Isorobide Mononitrate 40mg tablets

[KungfooPanda]

Is anyone else’s chemist completely out of Isorobide Mononitrate stock? Mine are saying they’ve called round and cannot get any. Apparently supplier is also out of stock. They are having to call my GP to prescribe an alternative. Slightly worried as this is something I’ve been on for a few years now. Without which I get chest pain. My prescription was supposed to be ready before Christmas but I’ve been twice, only to now be told the situation, luckily I have a week left. I’ve also called the GP. Who’s due to call me back. I have Microvascular Angina and get coronary artery spasms, that’s the pain that these tablets prevent. Along with Calcium Channel Blockers.

[KungfooPanda]

Update on this, my GP has issued a prescription for the modified release version because the pharmacy has these in. But not sure if this resolves supply shortages in the long term, I find that a bit worrying.

[Milkfairy Heart Star]

Hello,

I live with vasospastic angina and over the recent years my Pharmacist has had problems obtaining my medications.

My Pharmacist will use a different brand of Isosorbide mononitrate when necessary.

I take 120mgs Isosorbide mononitrate everyday.

I have on my repeat prescription an alternative brand of slow release diltiazem, even though you're not supposed to change brands of diltiazem.

My Cardiologist provided me with an outpatient prescription of the medications in short supply, so I have a reserve of medication. This relieves my stress.

It took more than 6 weeks for my Pharmacist to obtain my nicorandil recently.

My vasospastic angina is unfortunately quite brittle. I end up being admitted to hospital with unstable vasospastic angina about once or twice a year.

There is unfortunately a worldwide shortage of essential medications.

[KungfooPanda in reply to Milkfairy]

Thank you for your reply, it’s the first time I’ve hit an issue. I’m on Diltiziem as well. I might ask my GP about keeping a reserve. I’ve got to admit it worried me this morning. I think I’d finally started to relax, and feel as in control as you can under the circumstances with these conditions. And the pharmacy unable to obtain your medication for 6 weeks, that’s frightening. My fear is ending up in hospital. And pretty much would without the Isorobide. I consider myself very lucky in the sense that the meds I’m on control my condition. But there’s always been that niggle at the back of my mind in relation to availability. But I’ve pushed it to the back of my mind until now.

[fishonabike in reply to KungfooPanda]

I hope you can arrange for an extra prescription so that you can always keep a stock in hand, in case of future shortage

[Milkfairy Heart Star]

Have you needed to be admitted to hospital in the past?

I have over 12 years, been admitted to hospital nearly 20 times. I am usually in for about 10 days.

[KungfooPanda]

I’ve been a few times. But not since 2022, after they set me up with Isorobide, Diltiziem and Statins - statins were a prevention thing. I was borderline cholesterol wise. As said I consider myself lucky. But the idea of being in a situation where those visits become necessary again isn’t a thought I relish.

[Milkfairy Heart Star in reply to KungfooPanda]

I glad to hear that your angina is well managed. I have an agreed admission protocol and everyone knows me. I still hate going in, so I acknowledge your desire to keep out of hospital.

I hope your GP can help, if not I suggest you get in contact with your Cardiologist and ask for an outpatient prescription.

Happy New Year!

[KungfooPanda in reply to Milkfairy]

Happy New Year to you too

[Whiteghost]

Yes I'm in the same situation. I have 30mg x 2 a day. This is due to the supplier closing there factory in Wales. Went to see my GP last week to ask for alternative he nearly wet his pants his reply 'I'm unable to prescribe an alternative, you will need to speak to our pharmacist ' I asked when, he said I will get him to ring you on Monday, no call. So it continues. So good luck & Happy New Year 🤗

[Milkfairy Heart Star in reply to Whiteghost]

I am surprised you had this response from your GP.

There are other manufacturers who make isosorbide mononitrate.

I am dispensed whichever brand is available.

An alternative for you is to be prescribed 60mg tablets. The tablets are scored and can be easily broken in half.

[Whiteghost in reply to Milkfairy]

Firstly Happy New Year. Your surprised by his response you can imagine mine😯. His a very young, only just qualified,who has no confidence what so ever and our other Doc exactly the same only just qualified but she's over confident it's a very scary place. Our original Doc left I believe the new members of staff, who's mummy had the practice before wanted to make changes she was not happy with. So let the battle commence.

[Milkfairy Heart Star in reply to Whiteghost]

Happy New Year!

I hope you don't have too big a battle.

[KungfooPanda in reply to Whiteghost]

That is bad. They’ve actually changed the type of Isorobide for me. I was on IR (immediate release) 2 x 40mg. What they’ve had to do is issue me with the Modified Release version. So that’s going to be 1 x 80mg tablet taken in the morning. I’m expecting the awful headaches for a day or two as that sounds like double the amount my body is used to receiving in one dose. But I’m just grateful to get them to be honest. The other complication is I’m going abroad soon so needed it sorted. Fingers crossed they’ll be ok.

