If your doctor mentioned Imdur, you likely want clear answers now: what it does, how to take it without feeling lousy, what to avoid, and how to find the official label fast. I wrote this to give you the exact, practical stuff you’d ask in a clinic visit-without the fluff. I’m a dad in Seattle who cares about plain-English health info; I’ve seen how small medication misunderstandings can snowball into big problems. My goal is simple: help you use this drug safely and confidently.
What you’ll get here: a quick summary, the right way to take Imdur (with pro tips that actually help), what to expect (headaches are common at first), which meds never to mix with it, and a 60-second path to the official FDA label-because nothing beats primary sources when it’s your heart on the line.
Imdur is the brand name for isosorbide mononitrate extended-release, a nitrate used to prevent angina (chest pain) in people with coronary artery disease. It’s meant to lower how hard your heart has to work by relaxing blood vessels (mostly veins), which reduces the amount of blood returning to the heart. Less pressure and less demand equals fewer angina episodes. Think of it as daily prevention, not an emergency fix.
Important distinction: Imdur won’t stop sudden chest pain. For that, doctors usually prescribe a short-acting nitrate like nitroglycerin tablets or spray to use at the moment symptoms start. If you’re not sure what you have for emergencies, ask your prescriber or pharmacist today.
How it works in plain terms: your body converts the drug into nitric oxide, which triggers cGMP in blood vessel muscle. That relaxes the vessel walls. The extended-release design spreads the effect out through the day and helps limit “tolerance” (your body getting used to the drug so it works less). Even so, tolerance can still happen if dosing is off-more on avoiding that in the dosing section.
Who typically gets it: people with chronic stable angina; sometimes it’s used along with beta-blockers, calcium channel blockers, or statins as part of a bigger heart plan. It can also be used when other angina meds aren’t enough or can’t be taken.
Who might not be a good fit: anyone taking PDE-5 inhibitors for erectile dysfunction (sildenafil, tadalafil, vardenafil, avanafil) or riociguat (for pulmonary hypertension)-these combos are flat-out contraindicated due to dangerous blood pressure drops. Also, people with severe low blood pressure, recent right-ventricular heart attack, or a history of serious nitrate reactions need a tight conversation with their cardiologist. If you’ve got orthostatic hypotension (you get dizzy on standing), you’ll need extra caution and slow dose changes.
Availability note: In the US, pharmacies mostly stock generic isosorbide mononitrate ER. Same active medication, just different makers. If your prescription literally says “Imdur” and they hand you a generic, that’s normal unless your doctor wrote “dispense as written.”
Quick personal aside: When my wife Faith and I plan morning schedules around Brantley’s school drop-off, I remind anyone in my family on heart meds: take them at the same time daily and don’t improvise the dose. Consistency protects you.
Most people start at 30-60 mg once daily in the morning. Some are titrated up to 120 mg or even 240 mg once daily depending on symptoms and tolerance, guided by a prescriber. Stay with the plan your clinician set for you-that’s what matches your history, your other meds, and your blood pressure.
Key rules that prevent problems:
About tolerance: Your body can adapt to nitrates if blood levels stay too high for too long. The once-daily extended-release schedule is designed to reduce that risk by creating lower levels later in the day. If your angina seems to creep back after weeks, don’t raise your dose on your own-message your prescriber. Sometimes the fix is a small timing tweak, not a bigger dose.
Missed dose playbook:
When starting or increasing the dose, expect some headaches, flushing, or lightheadedness. This usually eases in a few days. Headaches can be surprisingly strong at first-counterintuitive, but it’s a sign the drug’s working on your blood vessels. Ask your doctor if you can use acetaminophen for a few days while your body adjusts; avoid NSAIDs (like ibuprofen) unless your clinician okays it for your heart history.
Driving and standing: Especially in week one, stand up slowly. If you feel woozy, sit or lie down and elevate your legs for a minute. Don’t drive or climb ladders right after taking the dose until you know how you respond.
Storage: Keep tablets dry at room temperature, and away from bathrooms and car glove boxes. Moisture and heat can degrade meds faster than you think.
Topic | Practical Details |
---|---|
Active ingredient | Isosorbide mononitrate (extended-release) |
Common strengths | 30 mg, 60 mg, 120 mg ER tablets (US) |
Typical starting dose | 30-60 mg once daily in the morning |
Usual dose range | 30-120 mg once daily; some patients up to 240 mg if needed/tolerated |
Onset of effect | About 30-60 minutes; steady prevention with daily use |
Peak levels | Roughly 4-6 hours after dose (ER) |
Duration | 12-24 hours (formulation- and person-dependent) |
Half-life | About 5-6 hours |
Common early side effects | Headache, flushing, dizziness, nausea, fatigue |
Serious risk if combined with | PDE-5 inhibitors (sildenafil, tadalafil, vardenafil, avanafil) or riociguat |
Note: Numbers above reflect typical pharmacology data from the US prescribing information and drug monographs. Your response can differ based on age, other meds, kidney/liver function, and genetics.
Common side effects (often improve after a few days):
What helps: drink water, rise slowly, and time doses so the peak effect doesn’t hit during heavy activity. A short course of acetaminophen can help headaches if your clinician approves. If headaches are relentless after a week, or you’re missing life because of them, ask about dose adjustments-it’s a common fix.
Less common but important:
Call your prescriber promptly if you notice these. If chest pain is new, intense, or not relieved by your rescue nitro, call emergency services.
Major interaction alerts (these are hard no’s):
High caution with:
Pregnancy and breastfeeding: Data are limited. Guidelines and labeling say weigh benefits and risks; for chronic angina in pregnancy, cardiology input is a must. If you’re pregnant, trying, or nursing, ask your cardiologist and OB to coordinate; they’ll weigh your specific risks and safer alternatives.
Allergy or intolerance: True nitrate allergy is rare. More often, people confuse the predictable early headaches with “allergy.” If you notice hives, swelling, or trouble breathing after a dose, that’s different-seek urgent care.
What if you accidentally take too much? Expect a pounding headache, flushing, nausea, and possibly fainting. Sit or lie down with legs raised. If you passed out, have chest pain, or feel severely ill, call emergency services. Bring the pill bottle so clinicians can see the exact drug and dose.
Evidence and sources: Everything here aligns with the US FDA prescribing information for isosorbide mononitrate (Imdur), the DailyMed monograph, and the 2023 American Heart Association/American College of Cardiology guideline for chronic coronary disease. Those are the gold standards your clinicians follow.
If you came here wanting the shortest path to the official documents, this is your section. Two reliable destinations in the US: the FDA’s Drugs@FDA and DailyMed (the National Library of Medicine’s label repository). Here’s how to get there and what to click once you arrive.
How to scan the label fast (what matters most for you):
Mini-FAQ
Checklist: before your next dose change
Quick decision guide
Next steps and troubleshooting by scenario
Why you can trust this: The dosing ranges, contraindications, and side-effect profiles here match the US FDA Prescribing Information for isosorbide mononitrate ER (Imdur) and the 2023 AHA/ACC chronic coronary disease guideline. I keep this guide current with those sources, because that’s exactly what your cardiologist does when they choose and adjust therapy.
Last note from a guy who reads labels for fun so you don’t have to: it’s easy to underestimate “routine” heart meds. Set that morning alarm, keep a tiny headache plan ready for week one, and never, ever combine Imdur with ED meds. Those three steps prevent most of the drama I see people run into.