{"product_id":"monis-tablets-40mg","title":"Monis 40mg Tablet (Isosorbide Mononitrate 40mg)","description":"\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eDrug Class:\u003c\/strong\u003e Organic Nitrate \/ Vasodilator | \u003cstrong\u003eForm:\u003c\/strong\u003e Standard-Release Oral Tablet | \u003cstrong\u003ePrescription Status:\u003c\/strong\u003e Prescription Only (Rx) — DRAP Registered\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eWhat is Monis 40mg Tablet?\u003c\/strong\u003e Monis 40mg contains Isosorbide Mononitrate — an organic nitrate vasodilator used exclusively for prevention and long-term management of chronic stable angina caused by coronary artery disease. Unlike the extended-release XR formulation, Monis 40mg is a standard-release tablet requiring careful twice-daily dosing with doses taken asymmetrically — not evenly spaced — to maintain a mandatory nitrate-free interval that prevents tolerance development. Like all nitrate formulations, it has no role in treating acute chest pain attacks where fast-acting sublingual nitrates are required. It must be used consistently under cardiological supervision for effective long-term angina prevention.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eWhat is Monis 40mg Used For?\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul class=\"[li_\u0026amp;]:mb-0 [li_\u0026amp;]:mt-1 [li_\u0026amp;]:gap-1 [\u0026amp;:not(:last-child)_ul]:pb-1 [\u0026amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\"\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eChronic stable angina prevention — recurring chest pain from reduced coronary blood flow (سینے کے درد کی روک تھام)\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eLong-term management of coronary artery disease related chest pain (دل کی شریانوں کی بیماری)\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eReducing frequency and severity of angina episodes (انجائنا کے دوروں کی تعداد اور شدت کم کرنا)\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eReducing cardiac workload in established ischaemic heart disease\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eAdjunctive therapy alongside beta-blockers or calcium channel blockers for angina control\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eHow Does it Work?\u003c\/strong\u003e Isosorbide Mononitrate releases nitric oxide in vascular smooth muscle — activating guanylate cyclase to increase cyclic GMP, causing smooth muscle relaxation and vasodilation. Venous dilation reduces blood returning to the heart, decreasing preload and cardiac workload. Coronary artery dilation simultaneously improves blood flow and oxygen delivery to heart muscle. Together these effects prevent the oxygen supply-demand mismatch responsible for angina pain. The asymmetric twice-daily dosing schedule — morning and early afternoon — maintains effective daytime protection while creating a nitrate-free overnight interval that prevents tolerance.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eDosage and Administration\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e⚠️ Never take doses evenly spaced — doses must be taken asymmetrically to preserve the nitrate-free overnight interval. Never crush or chew. Never stop suddenly after long-term use. This tablet does NOT treat acute angina attacks — always carry a fast-acting sublingual nitrate for acute episodes.\u003c\/p\u003e\n\u003cdiv class=\"overflow-x-auto w-full px-2 mb-6\"\u003e\n\u003ctable class=\"min-w-full border-collapse text-sm leading-[1.7] whitespace-normal\"\u003e\n\u003cthead class=\"text-left\"\u003e\n\u003ctr\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eIndication\u003c\/th\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eUsual Adult Dose\u003c\/th\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eTiming\u003c\/th\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eNotes\u003c\/th\u003e\n\u003c\/tr\u003e\n\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eChronic stable angina\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003e20 – 40mg\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eFirst dose on waking\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eSwallow whole with water\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eChronic stable angina\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003e20 – 40mg\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eSecond dose 7 hours later\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eNever take evening dose — preserves nitrate-free interval\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eSevere angina\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eUp to 40mg twice daily\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAs above timing\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAdjusted by cardiologist\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003c\/div\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eActive Ingredients\u003c\/strong\u003e\u003c\/p\u003e\n\u003cdiv class=\"overflow-x-auto w-full px-2 mb-6\"\u003e\n\u003ctable class=\"min-w-full border-collapse text-sm leading-[1.7] whitespace-normal\"\u003e\n\u003cthead class=\"text-left\"\u003e\n\u003ctr\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eIngredient\u003c\/th\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eStrength\u003c\/th\u003e\n\u003c\/tr\u003e\n\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eIsosorbide Mononitrate\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003e40mg\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003c\/div\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eWho Should NOT Take Monis 40mg?