Isopen-20 Adverse Reactions

Hematology: Possible formation of methemoglobin, in particular in patients with methemoglobin reductase deficiency as well as in patients with diaphorase deficiency and abnormal hemoglobin structure.
Gastrointestinal system: Occasionally, especially when first used, nausea and/or vomiting.
Cardiovascular system: Occasionally, especially at the beginning of treatment, postural hypotension, tachycardia or flush, which normally improve on continuation of therapy, rarely collapse, in some instances accompanied by bradyarrhythmias and syncope, or intensified symptoms of angina pectoris if there is a significant drop in blood pressure.
Administration of Isosorbide-5-mononitrate may produce transient hypoxemia as a result of redistribution of blood flow with a relative increase in perfusion of poorly ventilated areas of the lung. This may cause ischemia in patients with coronary heart disease.
Central nervous system: Frequently, particularly at the start of treatment, transient "nitrate headache" may occur, which normally subsides after some days of continued treatment, occasionally, particularly when first used, slight states of dizziness or feeling of weakness may occur, which normally improve during treatment.
Skin: Rarely allergic skin reactions.