Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Monosorb XL 60mg Prolonged-Release Tablets
⚠ This medicine appears to have been discontinued
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.
What it is and what it is used for
FOR MONOSORB XL 60mg Prolonged release Tablets (referred to as MONOSORB XL 60mg throughout this leaflet) contains the active substance called isosorbide mononitrate. This belongs to a group of medicines called 'nitrates'.
- It is used to prevent chest pain (angina). Angina is a crushing pain or tightness in the chest, although the pain may also be felt in the neck or arm. The pain happens when the muscle in the heart does not receive enough oxygen for the work it has to do.
- It works by making the blood vessels relax and widen. This makes it easier for the heart to pump blood around the body, improving the supply of blood and oxygen to the heart muscle. The tablets are made so that they release the medicine slowly over a number of hours.
What you need to know before you take it
E MONOSORB XL 60mg DO NOT use these tablets to treat sudden chest pain (acute angina). Instead seek immediate medical attention. These tablets work too slowly to treat this and are only used to prevent symptoms of angina from happening. Do not take MONOSORB XL 60mg:
- If you are allergic to isosorbide mononitrate or any of the other ingredients of this medicine (listed in Section 6).
- If you have ever had a stroke.
- If you have very low blood pressure.
- If you have severe anaemia.
- If you have a heart problem called 'cardiomyopathy' or 'pericarditis' or you have narrow heart valves.
- If you are taking sildenafil or similar medicines called Phosphodiesterase Type 5 Inhibitors, (used for male impotence). See the section "Other medicines and Monosorb XL 60mg". Isosorbide mononitrate should not be used in
patients with acute myocardial infarction with low filling pressure, head trauma, cerebral haemorrhage and severe hypotension or hypovolaemia. Do not take Monosorb XL 60mg if any of the above apply to you. If you are not sure, talk to your doctor or pharmacist before taking Monosorb XL 60mg. WARNINGS AND PRECAUTIONS Talk to your doctor or pharmacist before taking Monosorb XL 60mg:
- If you suffer from an under-active thyroid gland.
- If you have hypoxaemia (low oxygen level in your blood, due to lung disease for example).
- If you suffer from hypothermia (symptoms include shivering, abnormal drowsiness, confusion).
- If you suffer from malnutrition.
- If you suffer from severe liver or renal disease. Other medicines and Monosorb XL 60mg Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines that you buy without a prescription and herbal medicines. This is because Monosorb XL 60mg can affect the way some medicines work and some medicines can have an effect on Monosorb XL 60mg. Do not take Monosorb XL 60mg if you are taking the following medicines:
- Sildenafil or similar medicines called Phosphodiesterase Type 5 inhibitors, (used for male impotence). If you take one of these drugs for erectile dysfunction, taking nitrate preparations such as MONOSORB XL 60 mg as well can cause a severe and possibly dangerous fall in blood pressure. This could result in fainting, or even worse, in a heart attack. The following medicines may interfere with the way MONOSORB XL 60 mg works:
- noradrenaline (norepinephine) (used to treat sharp and severe drop in blood pressure)
- acetylcholine (used to shrink the pupil of the eye during cataract surgery and other types of eye surgery)
- histamine (used mostly as a diagnostic agent in some medical conditions)
- any drugs used to treat high blood pressure (e.g. beta-blockers, calcium channel blockers, vasodilators, angiotensin II receptor antagonists, ACE inhibitors). Taking MONOSORB XL 60 mg with alcohol Avoid drinking alcohol while taking MONOSORB XL 60 mg, as the side-effect of low blood pressure may be worse than normal and you may feel dizzy or faint. Pregnancy, breast-feeding and fertility If you are pregnant or breast feeding, think you may be pregnant or are planing to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Driving and using machines You may experience headache or feel dizzy after taking Monosorb XL 60mg. If this happens, do not drive or use any tools or machines.
MONOSORB XL 60mg contains lactose and sucrose If you have been told by your doctor that you have intolerance to one of more sugars, contact your doctor before taking this medicinal product.
Hypotension with symptoms such as dizziness and nausea with syncope in isolated cases, has occasionally been reported. These symptoms generally disappear during continued treatment.
How to take it
MONOSORB XL 60 mg Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Common (may affect up to 1 in 10 people)
- Low blood pressure. This may make you feel faint or dizzy.
- Faster heartbeat
- Headache
- Feeling dizzy
- Feeling sick (nausea).
Taking this medicine
- The tablets can be divided into equal doses.
- Take the tablets with half a glass of water.
- Do not crush or chew the tablets. How much to take
- The recommended dose is one or two Monosorb XL 60mg a day.
- Take the medicine in the morning.
