Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Isosorbide mononitrate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
for
Elantan LA belongs to a group of medicines called organic nitrates. Organic nitrates work by widening the blood vessels in your heart to allow an increased amount of blood to flow to areas which need it. Elantan LA is used to prevent angina pectoris. Angina usually feels like a tight pain in the chest, neck or arm area. The pain comes from the heart muscle and is a sign that part of it is not getting enough oxygen for the amount of work it is doing.
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e Elantan LA
Do not take Elantan LA if: You are allergic to isosorbide mononitrate, other nitrates or any of the other ingredients of this medicine (listed in section 6) You have an acute heart attack episode (acute myocardial infarction) Your blood is not circulating around your body properly (circulatory failure) You are suffering from "shock" or collapse of the blood vessels You are suffering from any of the following heart conditions: o hereditary thickened heart muscle (hypertrophic obstructive cardiomyopathy [HOCM]) o inflammation of the protective sac surrounding the heart (constrictive pericarditis) o build-up of fluid between the heart and its protective sac (cardiac tamponade) o low heart (cardiac) filling pressures o narrowing of the valves in the heart (aortic/mitral valve stenosis) o diseases associated with raised pressure inside the head (intra-cranial pressure) You suffer from reduction in red blood cells which can make the skin pale and cause weakness or breathlessness (severe anaemia) You have bleeding in the brain (brain haemorrhage) You have a head injury (trauma) You have severely low blood volume (hypovolaemia) You have severely low blood pressure 1
You take sildenafil (Viagra) or any other phosphodiesterase-5 (PDE-5) inhibitor drugs used for erectile dysfunction such as tadalafil and vardenafil You have an eye disease called closed angle glaucoma You take products that contain riociguat, a medicine used in treating pulmonary hypertension.
If any of the above applies to you talk to your doctor or pharmacist. Warnings and precautions Elantan LA is not suitable for the treatment of suddenly occurring chest pain (e.g. acute angina pectoris attack). In the event of an angina attack, an under-the-tongue (sublingual) treatment, such as GTN (glyceryl trinitrate) spray or tablet should be used instead of Elantan LA. Talk to your doctor or pharmacist before taking Elantan LA: if you have a recent history of heart attack, or the left side of your heart is not working properly. It is important that blood pressure does not fall too low if you suffer from low blood pressure (hypotension) as nitrates can further decrease it, or cause low blood pressure upon standing if you have an underactive thyroid gland if you are severely underfed (malnourished) if you have severe liver or severe kidney disease if you suffer from a very low body temperature (hypothermia) if you suffer from very poor blood circulation if you have slower than normal bowel movements if you have an abnormally low level of oxygen in the blood and impaired gas exchange due to lung disease or ischaemic heart failure if you are lactose intolerant, as Elantan LA contains lactose. Organic nitrates have been shown to stop working or become less effective if they are taken continuously at high doses. It is important to closely follow the dosing instructions to avoid this. Treatment with Elantan LA should not be stopped suddenly. Talk to your doctor before stopping Elantan LA (see section 3). During treatment with Elantan LA you must not take medicinal products that contain PDE-5 inhibitors (e.g. sildenafil, tadalafil, vardenafil) for the treatment of erectile dysfunction (see section Other medicines and Elantan LA). During treatment with Elantan LA, drinking alcohol should be avoided because alcohol can enhance the blood-pressure-lowering effect of Elantan LA (see section Elantan LA with food, drink and alcohol). Other medicines and Elantan LA Do not take Elantan LA with PDE-5 inhibitors such as sildenafil (Viagra) used for erectile dysfunction. Using Elantan LA with these medicines could cause your blood pressure to fall to a dangerously low level. You must not stop taking Elantan LA to take PDE-5 inhibitors as this will increase your chances of having an angina attack. Do not take Elantan LA with products that contain riociguat, a medicine used in treating pulmonary hypertension. Tell your doctor or pharmacist if you are taking, have recently taken or might take any of the following medicines: Medicines to lower your blood pressure such as beta-blockers, calcium channel blockers, vasodilators, alprostadil, aldesleukin, angiotensin II receptor antagonists Monoamine oxidase inhibitors (used to treat depression) 2
Tricyclic antidepressants (used to treat depression) and neuroleptics (used to treat anxiety) Ergotamine used for migraine Sapropterin used for phenylketonuria (PKU) Any other medicine, including medicines obtained without a prescription.
Alcohol may also potentiate the lowering of blood pressure effect of nitrates. Elantan LA with food, drink and alcohol Do not drink alcohol. It could increase the effect of Elantan LA and lower your blood pressure too much. If this happens, you may feel dizzy or faint. Pregnancy and breast-feeding If you are pregnant, or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Driving and using machines If you have blurred vision or feel dizzy or tired while taking Elantan LA, do not drive or operate machinery. This effect may be increased by alcohol use (see Elantan LA with food, drink and alcohol). Elantan LA contains lactose and sucrose If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
3.
