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Alcohol or marijuana (cannabis) can make you more dizzy. Talk to your pharmacist for more details.īefore using this medication, tell your doctor or pharmacist your medical history, especially of: This product may contain inactive ingredients, which can cause allergic reactions or other problems. Precautionsīefore taking this medication, tell your doctor or pharmacist if you are allergic to it or to similar drugs (such as isosorbide dinitrate, nitroglycerin) or if you have any other allergies. You may report side effects to Health Canada at 1-86. You may report side effects to FDA at 1-80 or at In Canada - Call your doctor for medical advice about side effects. If you notice other effects not listed above, contact your doctor or pharmacist.Ĭall your doctor for medical advice about side effects. This is not a complete list of possible side effects. itching/swelling (especially of the face/tongue/throat).However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: Tell your doctor right away if you have any serious side effects, including:Ī very serious allergic reaction to this drug is rare. Many people using this medication do not have serious side effects. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. This effect is harmless since your body has already absorbed the medication. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Īn empty tablet shell may appear in your stool. If headaches continue or become severe, tell your doctor promptly. Your doctor may recommend treating headaches with an over-the-counter pain reliever (such as acetaminophen, aspirin). Headache is often a sign that this medication is working. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. Headache, dizziness, lightheadedness, nausea, and flushing may occur as your body adjusts to this medication. Tell your doctor if this medication stops working well (for example, you have more frequent or worsening chest pain). Your dose may need to be gradually decreased.Īlthough unlikely, when this medication is used for a long time, it may not work as well and may require different dosing. Some conditions may become worse when the drug is suddenly stopped. Do not stop taking it without consulting your doctor. To help you remember, take it at the same time each day. Use this medication regularly to get the most benefit from it. Swallow the whole or split tablet without crushing or chewing. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Doing so can release all of the drug at once, increasing the risk of side effects. Swallow this medication whole with a half glass of water (4 ounces/120 milliliters) unless your doctor directs you otherwise. ISMN added to captopril increased treadmill exercise time in patients with heart failure and a lesser reduction in baseline ejection fraction, although for the group as a whole, the increase in treadmill time was not significant.Take this medication by mouth as directed by your doctor, usually once daily when you wake up. hypotension) were observed with ISMN, although headache was reported in 19% of the active treatment group (p = 0.0001). Treatment difference was greater in the prespecified subgroup with ejection fraction 31-40% (+55 s, 95% CI -11, +136 s at 12 weeks and +65 s, 95% CI +3, +147 s) (p = 0.035) at 24 weeks. Intention-to-treat analysis showed that mean change in treadmill exercise duration tended to be greater in patients receiving ISMN than placebo (treatment difference +42 s, 95% CI -5, +90 s at 12 weeks and +21 s, 95% CI -25, +74 s after 24 weeks) (NS). Secondary endpoints included left ventricular dimensions, ejection fraction, cardiothoracic ratio, functional class, quality of life, hospitalizations and plasma norepinephrine and atrial natriuretic peptide in a four-center substudy. Endpoints were treadmill exercise time at 12 weeks by modified Naughton protocol (primary), with an additional 12-week follow-up period.
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Oral isosorbide-5-mononitrate (ISMN) (50 mg once daily) or placebo was administered to 136 patients (NYHA Class 2-3) treated for heart failure, all receiving captopril and most also furosemide. Nitrate therapy improves hemodynamics in patients with heart failure, but the chronic effects of oral nitrates on exercise performance and clinical status have not been well studied.