Monoket is a nitrate that dilates (widens) blood vessels, making it easier for blood to flow through them and easier for the heart to pump.

Monoket is used to prevent angina attacks (chest pain).

Monoket will not treat an angina attack that has already begun.

Monoket may also be used for purposes not listed in this medication guide.

You should not take erectile dysfunction medicine (Viagra, Cialis, Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil, vardenafil) while you are taking Monoket. Taking these medicine together can cause a sudden and serious decrease in blood pressure.

Seek emergency medical attention if you have early symptoms of a heart attack (chest pain or pressure, pain spreading to your jaw or shoulder, sweating, general ill feeling).

Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended. If you use too much Monoket, it might stop working as well in controlling your condition.

Try to rest or stay seated when you take this medicine (may cause dizziness or fainting).

Do not crush, chew, or break an extended-release tablet. Swallow it whole.

Not all brands and forms of isosorbide mononitrate are taken the same number of times per day. You may need to take the medicine only once daily, in the morning after getting out of bed. You may also need a second dose later in the day.

Follow your doctor's dosing instructions very carefully. If your doctor changes your brand, strength, or type of isosorbide mononitrate, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of isosorbide mononitrate you receive at the pharmacy.

You may have very low blood pressure while taking this medicine. Call your doctor if you are sick with vomiting or diarrhea, or if you are sweating more than usual. Prolonged illness can lead to a serious electrolyte imbalance, making it dangerous for you to use Monoket.

Use Monoket regularly to prevent an angina attack. Get your prescription refilled before you run out of medicine completely.

You should not stop using Monoket suddenly or you could have a severe attack of angina. Keep this medicine on hand at all times. Get your prescription refilled before you run out of medicine completely.

Store at room temperature away from moisture, heat, and light. Keep the bottle tightly closed when not in use.

You should not use Monoket if:

• you are allergic to Monoket, isosorbide dinitrate, or nitroglycerin; or

• you have early signs of a heart attack (chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating).

You should not take erectile dysfunction medicine (Viagra, Cialis, Levitra, Stendra, Staxyn, sildenafil, avanafil, tadalafil, vardenafil) while you are taking Monoket. Taking these medicines together can cause a sudden and serious decrease in blood pressure.

To make sure Monoket is safe for you, tell your doctor if you have:

• congestive heart failure;

• kidney disease; or

• low blood pressure.

It is not known whether Monoket will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

It is not known whether isosorbide mononitrate passes into breast milk or if it could affect the nursing baby. Tell your doctor if you are breast-feeding.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Monoket can be fatal.

Overdose symptoms may include a severe throbbing headache, fever, confusion, severe dizziness, fast or pounding heartbeats, vision problems, nausea, vomiting, stomach pain, bloody diarrhea, trouble breathing, sweating, cold or clammy skin, fainting, and seizure (convulsions).

Monoket may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. Alcohol may increase certain side effects of isosorbide mononitrate (dizziness, drowsiness, feeling light-headed, or fainting).

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Monoket may cause serious side effects. Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• worsening angina pain;

• fast or slow heart rate; or

• pounding heartbeats or fluttering in your chest.

Monoket can cause severe headaches. These headaches may gradually become less severe as you continue to use nitroglycerin. Do not stop taking Monoket to avoid headaches. Ask your doctor before using any headache pain medication.

Common side effects of Monoket may include:

• 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 may report side effects to FDA at 1-800-FDA-1088.

Taking Monoket with certain other medicines can cause severely low blood pressure. This includes medicine to treat erectile dysfunction or pulmonary arterial hypertension. Serious, life-threatening side effects may occur.

Tell your doctor about all your current medicines and any you start or stop using, especially:

• avanafil (Stendra);

• a diuretic or "water pill";

• nitroglycerin;

• riociguat (Adempas);

• sildenafil (Viagra, Revatio);

• tadalafil (Cialis, Adcirca); or

• vardenafil (Levitra, Staxyn).

This list is not complete. Other drugs may interact with isosorbide mononitrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.