Isosorbide mononitrate (organic nitrate)Are you sure? Long‑acting nitrates can help with angina prophylaxis, but they are not first‑line monotherapy for stable angina in a patient who has not yet tried a rate‑limiting drug. They do not address activity‑related rises in heart rate and contractility as effectively as other drugs, and tolerance develops unless a daily nitrate‑free interval is built in, which can leave periods of reduced protection. Dr. Kyriacou explains, “Nitrates are useful add‑ons or alternatives when first line drugs are not suitable. If needed later, we can add a long‑acting nitrate.” Please go back and re‑consider. |
Map: Mattias Garcia_ORU (1096)
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Review your pathway |