[Whiteghost in reply to KungfooPanda]

You may be ok because like me you took 2 per day but now with the slow release your still getting the same dose but over a longer period of time. I'd give anything ago. Good luck.🤗

[T666]

I’m a newbie to isosorbide, what an absolute game changer this marvellous tablet has been

Only been on it since July 24 had one occasion with supply issue which they acquired some in 24 hours. Other than that 🤞no issues

[Whiteghost in reply to T666]

Its definitely a game changer. So hoping you don't have any issues. HAPPY NEW YEAR🤓

[Manalive]

l was on 90 mg daily,50 mg + 40 mg.the 40 mg was forever out of stock,so asked doctor if 2 x 50 mg would be okay,it was and l have no problem with supply since.

[dunestar]

I take 30mg isosorbide mononitrate extended release, so a 60mg tablet cut in half. Last time I went to the pharmacy (Boots) I had to go to a bigger store up the road to pick up the tablets. I remember once they couldn't get hold of my brand Chemydur, so got the GP to prescribe another type (can't remember what it was). But this brand was terribly difficult to cut in half even though I have a good little cutting device. There was a lot of dust and a big piece and a small piece. Things seem to be OK at the minute but the pharmacist is definitely taking longer to put my prescriptions together.

[Milkfairy Heart Star in reply to dunestar]

I have been given Medomon XL 60mgs or Monomil XL 60mgs, these are easy to break in half.

I switiched from Boots, to an independent Pharmacist. They are much better at sourcing my medication probably, because I have built up a relationship with the staff.

[KungfooPanda in reply to Milkfairy]

I think this relates to the supply issue with the IR versions of Isorobide at the moment:

cpe.org.uk/our-news/medicin...

[Milkfairy Heart Star in reply to KungfooPanda]

Thanks for the information.

There has been the same notice put out to pharmacists for other medications.

Hopefully, you will do better on slow release isosorbide mononitrate rather than the instant release isosorbide dinitrate.

I also use GTN patches. Maybe ask your Cardiologist or GP about whether this form of nitrate may help you?

I found drinking plenty of water helps with the headaches. When I am in hospital I am on really high doses of IV GTN and avoid the 'nitrate head' by drinking lots and lots of water.

I also stagger my doses, I take 60mgs ISMN at 6pm and 11pm. I experience most of my coronary vasospasms in the evening and during the night.

If I took 120mgs in one go it would drop my blood pressure too much.

[KungfooPanda in reply to Milkfairy]

Thank you, really appreciate you sharing your experience. Especially the drinking water bit, I’ll make sure I do that when I start the new tablets. Hopefully that’ll help. And I will be talking to my GP about options and having a backup supply of sorts going forward. Because the more I’ve looked into supply chain issues the more I’m thinking contingency is needed going forward.

[dunestar in reply to Milkfairy]

Thanks Milkfairy, I'll make a note of those brands. I'm not at all sure why my prescription specifies Chemydur. The Boots is right next to the GP surgery which is convenient if there's a problem which needs to be sorted out by a doctor.

[Qualipop]

Have you tried phoning different pharmacies who use a different supplier and may have different brands in stock? I've had to do this when my painkiller has been out of stock

[KungfooPanda in reply to Qualipop]

The chemist did, they also tried alternate suppliers before calling my GP. In addition to me also calling them.

[Qualipop in reply to KungfooPanda]

At least they tried. Mi chemist won't.

[Lowerfield_no_more in reply to Qualipop]

My local pharmacy were increasingly incompetent and unhelpful, but the final straw for me was when I told one of their members of staff that she was the rudest shop assistant I had ever come across (and that is some feat!) . So I changed to another pharmacy and they are excellent.

[Qualipop in reply to Lowerfield_no_more]

My local pharmacy was useless but that was the pharmacist himself. Another about a mile away were fantastic when my oxycodone was unavailable. She even went down to our GP surgery to collect a paper prescription so she could give me the two bottles they had in stock and she rang me as soon as any more came in. Afraid I stuck with the local one because they do phone reminders for repeats and deliver to the door but there are two others in town that are my "go to" places when there are any problems. I react really badly to generic versions but one of those suggested just one brand he knew a similar patient had coped with and thankfully the side effects were bearable so at least I do now have an alternative. It's not something I could just stop or change because of withdrawal.

[KungfooPanda in reply to Qualipop]

I think this relates to the supply issue cpe.org.uk/our-news/medicin...

[Qualipop in reply to KungfooPanda]

IT just emphasises why GPs should let people have just a few extra each month to ensure we don't run out. There needs to be an enquiry why so many drugs are in short supply.