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...