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Isosorbide mononitrate


Mechanism of action:

Isosorbide mononitrate is an organic nitrate vasodilator. After entering the body, it is enzymatically converted within vascular smooth muscle to release nitric oxide (NO). Nitric oxide stimulates soluble guanylate cyclase, increasing cGMP levels. cGMP promotes dephosphorylation of myosin light chains and reduces the effect of calcium on contractile proteins, leading to relaxation of vascular smooth muscle. This causes venous dilation, reduces venous return, lowers ventricular wall tension, and decreases myocardial oxygen demand.

Reference(s):

1. Munzel T et al. (2014). Organic nitrates: update on mechanisms underlying vasodilation, tolerance and endothelial dysfunction. Vascul Pharmacol. 


2. Abshagen UW et al. (1992). Pharmacokinetics of isosorbide mononitrate. Am J Cardiol.

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