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  • Generic name: isosorbide mononitrate
  • Brand Name: Ismo
Ismo Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

What is Ismo?

Ismo (isosorbide mononitrate) is a nitrate vasodilator used to treat angina, but not used to treat acute angina. Ismo is available as generic by several names, but isosorbide mononitrate is the umbrella term.

What are the side effects of Ismo?

Common side effects of Ismo include:

  • A headache,
  • Dizziness,
  • Warmth or redness of the skin,
  • Tingling under the skin,
  • Nausea,
  • Vomiting
  • Constipation,
  • Hot flashes,
  • dry mouth,
  • Diarrhea or
  • Pain or stiffness in joints or muscles.

Serious side effects of Ismo include:

  • irregular heart rate,
  • Lightheadedness or fainting
  • Chest pain and
  • Shortness of breath.

Dosage for Ismo

Ismo (isosorbide mononitrate) is available in a strength of 20 mg tablets. The dosage is usually 20 mg twice a day, about 7 hours apart.

Which drugs, substances or dietary supplements interact with Ismo?

Ismo can interact with dihydroergotamine or ergotamine, drugs for erectile dysfunction, beta blockers, or drugs for heart or blood pressure. Let your doctor know about all medications and supplements you use.

Ismo during pregnancy and breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant while using Ismo. It is not known whether Ismo harms a fetus. It's not known if Ismo passes into breast milk or if it could harm a breastfeeding baby. Ask your doctor before breastfeeding.

additional information

Our Ismo Side Effects Drug Center provides a comprehensive overview of the drug information available about the possible side effects of taking this drug.

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

Ismo consumer information

Get emergency medical help if you have Signs of an allergic reaction: Hives; Difficulty breathing; Swelling of the face, lips, tongue, or throat.

Call your doctor right away if you:

  • a light-headed feeling, as if you might pass out;
  • Worsening angina pain;
  • fast or slow heart rate; or
  • Palpitations or fluttering in the chest.

Isosorbide mononitrate can cause severe headaches. These headaches may gradually become less severe as you continue to use nitroglycerine. Do not stop taking this medicine to avoid a headache. Ask your doctor before taking headache medication.

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Common side effects can include:

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

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

Read the entire detailed patient monograph for Ismo (isosorbide mononitrate)

Find out more 'Ismo Professional information


The table below shows the frequency of adverse reactions observed in more than 1% of subjects (a) in 6 placebo-controlled home studies in which patients in the active treatment arm received isosorbide mononitrate 20 mg twice daily, and (b) in all studies in which patients received isosorbide mononitrate in different treatment regimens. In parentheses, the same table shows the frequency with which these side effects led to treatment discontinuation. Overall, 11% of patients who received isosorbide mononitrate in the six controlled US studies discontinued treatment because of side effects. Most of them were discontinued because of a headache. Dizziness and nausea were also frequently associated with discontinuing these studies.

Frequency of adverse reactions (discontinuations) *
6 controlled studies92 Clinical Studies
canplacebo20 mg(diversified)
a headache9% (0%)38% (9%)19% (4,3%)
dizziness1% (0%)5% (1%)3% (0,2%)
Nausea, vomiting
* Some people were hired for several reasons.

Other side effects, each reported by less than 1% of the exposed patients and in many cases an uncertain relationship with the drug treatment, were:

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Cardiovascular : Angina pectoris, arrhythmias, atrial fibrillation, hypotension, palpitations, postural hypotension, premature ventricular contractions, supraventricular tachycardia, syncope.

dermatological : Itching, rash.

Gastrointestinal : Abdominal pain, diarrhea, dyspepsia, tenesmus, tooth disorder, vomiting.

Urogenital : Dysuria, impotence, urinary frequency.

various : Asthenia, blurred vision, cold sweats, diplopia, edema, malaise, neck stiffness, rigidity.

Musculoskeletal system : Arthralgia.

Neurological : Restlessness, fear, confusion, dyscoordination, hypesthesia, hypokinesia, increased appetite, insomnia, nervousness, nightmares.

respiratory tract : Bronchitis, pneumonia, upper respiratory tract infection.

Extremely rarely, ordinary doses of organic nitrates have caused methaemoglobinemia in seemingly normal patients. For more information on diagnosis and treatment, see Overdose .

Read full FDA Prescribing Information for Ismo (Isosorbide Mononitrate).

Read more '' Related Resources for Ismo

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Ismo patient information is provided by Cerner Multum, Inc. and Ismo consumer information is provided by First Databank, Inc., which is used under license and is subject to their respective copyrights.