\u003c\/strong\u003e\u003c\/p\u003e\n\u003cul class=\"[li_\u0026amp;]:mb-0 [li_\u0026amp;]:mt-1 [li_\u0026amp;]:gap-1 [\u0026amp;:not(:last-child)_ul]:pb-1 [\u0026amp;:not(:last-child)_ol]:pb-1 list-disc flex flex-col gap-1 pl-8 mb-3\"\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eAllergy to Isosorbide Mononitrate, any organic nitrate, or nitrite compound\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eCurrently taking PDE-5 inhibitors — Sildenafil (Viagra), Tadalafil, or Vardenafil — life-threatening blood pressure drop\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eSevere hypotension — systolic blood pressure below 90mmHg\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eHypovolaemia — significant dehydration or blood loss\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eSevere anaemia\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eHypertrophic obstructive cardiomyopathy\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eConstrictive pericarditis or cardiac tamponade\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eClosed-angle glaucoma\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eSevere liver impairment\u003c\/li\u003e\n\u003cli class=\"whitespace-normal break-words pl-2\"\u003eAcute myocardial infarction with low filling pressures — specialist assessment required\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eSide Effects\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cem\u003eCommon:\u003c\/em\u003e Throbbing headache — most common especially when starting treatment (سر درد — عام طور پر چند دنوں میں کم ہو جاتا ہے), facial flushing and warmth (گرمی کا احساس), dizziness especially on standing quickly, mild nausea, mild weakness — most side effects reduce after the first few days as the body adjusts.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cem\u003eSerious — Stop and seek emergency help immediately:\u003c\/em\u003e Severe sudden drop in blood pressure with fainting — particularly if PDE-5 inhibitor taken (بلڈ پریشر کا اچانک گرنا — فوری ہسپتال جائیں), methaemoglobinaemia — bluish discolouration of lips and fingertips with breathing difficulty (ہونٹوں کا نیلا ہونا — فوری مدد لیں), severe persistent headache unresponsive to Paracetamol, worsening frequency of angina attacks suggesting tolerance development, severe allergic reaction with widespread rash and facial swelling.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eDrug Interactions\u003c\/strong\u003e\u003c\/p\u003e\n\u003cdiv class=\"overflow-x-auto w-full px-2 mb-6\"\u003e\n\u003ctable class=\"min-w-full border-collapse text-sm leading-[1.7] whitespace-normal\"\u003e\n\u003cthead class=\"text-left\"\u003e\n\u003ctr\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eMedicine\u003c\/th\u003e\n\u003cth scope=\"col\" class=\"text-text-100 border-b-0.5 border-border-300\/60 py-2 pr-4 align-top font-bold\"\u003eInteraction\u003c\/th\u003e\n\u003c\/tr\u003e\n\u003c\/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003ePDE-5 inhibitors (Sildenafil, Tadalafil, Vardenafil)\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eLife-threatening severe hypotension — absolutely contraindicated; never combine under any circumstances\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAntihypertensives \/ beta-blockers \/ calcium channel blockers\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAdditive blood pressure lowering — increased hypotension and dizziness risk\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eOther nitrates (sublingual GTN)\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAdditive vasodilation — monitor blood pressure carefully during acute use\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eDihydroergotamine\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eNitrates increase Ergotamine absorption — increased vasospasm risk\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAntidepressants (TCAs)\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAdditive hypotensive effect — increased dizziness and fainting risk\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eHeparin\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eIsosorbide Mononitrate may reduce Heparin anticoagulant effect — monitor closely\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eAlcohol (شراب)\u003c\/td\u003e\n\u003ctd class=\"border-b-0.5 border-border-300\/30 py-2 pr-4 align-top\"\u003eSeverely increases vasodilation and hypotension risk — avoid completely\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003c\/div\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eStorage:\u003c\/strong\u003e Store below 25°C in a cool, dry place. Protect from moisture and direct sunlight. Keep in original packaging. Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں). Do not use after expiry date.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eFAQs\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eQ: Why must Monis 40mg doses be taken asymmetrically rather than evenly spaced?\u003c\/strong\u003e Even spacing of nitrate doses maintains continuous nitrate exposure — causing the body to develop tolerance within 24 hours where the medicine loses its effectiveness completely. Taking both doses in the first half of the day creates a natural nitrate-free overnight interval that preserves full effectiveness the next morning.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eQ: Can Monis 40mg be used instead of sublingual GTN during an acute chest pain attack?\u003c\/strong\u003e No — Monis 40mg is a slow-acting prevention medicine only. It cannot relieve an acute angina attack. Always carry a fast-acting sublingual nitrate spray or tablet as prescribed by your cardiologist for immediate treatment of sudden chest pain.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cstrong\u003eQ: What is the difference between Monis 40mg and Monis XR 60mg?\u003c\/strong\u003e Monis 40mg is standard-release requiring careful asymmetric twice-daily dosing to preserve the nitrate-free interval. Monis XR 60mg is extended-release — taken once daily in the morning, it gradually releases medicine throughout the day while naturally providing a nitrate-free overnight interval without requiring dose timing management.\u003c\/p\u003e\n\u003cp class=\"font-claude-response-body break-words whitespace-normal leading-[1.7]\"\u003e\u003cem\u003e\u003cstrong\u003eMedical Disclaimer:\u003c\/strong\u003e This information is for general awareness only and does not replace medical advice. Always consult a qualified doctor or pharmacist before taking any prescription medicine.\u003c\/em\u003e\u003c\/p\u003e","brand":"Upper Lines Pharmacy","offers":[{"title":"Default Title","offer_id":50985510830395,"sku":"ULP-0618-40mg","price":650.0,"currency_code":"PKR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0950\/5885\/4203\/files\/MonisTablets40mg.webp?v=1771862456","url":"https:\/\/upperlines.com.pk\/products\/monis-tablets-40mg","provider":"Upper Lines Pharmacy","version":"1.0","type":"link"}