It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart while reducing its workload.

Nitrates enter the smooth muscle cell and are cleaved to inorganic nitrate and eventually to nitric oxide. The main symptom is likely to be hypotension.Methaemoglobinaemia (cyanosis, hypoxaemia, change in mental status, respiratory depression, convulsions, cardiac arrhythmias, circulatory failure, raised intracranial pressure). Low concentrations dilate both arteries and veins.Venous dilatation pools blood in the periphery leading to a decrease in venous return, central blood volume, and ventricular filling volumes and pressures. Attenuation of effect (tolerance) has occurred in some patients being treated with sustained release preparations. Arterial blood pressure usually declines secondary to a decrease in cardiac output or arteriolar vasodilatation, or both. Dizziness, nausea, tachycardia and paroxysmal bradycardia have been reported. Both dosage and frequency should be tapered gradually over several days, and the patient carefully monitored (see section 4.4).The core of the tablet is insoluble in the digestive juices but disintegrates into small particles when all the active substance has been released. Isosorbide mononitrate dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.Isosorbide mononitrate is used to prevent angina attacks (). Attenuation of effect (tolerance) has occurred in some patients being treated with sustained release preparations (prolonged release). When used regularly on a long-term basis, this helps prevent angina attacks from occurring. Hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, aortic/mitral valve stenosis, hypovolaemia closed-angle glaucoma, severe anaemia, conditions causing raised intracranial pressure e.g following head trauma, cerebral haemorrhage.Eumon 40 XL should not be given to patients with a known sensitivity to nitrates.Concomitant use with the soluble guanylate cyclase stimulator, riociguat, can cause hypotension and is contraindicated (see section 4.5).Eumon 40 XL modified release tablets are not indicated for relief of acute anginal attacks. Store in the original container.The tablets are packed in blisters which consist of 250 μm PVC with a 25 μm PVdC coating which is sealed to 25 μm thick aluminium foil with 20 μm PVdC sealing lacquer. When you are taking isosorbide mononitrate you should not take You must inform you doctor if you have any of these medical conditions in order to make isosorbide mononitrate safe for you:If you are planning to become pregnant or is pregnant at the moment, you must inform your doctor as it is unknown if isosorbide mononitrate can harm unborn child.Also inform your doctor if you are breast feeding you child as it is unknown if the medicine passes through breast milk to the feeding babyIsosorbide mononitrate is for the treatment and prevention of angina pectoris that occur mainly because of coronary artery disease. Very occasionally the matrix may pass through the gastrointestinal tract without disintegrating and be found inside the stool, but all active substance has been releasedThe tablets should not be chewed or crushed and should be swallowed with half a glass of fluid.Hypersensitivity to the active substance or to any of the excipients listed in section 6.1. Animal studies have shown reproductive toxicity (see section 5.3). Does Isosorbide Mononitrate Interact with other Medications?

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