- Your doctor may ask you to start a low dose so you are less likely to have a reaction to starting Monosorb XL 60mg. Your dose may be from half a tablet (30mg) up to 2 tablets (120mg) a day. You must not take Monosorb XL 60mg for a sudden attack of angina. If you have a sudden attack, take a glyceryl trinitrate tablet (follow the instructions given on the label). Use in Children Do not give these tablets to children. Use in Elderly If you are an elderly person, your dosage should be the same as above, unless you suffer from low blood pressure or have a severe liver or kidney disorder – in any case you should follow your doctor's instructions. If you are already taking medication such as betablockers or calcium channel blockers, let your doctor or pharmacist know, as he/she may need to adjust your dose of MONOSORB XL 60 mg or existing treatment (see Section 2 "What you need to know before you take MONOSORB XL 60 mg"). If you take more MONOSORB XL 60mg than you should If you take more Monosorb XL 60mg Tablets than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you so the tablets can be identified. Symptoms of an overdose can include: Pounding headache, excitation, cold sweat, nausea (feeling sick), vomiting (being sick), vertigo (a feeling of dizziness or "spinning"), fainting, racing pulse. If you forget to take MONOSORB XL 60mg
- If you forget a dose, take it as soon as you remember it. However, if it is nearly time for your next dose, skip the missed dose.
- Do not take a double dose to make up for a forgotten dose. If you stop taking MONOSROB XL 60 mg Do not suddenly stop taking MONOSORB XL 60 mg tablets, as this could make your angina worse. If your treatment is to be stopped this should be done gradually. Be sure to follow your doctor's instructions. Ask your doctor or pharmacist any further questions you may have.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Headache may occur when treatment is initiated but usually disappears after 1-2 weeks of treatment.
Other possible side effects:
Uncommon (may affect up to 1 in 100 people)
- Being sick (vomiting).
- Diarrhoea Rare (may affect up to 1 in 1,000 people)
- Fainting
- Rash
- Itchy skin Very rare (may affect up to 1 in 10,000 people)
- Pain in muscles. Reporting 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.
How to store it
MONOSORB XL 60 mg
- Keep this medicine out of the sight and reach of children.
- Do not store above 25°C.
- 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 throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help to protect the environment.
Contents of the pack and other information
What MONOSORB XL 60 mg contains
- The active substance is isosorbide mononitrate. Each tablet contains 60 mg of the active substance.
- The other ingredients are hydroxypropyl methylcellulose 2208, lactose, compressible sugar (composed of sucrose and maltodextrin), magnesium stearate, silica colloidal anhydrous, ferric oxide yellow E-172. What MONOSORB XL 60mg looks like and contents of the pack MONOSORB XL 60 mg tablets are light yellow, biconvex, oval-shaped, scored on both sides and marked "DX 31" on one side. MONOSORB XL 60 mg tablets are available in packs of 28, 30 or 98 tablets in blister strips. Not all pack sizes may be marketed. Marketing Authorization Holder and Manufacturer: Dexcel®-Pharma Ltd., 2nd Floor, Bourn, 1 Manor House Drive, Coventry, CV1 2FX, UK This leaflet was last revised in November 2025 1239745115-K_ Dexcel/001680/1
Frequently asked questions about Monosorb XL 60mg Prolonged-Release Tablets
How do I take Monosorb XL 60mg Prolonged-Release Tablets?
Monosorb XL 60mg Prolonged-Release Tablets comes as tablet containing 60mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Monosorb XL 60mg Prolonged-Release Tablets?
The active substance in Monosorb XL 60mg Prolonged-Release Tablets is isosorbide mononitrate.
Are there equivalent medicines to Monosorb XL 60mg Prolonged-Release Tablets?
Medicines with the same active substance, strength and form include: Carmil XL 60 mg Tablets, Imdur Tablets 60mg, Isotard 60 mg XL Tablets. In total there are 5 equivalent products. They are interchangeable only if your prescriber or pharmacist says so.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Monosorb XL 60mg Prolonged-Release Tablets, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Monosorb XL 60mg Prolonged-Release Tablets without a prescription?
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.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: isosorbide mononitrate
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Prophylactic treatment of angina pectoris.
4.2. Posology and method of administration
Posology
Adults
Monosorb 60mg Tablets (one tablet) once daily given in the morning. The dose may be increased to 120mg (two tablets) daily, both to be taken once daily in the morning. This will produce effective nitrate blood levels during the day with low blood levels at night to prevent the development of tolerance. The dose can be titrated to minimize the possibility of headache, by initiating treatment with 30mg (half a tablet) for the first 2-4 days.
Paediatric population
The safety and efficacy of Monosorb XL 60mg Tablets in children has not yet been established.
Elderly
No evidence of a need for routine dosage adjustment in the elderly has been found, but special care may be needed in those with increased susceptibility to hypotension or marked hepatic or renal insufficiency.
There is a risk of tolerance developing when nitrate therapy is given. For this reason it is important that Monosorb XL 60mg tablets are taken once a day to achieve an interval with low nitrate concentration, thereby reducing the risk of tolerance development.
When necessary the product may be used in combination with beta-adrenoreceptor blockers and calcium antagonists. Dose adjustments of either class of agent may be necessary.
Method of administration
Monosorb XL 60mg Tablets must not be chewed or crushed. They should be swallowed with half a glass of water.
