Headaches from monomil isorbide mononitrate

[Copsem]

Started monomil yesterday for heart damage due to radiotherapy. Took 60mg and had big headache but felt better in my chest . Today I read the notes and it says you can start with half a tablet 30 mg and build up . Anyone else done this

[Hidden]

Hi Copsem,

I started isosorbide mononitrate a few months ago. I was told to start at 25mg and then increase in 25mg steps till I reached the target dose.

It gave me a terrible headache and I felt I was going t9 keel over every time I stood up!

I worked with my GP and reduced down to 10mg, I have slowly made my way up to my target dose.

This approach worked for me, no more headaches and my BP has stabilised.

[Copsem in reply to Hidden]

Oh thank you . I am doing better today on half dose 30 mg . How to you get 10 mg ? Are they different tablets. Mine are 60 with an option to beak in half . Does the effect last a full 24 hours . I woke up a lot last night and had arm ache .

[Hidden in reply to Copsem]

The smallest tablet is 20mgs which I halved.

I still get chest pain so not sure if effect lasts 24hrs, sorry.

[Dovaston]

Hi I was on 60 mg gave me bad heads. Split tablet in two and effectively took 30 mg morning and 30 mg evening and headaches went away for me ! Good Luck

[Copsem in reply to Dovaston]

Oh thank you yes I was wondering if I did that if I would get through the night better

[Milkfairy Heart Star]

I started on 30 mgs and worked up the dosage very slowly over several weeks.

I was lucky no headache just my blood pressure dropping instead.

I now take 90mgs a day with nitrate patches without any problems.

I take mine in the evening 60mgs at 6pm 30mgs at 11pm as my spasms and angina are worse at night.

Patches on at 6pm off in the morning to ensure at least 15 hours break between doses otherwise your body can build up a tolerance to the nitrates and they become less effective.

[Copsem in reply to Milkfairy]

Oh thank you . It looks like a bit of an art form getting the dose right .

[Hidden in reply to Milkfairy]

Hi Milkfairy,

That’s interesting as my angina is worse at night too. May try taking my tablets later. Managed to get up to 100mg.

[Milkfairy Heart Star in reply to Hidden]

Hi Tynemouth

Spasms at night are a classic symptom of Vasospastic angina especially Coronary artery spasms.

Drives me nuts being woken at night in pain.

I have over the years worked out the best time to take my medication.

Everyone I have been in contact with who lives with vasospastic or Microvascular angina takes their variety of medications at diffetent times.

[Bassman65]

Yes I also started on 30mg and got bad headache but it decreased after a week or so ago increased to 60 then 90 now on 120mg and don’t get any headaches

[Copsem in reply to Bassman65]

That’s very encouraging thank you

[kizza67]

I'm only on half a tablet a day but at first I had the most awful headaches I really didn't think I would be able to continue with such pain every daybut doctor told me to persevere with them and after a few weeks they eased off as my body got used to them so stick with it

[Copsem in reply to kizza67]

That’s so encouraging. Thank you . I was going to go back and ask for 20mg rather than 60 mg . Did you do that or are you on 30mg a day . How long did it take to manage the headaches ?

[kizza67 in reply to Copsem]

I'm on 30 mg a day it took about a month for them to go completely I tried not to use painkillers I used tiger balm rubbed into my temples but that's just me I already take 7 tablets a day so couldn't face another one😂😂

[Copsem]

Could I also ask everyone do you take paracetamol to help with the nitrate headaches does that work ? Is it contraindicated?

[Hidden in reply to Copsem]

Paracetamol isn’t contraindicated with nitrates. I doesn’t touch my headaches ( I have migraines ) but it’s worth a try.