemAxon
Refractivity38.08 m3·mol-1ChemAxon
Polarizability15.85 Å3ChemAxon
Number of Rings2ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
Human Intestinal Absorption+0.9156
Blood Brain Barrier+0.9355
Caco-2 permeable-0.579
P-glycoprotein substrateNon-substrate0.7621
P-glycoprotein inhibitor INon-inhibitor0.7159
P-glycoprotein inhibitor IINon-inhibitor0.9116
Renal organic cation transporterNon-inhibitor0.8563
CYP450 2C9 substrateNon-substrate0.8674
CYP450 2D6 substrateNon-substrate0.8613
CYP450 3A4 substrateSubstrate0.5357
CYP450 1A2 substrateNon-inhibitor0.8532
CYP450 2C9 inhibitorNon-inhibitor0.8769
CYP450 2D6 inhibitorNon-inhibitor0.9106
CYP450 2C19 inhibitorNon-inhibitor0.8469
CYP450 3A4 inhibitorNon-inhibitor0.9471
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9596
Ames testNon AMES toxic0.9133
BiodegradationReady biodegradable0.8359
Rat acute toxicity2.0753 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.5741
hERG inhibition (predictor II)Non-inhibitor0.9304
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)


Mass Spec (NIST)
Not Available
SpectrumSpectrum TypeSplash Key
Predicted GC-MS Spectrum - GC-MSPredicted GC-MSNot Available
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available


This compound belongs to the class of organic compounds known as isosorbides. These are organic polycyclic compounds containing an isosorbide(1,4-Dianhydrosorbitol) moiety, which consists of two -oxolan-3-ol rings.
Organic compounds
Super Class
Organoheterocyclic compounds
Sub Class
Direct Parent
Alternative Parents
Tetrahydrofurans / Alkyl nitrates / Secondary alcohols / Organic nitro compounds / Organic nitric acids and derivatives / Oxacyclic compounds / Dialkyl ethers / Organic zwitterions / Organic oxides / Organic nitrogen compounds
show 1 more
Isosorbide / Organic nitrate / Tetrahydrofuran / Alkyl nitrate / Organic nitric acid or derivatives / Secondary alcohol / Organic nitro compound / Dialkyl ether / Ether / Oxacycle
show 10 more
Molecular Framework
Aliphatic heteropolycyclic compounds
External Descriptors
nitrate ester, glucitol derivative (CHEBI:6062)


Pharmacological action
General Function
Heme binding
Specific Function
Has guanylyl cyclase on binding to the beta-1 subunit.Isoform 2 acts as a negative regulator of guanylyl cyclase activity as it forms non-functional heterodimers with the beta subunits.
Gene Name
Uniprot ID
Uniprot Name
Guanylate cyclase soluble subunit alpha-2
Molecular Weight
81749.185 Da
  1. Moncada S, Palmer RM, Higgs EA: Nitric oxide: physiology, pathophysiology, and pharmacology. Pharmacol Rev. 1991 Jun;43(2):109-42. [PubMed:1852778]
  2. Mancuso C, Navarra P, Preziosi P: Roles of nitric oxide, carbon monoxide, and hydrogen sulfide in the regulation of the hypothalamic-pituitary-adrenal axis. J Neurochem. 2010 May;113(3):563-75. doi: 10.1111/j.1471-4159.2010.06606.x. Epub 2010 Jan 20. [PubMed:20089135]

Drug created on June 13, 2005 07:24 / Updated on November 20, 2019 12:23