MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Nitrates

NICE Guidance

  CG126: Management of stable angina, updated Aug 2016

Nitrate tolerance - this can occur with all nitrates. In order to minimise this use a dosing regimen which includes an 8 hour nitrate-free interval corresponding to the least symptomatic part of the 24 hour period (usually at night). Isosorbide mononitrate modified-release tablets are formulated to give a nitrate-free period.

Isosorbide mononitrate standard-release tablets should be given twice daily 6-8 hours apart eg morning and early afternoon to avoid nitrate tolerance.

 Guidance for switching between isosorbide preparations

Pack Price
100 tablet
56 tablet £0.97
60 tablet
84 tablet
Pack Price
100 tablet
50 tablet
56 tablet £0.95
60 tablet
84 tablet
Pack Price
28 tablet £10.50
30 tablet
60 tablet
Pack Price
28 tablet £6.75
Pack Price
28 tablet £6.75
30 tablet