Lower Dose Options for Isosorbide Mononitrate

Introduction to Dosing Considerations

• The American Heart Association recommends that for isosorbide mononitrate 60mg once daily, the lower dose option is 30mg once daily, or alternatively 20mg twice daily using the conventional formulation, to maintain efficacy while minimizing tolerance 1

Tolerance Development and Dosing

• Tolerance to isosorbide mononitrate is dose and duration dependent, typically becoming important after 24 hours of continuous therapy, and the American College of Cardiology notes that a daily dose-free interval of at least 14 hours is essential to prevent tolerance 2, 1