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Imdur

0.57
A long-acting nitrate tablet taken daily to prevent chest pain (angina) caused by heart disease.


Ingredient
Availability
In Stock
Delivery
Airmail (14-21 days) | EMS trackable (5-9 days)
Product is shipped in a fully discreet envelope with no content disclosure, including all required documentation inside

Product Sheet

Alternative/Local Brand
Imdur Durules
Active Ingredient(s)
Isosorbide
Primary Category
Angina Prevention
Therapeutic Class
Cardiovascular system, Cardiac therapy, Vasodilators used in cardiac diseases
Pharmacological Class
Organic nitrates
Indications
Prevention of angina pectoris, Chest pain relief
Contraindications
Severe hypotension (low blood pressure), Acute circulatory failure (shock), Hypertrophic obstructive cardiomyopathy, Use of PDE5 inhibitors (e.g. Viagra)
Minor Side Effects
Headache (often resolves with use), Dizziness, Flushing
Moderate Side Effects
Nausea, Low blood pressure, Pulsatile headache
Serious Side Effects
Severe hypotension, Fainting (syncope), Worsening of angina, Allergic skin reactions
Dosage Forms
Modified-release tablet
Administration Route
Oral
Mechanism of Action
It works by relaxing the smooth muscles of the blood vessels, particularly the veins. This dilates the vessels, making it easier for the heart to pump and reducing its oxygen demand, which prevents angina attacks.
Prescription Status
Rx
Manufacturer
AstraZeneca
Patient Summary
A long-acting nitrate tablet taken daily to prevent chest pain (angina) caused by heart disease.
Onset Time
30-60 minutes
Duration
12-24 hours
Storage Instructions
Store at room temperature; do not crush MR tablets
Drug Interactions
Sildenafil (Viagra), Tadalafil, Alcohol, Antihypertensives
Age Restrictions
Safety in children not established
Pregnancy Use
Only if clearly needed; use with caution.
Alternative Drugs
Monoket, Ismo, Glyceryl Trinitrate (GTN)

Imdur: Brand Overview and Active Ingredient

Imdur is a prescription medication marketed in Hong Kong for the management of chronic angina pectoris. The active component in Imdur is isosorbide, a nitrate that belongs to the heart- and blood-pressure therapeutic class. It is supplied as oral pills in strengths of 20 mg, 30 mg, 40 mg, and 60 mg.

How Imdur Works in the Body

Isosorbide belongs to the nitrate family, drugs that widen (dilate) blood vessels. After oral administration, the pill is absorbed into the bloodstream where it is converted to nitric oxide. This signaling molecule relaxes the smooth muscle in the walls of veins and arteries, producing two main effects:

  • Reduced cardiac workload: By dilating veins, less blood returns to the heart, decreasing the amount of blood the heart must pump with each beat.
  • Improved coronary blood flow: Dilation of coronary arteries enhances oxygen delivery to the heart muscle, helping to prevent angina episodes.

Onset of action typically occurs within one hour, with peak effects around two to three hours after a dose. The medication’s half-life allows once-daily dosing for most patients.

Conditions Treated with Imdur

Imdur is approved by the Hong Kong Department of Health for the prevention of angina pectoris in patients with documented coronary artery disease. It is used as part of a long-term management plan that may also include lifestyle changes and other cardiovascular drugs such as beta-blockers or calcium-channel blockers.

Patient Suitability and Contra-indications

Who Should Use Imdur?

  • Adults diagnosed with stable angina who require additional symptom control beyond lifestyle measures.
  • Patients who are already on other anti-anginal agents and need a nitrate that can be taken once daily.

Absolute Contra-indications

  • Known hypersensitivity to isosorbide or any nitrate medication.
  • Concurrent use of phosphodiesterase-5 (PDE-5) inhibitors (e.g., sildenafil, tadalafil) because of the risk of severe hypotension.
  • Unstable hemodynamics such as uncontrolled severe hypertension or hypotension.

Relative Contra-indications

  • Severe hepatic impairment (dose adjustment may be required).
  • Recent use of other nitrates (e.g., nitroglycerin) within the past 24 hours, as combined therapy can increase the chance of low blood pressure.
  • Pregnancy and lactation: Nitrates cross the placenta; use only if the potential benefit outweighs the risk.

Special Populations

  • Elderly patients: May be more sensitive to blood-pressure-lowering effects; start at the lowest dose and titrate cautiously.
  • Renal impairment: No dose adjustment is required for mild to moderate renal dysfunction, but severe renal failure should be evaluated by a clinician.

Safety Profile: Side Effects and Interactions

Common Side Effects

  • Headache: Frequently reported, often described as a throbbing sensation that improves with continued therapy.
  • Dizziness or light-headedness: May occur, especially when standing quickly.
  • Flushing: Warm, red skin, usually on the face or neck.
  • Nausea: Mild and transient in most cases.

These reactions are generally mild and tend to lessen after the first few days of treatment.

Serious Adverse Events

  • Severe hypotension: Marked drop in blood pressure leading to fainting or shock; requires immediate medical attention.
  • Syncope (loss of consciousness): May be a sign of excessive vasodilation.
  • Allergic reactions: Rash, itching, swelling of the face or throat suggest a hypersensitivity reaction and should be evaluated urgently.

