Monodignity

Monodignity – a peripheral vazodilatator with preferential influence on venous vessels, anti-anginal means.

Form of release and structure

Dosage form – tablets: flat, round, almost white or white color, on one of the parties of risk (on 10 tablets in blisters, 3 blisters in a cardboard pack).

Active ingredient: isosorbide-5-mononitrate, its contents in 1 tablet – 20 or 40 mg.

Additional components: cellulose microcrystallic, the lactose granulated starch corn, talc, magnesium stearate.

Indications to use

Combination therapy:

• Chronic heart failure;
• Pulmonary heart;
• Pulmonary hypertensia.

Also Monosang is applied to prevention of attacks of stenocardia at patients with coronary heart disease.

Contraindications

• Cardiac tamponade;
• Left ventricular failure with low diastolic pressure;
• Arterial hypotension and arterial hypovolemia (systolic arterial pressure is lower than 100 mm hg, diastolic – it is lower than 60 mm hg, central venous – it is lower than 4-5 mm hg);
• The acute myocardial infarction which is followed by the expressed arterial hypotension;
• Closed-angle glaucoma;
• Vascular collapse;
• Shock;
• The diseases which are followed by the increased intracranial pressure (including a hemorrhagic stroke, and also a craniocereberal injury);
• Toxic fluid lungs;
• Age up to 18 years;
• Lactation period;
• Hypersensitivity to drug or other nitrates.

In the following cases Monosang it is necessary to apply with care:

• Aortal and/or mitral stenosis;
• Tendency to orthostatic disturbances of vascular regulation;
• Hypertrophic cardiomyopathy;
• Chronic cardial compression;
• The expressed renal failure;
• Liver failure;
• Heavy anemia;
• Thyrotoxicosis;
• Advanced age.

Route of administration and dosage

The monodignity should be accepted inside after meal: to swallow of tablets entirely and to wash down them with enough liquid.

The doctor establishes an optimum dose individually for the patient depending on weight of a course of a disease.

At the beginning of therapy usually appoint 10-20 mg from 1 to 3 times a day. At insufficiency of therapeutic effect from the 3-5th day of treatment the pink dose is raised to 40-60 mg.

The highest resolved daily dose makes 80 mg.

Side effects

• Allergic reactions: skin rash; in rare instances – exfoliative dermatitis;
• From the central nervous system: a sight illegibility, drowsiness, constraint, reduction of speed of mental and motor reactions (especially in an initiation of treatment); in rare instances – brain ischemia;
• From the alimentary system: feeling of easy burning of language, dryness in a mouth, nausea and/or vomiting;
• From cardiovascular system: a passing dermahemia of the person, a "nitrate" headache, вертиго, the expressed lowering of arterial pressure, feeling of heat, tachycardia; in rare instances – an orthostatic collapse, paradoxical strengthening of attacks of stenocardia;
• Others: tolerance, including cross to other nitrates.

Special instructions

The monodignity is not intended for stopping of attacks of stenocardia.

During treatment it is necessary to control the arterial pressure and heart rate.

Patients with arterial hypertension Monosang should appoint in a combination with the drugs possessing a positive inotropic effect.

In case of frequent reception and/or use of high doses of drug tolerance development is possible. If it occurred, in 3-6 weeks of treatment Monosang's cancellation is recommended temporary (for 24-48 hours) or having rummaged in therapy for 3-5 days with replacement of isosorbide-5-mononitrate by this time with other anti-anginal means.

It is not recommended to cancel sharply drug, it is necessary to reduce its dose gradually.

As medicine can influence the speed of psychophysical reactions, it is necessary to be careful when driving the car and employment on potentially dangerous productions.

Medicinal interaction

• Digidroergotamin: its concentration in a blood plasma increases;
• Barbiturates: biotransformation accelerates and concentration of isosorbide-5-mononitrate in blood decreases;
• Anti-hypertensive drugs, peripheral vazodilatator, tricyclic antidepressants, antipsychotic means, blockers of slow calcium channels, beta adrenoblockers, quinidine, sildenafit, новокаинамид, dihydroergotamine, ethanol: hypotensive action amplifies;
• Blockers of slow calcium channels, propranolol, Amiodaronum, acetylsalicylic acid: the anti-anginal effect amplifies;
• Alpha adrenoblockers, beta адреностимуляторы: expressiveness of anti-anginal action of Monosang decreases owing to what perhaps excessive lowering of arterial pressure and development of tachycardia;
• M-holinoblokatory (for example, atropine): the risk of increase in intraocular pressure increases;
• The adsorbents enveloping and the knitting drugs: absorption of isosorbide-5-mononitrate from digestive tract decreases.

Terms and storage conditions

To store at a temperature from 15 to 25 ºС in the unavailable to children, dry and protected from light place.

Period of validity – 4 years.