First dose Isosorbide Mononitrate 30mg MR

[Kluckieduc]

Hello

I am not sure if l should have persevered more with this medication. I have mild CAD diagnosed after an angiogram. Bisoperol 1.25 mg was not helping with heart spasms/chest pain. I have had no consultant follow up appointment post angiogram yet so l am only going by what letter l have been sent states.

I contacted the secretary of my consultant and consultant wrote to my GP suggesting adding Isosorbide Mononitrate 30MR.

I went to see my GP to discuss this. I have low blood pressure and along with Bisoperol l take Topiramate for complex migraines which both lower my blood pressure even more.

So the GP has me coming off the Bisoperol for a week which then turned into three weeks due to a nasty viral thing going around. During this time l had not chest pain at all

I took my first Isosorbide Mononitrate 30MR in the morning as per instructions. I quickly had the most horrendous headache that went into my neck and shoulders. My eyes were really painful and l woke up in the early hours with chest and back pain. Paracetamol did help at all. I am used to headaches and can usually cope with them but this felt awful.

If it had been a mild background headache l could have tolerated it

I am scared to take any more of this medication.

Has anyone else experienced this side effect and what did you do.

Thank you so much for your help

[Milkfairy Heart Star]

Hello,

Has anybody considered whether you may have angina without obstructed coronary arteries ANOCA?

Microvascular and vasospastic angina are types of ANOCA.

Vasospastic angina is caused by transient constrictions of the coronary arteries, coronary vasospasms.

I noticed you have written

'Bisoperol 1.25 mg was not helping with heart spasms/chest pain.'

Beta blockers can make coronary vasospasms worse. You have said your chest pain appears to be less, since you have stopped taking beta blockers.

I have coronary vasospasms and ended up in hospital after being prescribed beta blockers.

I have been taking Isosorbide mononitrate tablets as well as GTN patches for many years.

I haven't forgotten the ' nitrate head'.

It's very common to have a headache when you first start taking nitrates.

The headache can last a couple of weeks.

I took paracetamol regularly and drank lots and lots of water. I also take my isosorbide mononitrate in the evenings.

However your experience sounds more unusual.

I suggest you go back to your GP, and ask for a referral back to a Cardiologist who has some understanding of microvascular and vasospastic angina.

The BHF has this information about vasospastic angina.

bhf.org.uk/informationsuppo...

[Scooby21 in reply to Milkfairy]

Hi

So sorry to hear you had that awful experience with Isosorbide!!!

I too had exactly the same reaction when I was given it as a new med when in hospital!!..Its horrendous!!

I was in so much pain in my head, neck, eyes and I could feel the pain under my skull!!

Eventually after 4 days of this and being sick, hallucinating and light sensitivity, a CT head scan was done, which thankfully came back all clear.

Isosorbide was then stopped and I'm told it was the culprit!! It did take nearly ten days for the headache and pain to completely disappear!.

I will never take this drug knowingly again.

Ive also been told if you have a history of migraines (which I do not) it can make you react like this.

I hope you manage to find something that works for you!

Good luck.

[Milkfairy Heart Star in reply to Scooby21]

Hello Scooby21,

Did you mean to reply to Kluckieduc?

[Scooby21 in reply to Milkfairy]

Oh yes, Thanks 🤦‍♀️🤣

[Kluckieduc in reply to Milkfairy]

Thank you for your reply. I have not seen a consultant yet. My gp referred me because of SOB and chest pain. A stress echocardiogram was done in May which showed part of my heart not functioning so well under stress. All other checks bp pulse ecg etc all come back clear. I then had an angiogram done in July and was discharged without seeing a doctor.

When l contacted my consultant’s secretary she said he had been off ill and only back part time so did know when l would get to see him. It all feels a bit like pot luck and guess work on my part. The IMononitrate dropped my bp to 79/47 which was another worry.

I was rushed into hospital twice in August this year with complex migraine which is basically a migraine with stroke symptoms. If l get them l have to go straight to hospital. So the headache being so severe concerned me. I also have other health problems that leave me riddled with pain so it was hard to deal with.

I will contact the consultant’s secretary again and see if l can find out if there is an apt in the near future. Thank you again

[AuntyEdna]

hi to add to the replies so far I have a history of cluster head aches and migraines . My experience with Isosorbide was the same , my neurologist said it would trigger them and best to avoid if possible. Once stopped the unbelievable pain went. I also have microvascular Angina (as well as a leaky valve) so take a calcium blocker, I absolutely cannot take beta blockers.

I hope you find a solution that works for you. Milkfairy is the voice we follow such a wise person full of incredible knowledge.

Take care especially in the cold weather ☺️

[Scooby21]

HiSo sorry to hear you had that awful experience with Isosorbide!!!

I too had exactly the same reaction when I was given it as a new med when in hospital!!..Its horrendous!!

I was in so much pain in my head, neck, eyes and I could feel the pain under my skull!!

Eventually after 4 days of this and being sick, hallucinating and light sensitivity, a CT head scan was done, which thankfully came back all clear.

Isosorbide was then stopped and I'm told it was the culprit!! It did take nearly ten days for the headache and pain to completely disappear!.

I will never take this drug knowingly again.

Ive also been told if you have a history of migraines (which I do not) it can make you react like this.

I hope you manage to find something that works for you!

Good luck.

[Collectone]

I was the same .Headache on another level .I couldn't eat,sleep ,think or function normally .I stopped after 10 days .I was then prescribed Nicorandil and this had the same effect !

[Pinky20J]

hi, yes I had the same when I started taking isosorbide mono nitrate. The headaches ate bad but they do eventually subside after about a week or so. I used an eye mask type thing kept in the freezer when it was bad. The cold really helped the pain.

[Whiteghost]

Common side effects of isosorbide mononitrate or isosorbide dinitrateHeadaches. Make sure you rest and drink plenty of water. ...

Feeling dizzy, weak, tired or sleepy. Stop what you're doing and sit or lie down until you feel better. ...

Feeling sick (nausea) ...

Flushing of the face.

I've been on 30mg twice a day for well over 2 years now. I've been told if you experience headaches the medication is working🤔 I do get headaches dizzy spells but I just rest sip water and it does go. My own personal view is the pains I was experiencing was more frightening than these side effects.

[Kluckieduc in reply to Whiteghost]

Thank you for your reply. I am going back to see my gp. I was still in a lot of pain from headache and neck and shoulder pain 24 hours after my first dose and could not face taking another dose on top. The pain continued for nearly four days from just one 30mg dose. If it had settled down later in the day and l had a break from it l could have coped better. I am concerned as well because l am newly diagnosed with complex migraines which are caused by dilated blood vessels in the brain.