Drug Interactions

  • Other nitrates (e.g., nitroglycerin, isosorbide dinitrate): Additive vasodilatory effect; avoid concurrent use or stagger dosing by at least 24 hours.
  • PDE-5 inhibitors: Co-administration can cause profound hypotension; contraindicated.
  • Antihypertensive agents (ACE inhibitors, ARBs, beta-blockers, calcium-channel blockers): May enhance blood-pressure-lowering effects; monitor blood pressure and adjust doses as needed.
  • Alcohol: Can amplify hypotensive effects; limit intake.

If a patient is taking multiple medications, a pharmacist should review the full medication list before starting Imdur.

Food and Lifestyle Interactions

  • Alcohol: Excessive consumption may increase the risk of dizziness and low blood pressure.
  • Grapefruit juice: No significant interaction has been documented, but patients should maintain a consistent diet.
  • Driving or operating machinery: Caution is advised until the individual knows how Imdur affects them, especially if experiencing dizziness or light-headedness.

How to Take Imdur

  • Standard dosing: Most adults begin with a 20 mg tablet taken once daily in the morning. The dose can be increased in increments (e.g., to 30 mg, 40 mg, or 60 mg) based on symptom control and tolerance.
  • Administration: Swallow the pill whole with a full glass of water. It may be taken with or without food; however, taking it with a light meal can reduce the likelihood of stomach upset.
  • Missed dose: If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose.
  • Overdose: Symptoms may include severe headache, profound dizziness, fainting, and extremely low blood pressure. Seek emergency medical care; treatment is supportive, focusing on maintaining blood pressure and monitoring cardiac function.
  • Discontinuation: Imdur does not usually require tapering, but abrupt cessation may lead to a rebound increase in angina frequency. Discuss any plan to stop the medication with a healthcare provider.

Monitoring and Follow-Up

  • Blood pressure checks: Recommended at baseline, after dose adjustments, and periodically thereafter.
  • Heart rate: Observe for bradycardia or tachycardia, especially when combined with other cardiac drugs.
  • Symptom diary: Patients may record the frequency and severity of angina episodes to help the clinician assess effectiveness.
  • Routine labs: No specific laboratory monitoring is required for isosorbide mononitrate alone, but liver function may be checked if hepatic disease is present.

Storage and Handling

  • Store Imdur tablets at room temperature (15 °C-30 °C), away from moisture and direct sunlight.
  • Keep the container tightly closed and out of reach of children.
  • Do not use the medication after the expiration date printed on the label.
  • Dispose of unused tablets according to local pharmacy-take-back programs or Hong Kong waste-management guidelines.

Medication-Specific Glossary

Nitrate tolerance
A phenomenon where the vasodilatory response diminishes with continuous nitrate exposure, often managed by drug-free intervals.
Vasodilation
The relaxation of blood-vessel smooth muscle leading to increased vessel diameter and reduced vascular resistance.
First-pass metabolism
The initial breakdown of a drug by the liver after oral ingestion, influencing the amount of active medication reaching systemic circulation.
Coronary artery disease (CAD)
A condition characterized by atherosclerotic plaque buildup in the arteries that supply the heart, leading to reduced oxygen delivery and potential angina.

Medical Disclaimer

This article provides educational information about Imdur and is not a substitute for professional medical advice. Treatment decisions, including use for unapproved indications, must be made under the guidance of a qualified healthcare provider. The content is intended for informational purposes and does not constitute medical recommendations. Always consult a physician before starting, stopping, or changing any medication regimen.

Imdur FAQ

Can I take Imdur with my blood pressure medication?

Imdur can be combined with many antihypertensive agents, but the combined effect may lower blood pressure more than expected. Your healthcare provider should monitor your blood pressure after any dose adjustment.

What should I do if I feel a sudden, intense headache after a dose?

A severe headache is a common early side effect of nitrates. Resting in a quiet, dim environment and staying hydrated often helps. If the headache persists or worsens, contact your clinician for possible dose modification.

Is it safe to travel abroad with Imdur pills?

Yes, but keep the medication in its original labeled container, carry a copy of the prescription, and be aware of any country-specific import restrictions for prescription drugs.

Do all Imdur tablets look the same worldwide?

Imdur tablets are typically round, white to off-white, and may have an imprint indicating strength (e.g., “20”, “30”). Appearance can vary slightly between manufacturing batches and regions.

Can Imdur affect drug testing for employment or sports?

Nitrates are not typically screened for in standard workplace drug tests. However, some athletic anti-doping agencies monitor cardiovascular drugs; disclose your prescription if required.

Why is there a “drug-free interval” recommendation for some nitrates but not for Imdur?

Imdur (isosorbide mononitrate) has a longer half-life and is less prone to tolerance, so it is usually taken once daily without a scheduled nitrate-free period. Your clinician will determine the best schedule for you.

What happens if I accidentally take two doses close together?

Taking two doses too close together can cause a rapid drop in blood pressure, leading to dizziness or fainting. Treat it as a potential overdose and seek medical attention promptly.

Is it okay to crush or split Imdur tablets?

Imdur tablets are designed for intact oral ingestion to ensure proper absorption. Crushing or splitting may alter the drug’s release profile and should be avoided unless specifically directed by a pharmacist.

How long does it take to feel relief from angina after starting Imdur?

Patients often notice a reduction in angina frequency within a few days, though full benefit may take up to two weeks as the body adjusts to the medication.

Are there any dietary restrictions while taking Imdur?

No specific foods must be avoided, but excessive alcohol can worsen low-blood-pressure effects. Maintaining a balanced diet and consistent sodium intake supports overall cardiovascular health.

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