Elantan LA
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Important: Your doctor will choose the dose that is right for you. Your dose will be shown clearly on the label that your pharmacist puts on your medicine. If it does not, or you are not sure, ask your doctor or pharmacist. Adults The usual adult dose is one capsule once a day, in the morning. If your doctor increases your dose to two capsules, you should take them together in the morning. To remove the capsule from the packaging, carefully push one end of the capsule through the foil. If you push in the middle you may damage the capsule. Swallow the capsule whole with a drink of water. Do not use Elantan LA to treat an actual angina attack. Your doctor will give you a different medicine such as a GTN (glyceryl trinitrate) spray or tablet for this. A reduced effect during use of this type of medicine has occurred in some patients, so intermittent treatment may be more suitable. Your doctor will decide the most suitable dosing for you. Treatment with Elantan LA should not be stopped suddenly; the dosage and frequency should be gradually decreased. Talk to your doctor before stopping Elantan LA. Use in children This medicine is not suitable for children.
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If you take more Elantan LA than you should Do not take more Elantan LA than you should. If you accidentally take too much, immediately contact the nearest hospital casualty department or your doctor. Symptoms of taking too much Elantan LA may include a decrease in blood pressure, paleness, diarrhoea, sweating, weak pulse, rapid heartbeat, headache, weakness, feeling sick, vomiting, feeling faint or dizzy. Taking too much Elantan LA may cause a change in red blood cells (methaemoglobinemia), potentially resulting in bluish discolouration of the skin, which may be followed by rapid breathing, anxiety, unconsciousness and heart attack. This is a possible reaction to Elantan LA and similar medicines, due to the way they are changed when they are absorbed into the body. If you have any of these symptoms, lie on your back and position your feet so that they are higher than your head. Contact a doctor or a hospital immediately. The doctor can decide on the actions that must be taken according to the severity of the overdose and the nature of the discomfort. Take this package leaflet or the Elantan LA package with you so that the doctor knows which medicine you have taken. A very large overdose could cause an increase in the pressure in the head, a coma or collapse and require immediate resuscitation. If you forget to take Elantan LA Do not take a double dose to make up for a forgotten dose. Take your next dose at the usual time. If you stop taking Elantan LA Do not stop taking Elantan LA without first talking to your doctor. You should keep taking your medicine until your doctor tells you to stop. Do not stop taking it just because you feel better. If you stop taking the medication your condition may get worse. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4.
Like all medicines, this medicine can cause side effects, although not everybody gets them. Seek immediate medical help if you have any of the following symptoms: Fainting or collapse Severe decrease in blood pressure (hypotension), with nausea, vomiting, restlessness, looking pale and excessive sweating, which have been reported during treatment with organic nitrates. Increased chest pain, which may occur due to a lack of oxygen to the heart muscle and areas around the chest. Very common side effects (affects more than 1 in 10 people): Headache Common side effects (affects less than 1 in 10 people): Dizziness Sleepiness Feeling weak Fast heartbeat Lowering of blood pressure when standing up. They may occur for the first few days of treatment or after your dosage has been increased. 4
Uncommon side effects (affects less than 1 in 100 people): Fainting or collapse Feeling sick or being sick Skin rashes Flushing Increase in chest pain/angina Blood vessel collapse (possibly together with slow abnormal heart rate and sudden loss of consciousness). Very rare side effects (affects less than 1 in 10,000 people): Heartburn Other side effects (frequency unknown): Red or scaly skin (exfoliative dermatitis) Low blood pressure Swelling of the skin. Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.
5.
Elantan LA
Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton. The expiry date refers to the last day of that month. Do not store above 30°C. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
6.
What Elantan LA contains The active substance is isosorbide mononitrate. Each capsule contains 50 mg of isosorbide mononitrate. The other ingredients are lactose monohydrate, purified talc, ethyl cellulose, macrogol 20,000, hydroxypropyl cellulose, sucrose, corn starch, gelatin, titanium dioxide, iron oxide red (E172), iron oxide black (E172). What Elantan LA looks like and contents of the pack Elantan LA 50 mg is a hard capsule with brown opaque cap and flesh opaque body, containing white to off-white pellets. They come in blister packs of 28 capsules.
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Marketing Authorisation Holder Norgine Pharmaceuticals Limited ARC Uxbridge, Building 01, Sanderson Road, Uxbridge, UB8 1DH, UK Manufacturer Aesica Pharmaceuticals GmbH Alfred Nobel Strasse 10, D-40789, Monheim, Germany This leaflet was last revised in March 2025. If this leaflet is difficult to see or read or you would like it in a different format, please contact Norgine Pharmaceuticals Limited ARC Uxbridge, Building 01, Sanderson Road, Uxbridge, UB8 1DH, UK
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Elantan LA 50 mg prolonged release capsules comes as capsule containing 50mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Elantan LA 50 mg prolonged release capsules is isosorbide mononitrate.
