Isosorbide mononitrate 20 mg: uses, price & cheaper substitutes
Prescription required (Schedule H)
Common uses: Preventing angina (chest pain on exertion) in people with coronary artery disease; Reducing how often angina attacks happen and improving exercise tolerance.
Listed MRPs range from ₹0.75 to ₹5.05 per tablet across 7 listings. Use only on a doctor's prescription.
Price comparison
| Brand | Manufacturer | Pack | MRP | ₹ / tablet | As on |
|---|---|---|---|---|---|
| Isosorbidemononitrate Tablets IP 20mgJan Aushadhi | Jan Aushadhi (PMBJP) | 10 | ₹7.50 | ₹0.75 | 19 October 2026 |
| Isonorm 20 | Lupin Ltd | 10 | ₹32.45 | ₹3.25 | 19 October 2026 |
| Numotrate 20 | Emcure Pharmaceuticals Ltd | 10 | ₹35.63 | ₹3.56 | 19 October 2026 |
| Isotrate 20 | Knoll Pharmaceuticals Ltd | 10 | ₹37.03 | ₹3.70 | 19 October 2026 |
| Ismo 20 | Abbott | 30 | ₹138.73 | ₹4.62 | 19 October 2026 |
| Monotrate 20 | Sun Pharmaceutical Industries Ltd | 10 | ₹49.00 | ₹4.90 | 19 October 2026 |
| Monit 20 | Intas Pharmaceuticals Ltd | 15 | ₹75.80 | ₹5.05 | 19 October 2026 |
MRPs as printed/listed on the date shown; actual price may vary.
Uses
- Preventing angina (chest pain on exertion) in people with coronary artery disease.
- Reducing how often angina attacks happen and improving exercise tolerance.
- Heart failure, along with other medicines, on a cardiologist's advice.
How to take it
Take the 20 mg tablet twice a day, usually in the morning and about 7 to 8 hours later in the early afternoon – not evenly 12 hours apart. This uneven gap gives the body a nitrate-free period overnight so the medicine keeps working; a cardiologist decides the exact timing. Swallow it whole with water, with or without food. It prevents angina but does not stop an attack that has already started – keep your sorbitrate or nitroglycerin tablet under the tongue for that. Do not stop suddenly, as angina can return worse.
Side effects
Common
- Headache, often in the first 1 to 2 weeks, then easing.
- Dizziness or light-headedness, especially on standing.
- Flushing of the face.
- Nausea.
- Fast heartbeat.
Serious
Stop and get medical help urgently if you notice any of these.
- Fainting or very low blood pressure.
- Chest pain that is getting more frequent, severe or lasts longer – seek urgent care.
- Severe allergic reaction – rash, swelling, breathlessness.
- Bluish lips or fingers with breathlessness (very rare).
Safety information
Alcohol
Avoid alcohol. It widens blood vessels further and can cause a sharp drop in blood pressure and fainting.
Pregnancy
Tell your doctor if you are pregnant or breastfeeding; it is used only when clearly needed.
Kidney problems
No routine dose change, but tell your doctor about kidney disease.
Liver problems
Tell your doctor about liver disease.
Children
Not used in children.
Missed dose
Take it as soon as you remember unless the next dose is nearly due – then skip it. Never double the dose.
Interactions
- Sildenafil (Viagra), tadalafil, vardenafil – never combine; the blood pressure can fall dangerously. Keep a gap of at least 24 to 48 hours and tell any doctor you take a nitrate.
- Blood pressure medicines (amlodipine, telmisartan, metoprolol) – more dizziness; doses may be adjusted.
- Riociguat – do not combine.
- Antidepressants like amitriptyline, and antipsychotics – more dizziness and low blood pressure.
- Migraine medicines (ergotamine) – may counter the effect.
Frequently asked questions
When should I take Monotrate 20?
Usually twice a day with an uneven gap – for example on waking and again in the early afternoon. The long nitrate-free gap overnight stops the body getting used to the medicine. Follow the timing your cardiologist gave.
Can I take Monotrate 20 during a chest pain attack?
No. Isosorbide mononitrate prevents attacks; it is too slow to stop one. Use your under-the-tongue nitroglycerin or sorbitrate and seek emergency help if pain lasts more than a few minutes.
Can I take Viagra with Monotrate 20?
No. Sildenafil, tadalafil and similar tablets with any nitrate can cause a dangerous collapse in blood pressure. Tell your doctor about all medicines before using them.
Why do I get a headache on Ismo 20?
Headache is the commonest effect because nitrates widen blood vessels. It usually settles in 1 to 2 weeks; paracetamol helps. Do not stop the tablet without your doctor.
Can I take Monotrate 20 with alcohol?
Avoid it. Alcohol adds to the blood pressure drop and can make you faint.
Monotrate 20 vs Monotrate OD 30 – what is the difference?
Monotrate 20 is a plain tablet taken twice daily. OD/SR versions are long-acting, taken once a day in the morning. Do not swap between them without your cardiologist.
Is Ismo 20 safe in pregnancy?
Tell your doctor if you are pregnant or planning to be. It is used in pregnancy only when the heart condition clearly needs it.
Can I stop Monotrate once my chest pain is gone?
No. The pain is controlled because of the tablet, and stopping suddenly can bring back angina. Only your cardiologist should change it.
Is isosorbide mononitrate 20 available at Jan Aushadhi?
Yes, it is listed under the Jan Aushadhi scheme. A prescription is needed and the timing schedule should be kept the same as with your current brand.
Sources
- MedlinePlus – Isosorbide (19 October 2026)
- NPPA Pharma Sahi Daam (ceiling prices) (19 October 2026)
- PMBI Jan Aushadhi Product & MRP List (19 October 2026)
Medyzen Editorial Team · Last updated
This page is general information, not medical advice. Do not start, stop or change a medicine without asking a doctor or pharmacist. Terms