4.3. Contraindications
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Acute myocardial infarction with low filling pressure, head trauma, cerebral haemorrhage, severe hypotension or hypovolaemia
Constrictive cardiomyophaty and pericarditis, aortic stenosis, cardiac temponade, mitral stenosis and severe anaemia.
Patients treated with Monosorb XL 60mg Tablets must not be given Phosphodiesterase Type 5 Inhibitors (e.g. sildenafil).
Severe cerebrovascular insufficiency or hypotension are relative contraindications to the use of Monosorb XL 60mg Tablets.
4.4. Special warnings and precautions for use
Monosorb XL 60mg Tablets is not indicated for relief of accute angina attacks; in the event of accute attack, sublingual or buccal glyceril trinitrate tablets should be used.
Nitrates may give rise to symptoms of collapse after the first dose in patients with labile circulation. These symptoms can largely be avoided if the treatment is started with a 30 mg dose.
Other special warnings and precautions with Isosorbide mononitrate:
Hypoxaemia, Hypothyroidism, Hypothermia, Malnutrition, severe liver or renal disease.
Patients with rare hereditary problems of fructose intolerance or galactose intolerance, total lactase deficiency, sucrase-isomaltase insufficiency or glucose-galactose malabsorption should not take this medicine.
4.5. Interaction with other medicinal products and other forms of interaction
Isosorbide mononitrate may act as a physiological antagonist to noradrenaline, acetylcholine, histamine and many other agents. The effect of anti-hypertensive drugs may be enhanced. Alcohol may enhance the hypotensive effects of isosorbide mononitrate.
Concomitant administration of Monosorb XL 60mg Tablets and Phosphodiesterase Type 5 Inhibitors can potentiate the vasodilatory effect of Monosorb XL 60mg Tablets with the potential result of serious side effects such as syncope or myocardial infacrction. Therefore, Monosorb XL 60mg Tablets and Phosphodiesterase Type 5 Inhibitors (e.g. sildenafil) must not be given concomitantly.
4.6. Fertility, pregnancy and lactation
The safety and efficacy of Isosorbide Mononitrate Tablets during pregnancy or lactation has not been established. Monosorb XL 60mg should not be used during pregnancy and lactation.
4.7. Effects on ability to drive and use machines
Patients may develop headache or dizziness when first using Monosorb XL 60mg Tablets. Patients should be advised to determine how they react to Monosorb XL 60mg Tablets before they drive or use machinery.
4.8. Undesirable effects
Most of the adverse reactions are pharmacodynamically mediated and dose dependent.
Headache may occur when treatment is initiated but usually disappears after 1-2 weeks of treatment. The dose can be titrated to minimize the possibility of headache, by initiating treatment with 30mg. Hypotension with symptoms such as dizziness and nausea with syncope in isolated cases, has occasionally been reported. These symptoms generally disappear during continued treatment.
The following definitions of frequencies are used: 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) and very rare (<1/10,000).
Adverse drug reactions by frequency and system organ class (SOC)
System Organ Class
Frequency
Reaction
Nervous system disorders
Common
Headache, dizziness
Rare
Fainting
Cardiac and vascular disorders
Common
Hypotension, tachycardia
Gastrointestinal disorders
Common
Nausea
Uncommon
Vomiting, diarrhoea
Skin and subcutaneous tissue disorders
Rare
Rash, pruritus
Musculoskeletal and connective tissue disorders
Very rare
Myalgia
Reporting side effects
Reporting suspected adverse reactions after authorization of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medical product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card SchemeWebsite: www.mhra.gov.uk/yellowcard or search for MHRA Yellow card in the Google Play or Apple App Store.
4.9. Overdose
Symptoms
Pulsing headache. More serious symptoms are excitation, flushing, cold perspiration, nausea, vomiting, vertigo, syncope, tachycardia and a fall in blood pressure. Very large doses may give rise to methaemoglobinaemia (Very rare).
Treatment: In cases of cyanosis as a result of methaemoglobinaemia, methyl thionine (methylene blue) 1-2mg/Kg, slow intravenous delivery.
Management
Induction of emesis, activated charcoal. In case of pronounced hypothension the patient should first be placed in the supine position with legs raised. If necessary fluids should be administrated intravenously.
💬 Ask about this leaflet
Ask anything about Monosorb XL 60mg Prolonged-Release Tablets. 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.
Medicines containing Isosorbide mononitrate
- Carmil XL 60 mg Tablets
- Chemydur 60XL Tablets
- Elantan LA 25 mg prolonged release capsules
- Elantan LA 50 mg prolonged release capsules
- Eumon 40 XL Modified Release Tablets (Isosorbide Mononitrate)
- Imdur Tablets 60mg
- ISMO 10, 10 mg, tablets
- ISMO 20, 20 mg, tablets
- ISMO Retard, 40 mg, prolonged-release tablets
- Isodur 25XL Capsules
- Isodur 50XL Capsules
- Isosorbide Mononitrate 10 mg Tablet
- Isosorbide Mononitrate 20 mg Tablet
- Isosorbide Mononitrate 40 mg Tablet