This leaflet reproduces the patient information leaflet approved for Elantan LA 50 mg prolonged release capsules, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
For the prophylaxis of angina pectoris
Posology
Adults
One capsule to be taken in the morning. For patients with higher nitrate requirements the dose may be increased to two capsules taken simultaneously. The lowest effective dose should be used.
Elderly
There is no evidence to suggest an adjustment of dosage is necessary.
Paediatric population
The safety and efficacy of Elantan LA has yet to be established in children.
Method of administration
For oral administration
Attenuation of effect has occurred in some patients being treated with prolonged release preparations. In such patients intermittent therapy may be more appropriate (see section 4.4).
Treatment with Elantan LA, as with any other nitrate, should not be stopped suddenly. Both dosage and frequency should be tapered gradually (see section 4.4).
Hypersensitivity to the active substance, other nitrates or to any of the excipients listed in section 6.1.
The capsules should not be used in cases of acute myocardial infarction with low filling pressure, acute circulatory failure, (shock, vascular collapse), or very low blood pressure, hypertrophic obstructive cardiomyopathy (HOCM), constrictive pericarditis, cardiac tamponade, low cardiac filling pressures, aortic/mitral valve stenosis, and diseases associated with a raised intra-cranial pressure e.g. following a head trauma and including a cerebral haemorrhage.
Elantan LA should not be used in patients with severe anaemia, closed angle glaucoma, severe hypotension or severe hypovolaemia.
Phosphodiesterase type-5 inhibitors (e.g. sildenafil, tadalafil and vardenafil) have been shown to potentiate the hypotensive effects of nitrates, and their co-administration with nitrates or nitric oxide donors is therefore contraindicated (see section 4.4 and 4.5).
During nitrate therapy, the soluble guanylate cyclase stimulator riociguat must not be used (see section 4.5).
The capsules should be used with caution in patients who have a recent history of myocardial infarction or low filling pressures e.g. in acute myocardial infarction, impaired left ventricular function (left ventricular failure). Reducing systolic blood-pressure below 90 mmHg must be avoided. Also in patients who are suffering from hypothyroidism, hypothermia, malnutrition, severe liver disease or severe renal disease.
Symptoms of circulatory collapse may arise after first dose, particularly in patients with labile circulation.
This product may give rise to symptoms of postural hypotension and syncope in some patients. Severe postural hypotension with light-headedness and dizziness is frequently observed after the consumption of alcohol.
Hypotension induced by nitrates may be accompanied by paradoxical bradycardia and increased angina.
Elantan LA capsules contain lactose. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Due to the presence of sucrose, patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.
In the event of an acute angina attack, a sublingual treatment such as a GTN spray or tablet should be used instead of Elantan LA capsules.
The development of tolerance (decrease of efficacy) as well as cross tolerance towards other nitrate-type drugs (decrease in effect in case of a prior therapy with another nitrate drug) has been described. Continuously high dosages should be avoided.
In some patients being treated with prolonged release preparations, attenuation of effect is observed. In such patients, intermittent therapy may be more appropriate. The lowest effective dose should be used.
Treatment of Elantan LA, as with any other nitrate, should not be stopped suddenly. Both the dosage and frequency should be tapered gradually (See section 4.2).
In patients with decreased gastrointestinal transit time, a decrease in release of the active ingredient may occur.
Patients who undergo a maintenance treatment with Elantan should be informed that they must not use phosphodiesterase inhibitor-containing products (e.g. sildenafil, tadalafil, vardenafil).
Elantan therapy should not be interrupted to take phosphodiesterase inhibitor-containing products (e.g. sildenafil, tadalafil, vardenafil), because the risk of inducing an attack of angina pectoris could increase by doing so (see Section 4.3 and 4.5).
Hypoxaemia
Caution should be exercised in patients with hypoxaemia and ventilation/perfusion imbalance due to lung disease or ischaemic heart failure. As a potent vasodilator, isosorbide mononitrate (ISMN) could result in increased perfusion of poorly ventilated areas, worsening of the ventilation/perfusion imbalance, and a further decrease in the arterial partial pressure of oxygen.
During treatment with ISMN alcohol should be avoided as it may potentiate the hypotensive and vasodilating effect of ISMN (see section 4.5).
Concurrent administration of drugs with blood pressure lowering properties, e.g. beta-blockers, calcium channel blockers, vasodilators, alprostadil, aldesleukin, angiotensin II receptor antagonists, ACE-inhibitors, monoamine oxidase inhibitors etc and/or alcohol may potentiate the hypotensive effect of Elantan LA. This may also occur with neuroleptics and tricyclic antidepressants.
The concurrent intake of ISMN with ACE-inhibitors or arterial vasodilators could be a desirable interaction unless the antihypertensive effects are excessive in which case consider reducing the dose of one or both drugs.
Any blood pressure lowering effect of Elantan LA will be increased, if used together with phosphodiesterase type-5 inhibitors which are used for erectile dysfunction (seesections 4.3 and 4.4). This might lead to life threatening cardiovascular complications. Patients who are on Elantan LA therapy therefore must not use phosphodiesterase type-5 inhibitors (e.g. sildenafil, tadalafil, vardenafil).
Reports suggest that concomitant administration of Elantan LA may increase the blood level of dihydroergotamine and its hypertensive effect.
Sapropterine (Tetrahydrobiopterine, BH4) is a cofactor for nitric oxide sythetase. Caution is recommended during concomitant use of saproterine-containing medicine with all agents that cause vasodilation by affecting nitric oxide (NO) metabolism or action, including classical NO donors (e.g. glyceryl trinitrate (GTN)), isosorbide dinitrate (ISDN), isosorbide 5-mononitrate (5-ISMN) and others).
The use of isosorbide mononitrate with riociguat, a soluble guanylate cyclase stimulator, is contraindicated (see section 4.3) since concomitant use can cause hypotension.
Pregnancy
No data have been reported which would indicate the possibility of adverse effects resulting from the use of isosorbide mononitrate in pregnancy. Safety in pregnancy, however, has not been established. Isosorbide mononitrate should only be used in pregnancy and during lactation if, in the opinion of the physician, the possible benefits outweigh the possible hazards.
Breast-feeding
It is not known whether nitrates are excreted in human milk and therefore caution should be exercised when administered to nursing women.
Fertility
There is no data available on the effect of isosorbide mononitrate on fertility in humans.
Dizziness, tiredness or blurred vision may occur at the start of treatment. The patient should therefore be advised that if affected, they should not drive or operate machinery. This effect may be increased by alcohol.
Undesirable effects frequencies are defined as: very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data).
During administration of Elantan LA the following undesirable effects may be observed:
Nervous system disorders:
• very common: headache,
• common: dizziness (including dizziness postural), somnolence.
Cardiac disorders:
• common: tachycardia,
• uncommon: angina pectoris aggravated.
Vascular disorders:
• common: orthostatic hypotension,
• uncommon: circulatory collapse (sometimes accompanied by bradyarrhythmia and syncope).
• not known: hypotension
Gastrointestinal disorders:
• uncommon: nausea, vomiting,
• very rare: heartburn.
Skin and subcutaneous tissue disorders:
• uncommon: allergic skin reactions (e.g. rash), flushing,
• not known: dermatitis exfoliative.
Immune system disorders:
• not known: angioedema
General disorders and administration site conditions:
• common: asthenia.
Severe hypotensive responses have been reported for organic nitrates and include nausea, vomiting, restlessness, pallor and excessive perspiration.
During treatment with Elantan LA, a temporary hypoxemia may occur due to a relative redistribution of the blood flow in hypoventilated alveolar areas. Particularly in patients with coronary artery disease this may lead to a myocardial hypoxia.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Animal experience:
In rats and mice, significant lethality at oral doses of 1965 mg/kg and 2581 mg/kg, respectively, was observed.
Human experience:
Symptoms:
- Fall of blood pressure ≤ 90 mmHg
- Paleness
- Sweating
- Weak pulse
- Tachycardia
- Light-headedness on standing
- Headache
- Weakness
- Dizziness
- Nausea
- Vomiting
- Diarrhoea
Methaemoglobinaemia has been reported in patients receiving other organic nitrates. During isosorbide mononitrate biotransformation nitrite ions are released, which may induce methaemoglobinaemia and cyanosis with subsequent tachypnoea, anxiety, loss of consciousness and cardiac arrest. It cannot be excluded that an overdose of isosorbide mononitrate may cause this adverse reaction.
In very high doses the intracranial pressure may be increased. This might lead to cerebral symptoms.
General procedure:
• Stop intake of the drug
• General procedures in the event of nitrate-related hypotension
o
Patients should be kept horizontal with the head lowered and legs raised
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Supply oxygen
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Expand plasma volume (i.v. fluids)
o
Specific treatment for shock (admit patient to intensive care unit)
Special procedure:
• Raising the blood pressure if the blood pressure is very low.
• Treatment of methaemoglobinaemia
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Reduction therapy of choice with vitamin C, methylene-blue or toluidine-blue
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Administer oxygen (if necessary)
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Initiate artificial ventilation
o
Hemodialysis (if necessary)
• Resuscitation measures
In case of signs of respiratory and circulatory arrest, initiate resuscitation measures immediately.
Ask anything about Elantan LA 50 mg prolonged release capsules. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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