isosorbide mononitrate / Generic mfg. - LARVOL DELTA

Trends in Out-of-Pocket Spending for Drugs Under Medicare Part D in Coronary Artery Disease and the Impact of the Inflation Reduction Act (AHA 2025) - "C1 included ticagrelor, isosorbide mononitrate, and atorvastatin; C2 is C1 + ezetimibe; C3 is C2 +bempedoic acid; C4 is C2 + evolocumab; and C5 is C3 + icosapent ethyl and ranolazine. From 2020–2024, modest cost reductions were observed ( C5: $5,632 to $4,400). After the IRA cap in 2025, costs approached or reached $2,000 for all regimens. However, C1 and C2, previously low-cost, paradoxically saw significant OOP increases (C1: +$795, p = 0.0068; C2: +$878, p = 0.009), while C5 experienced a significant reduction (–$2,366, p = 0.005)."

Medicare • Reimbursement • US reimbursement • Cardiovascular • Coronary Artery Disease

A DOUBLE-EDGED PILL: ASPIRIN-INDUCED KOUNIS SYNDROME (CHEST 2025) - "Coronary angiography showed vasospasm in the proximal left anterior descending (90%) and distal right coronary artery (50%), completely resolving with intracoronary nitroglycerin.She was admitted to the intensive care unit and started on nitroglycerin, clopidogrel (without aspirin), diltiazem, nifedipine, and isosorbide mononitrate. Kounis syndrome should be considered in patients with acute coronary syndrome in the context of an allergic reaction. Early recognition and avoidance of the causative agent are crucial for improving outcomes."

Acute Coronary Syndrome • Asthma • Atherosclerosis • Cardiovascular • CNS Disorders • Depression • Dermatology • Eosinophilia • Immunology • Migraine • Nasal Polyps • Otorhinolaryngology • Psychiatry • Respiratory Diseases • Sinusitis • Urticaria

Statement of Retraction: Comparing vaginal misoprostol versus Foley catheter plus vaginal isosorbide mononitrate for labor induction. (PubMed, J Matern Fetal Neonatal Med) - No abstract available

Journal

ASRAB: Effect of Oral Isosorbide Mononitrate Plus Amlodipine Antispasm Therapy on Outcomes of Radial Artery Grafts After CABG (clinicaltrials.gov) - P4 | N=0 | Withdrawn | Sponsor: Ruijin Hospital | N=500 ➔ 0 | Not yet recruiting ➔ Withdrawn

Enrollment change • Trial withdrawal

Developing treatments for cerebral small vessel disease: a scoping review of licensed interventions for potential repurposing. (PubMed, F1000Res) - "Focussed literature review short-listed ten interventions for review by an independent scientific advisory group; they ranked three as most suitable for immediate testing: metformin, tadalafil and isosorbide mononitrate. The approach could be improved with partial automation, text mining and generative pre-trained transformer approaches which would help manage the large data volumes. Further, our data-driven approach could be combined with genetic or other mechanistic methods to further de-risk future trials."

Journal • Review • Alzheimer's Disease • Cardiovascular • Cognitive Disorders • Ischemic stroke • Psychiatry

Drug repurposing: isosorbide mononitrate enhances tumor accumulation to augment sonodynamic therapy for hepatocellular carcinoma. (PubMed, J Nanobiotechnology) - "Crucially, the near-infrared fluorescence of nanosonosensitizer enabled real-time, image-guided tracking of sonosensitizer uptake and therapeutic response. By repurposing a safe vasodilator and integrating it with a high-performance organic sonosensitizer, this work establishes a readily translatable, minimally invasive paradigm for precise SDT of localized, inoperable or metastatic HCC."

Journal • Hepatocellular Cancer • Oncology • Solid Tumor

Injectable protein hydrogel microspheres with reactive oxygen species-responsive nitric oxide release for cardiac protection against ischemia/reperfusion injury. (PubMed, Acta Biomater) - "Here, we designed an injectable hydrogel microsphere system (WPI-H-N) based on acrylated whey protein (WPI), onto which phenylborate ester group was attached and served as a ROS-cleavable linker for 5-isosorbide mononitrate (ISMN), a NO donor...This strategy offers a potentially translatable approach for local and controlled NO release to achieve cardiac repair. The work holds broad implications for ROS-related pathologies and precision therapeutic delivery in regenerative medicine."

Journal • Cardiovascular • Coronary Artery Disease • Myocardial Ischemia • Reperfusion Injury

Cervical Ripening With Misoprostol vs Isosorbide Mononitrate ; A Parallel -Arm Randomized Controlled Trial (clinicaltrials.gov) - P=N/A | N=80 | Active, not recruiting | Sponsor: Raid M. Al-Ani

New trial

Rechallenge of 5-Fluorouracil in a Patient With Coronary Vasospasm Unable to Receive Oral Medications. (PubMed, JACC Case Rep) - "This case highlights the challenge of 5-FU rechallenge in patients unable to take oral prophylaxis. Transdermal nitroglycerin monotherapy proved insufficient, suggesting that intravenous prophylaxis may be required. Future studies should determine optimal strategies for preventing CV in patients with a similar presentation."

Journal • Gastric Adenocarcinoma • Gastric Cancer • Gastrointestinal Cancer • Gastrointestinal Disorder • Oncology • Solid Tumor • HER-2

Mitochondrial homeostasis restoring peptide-drug conjugates with ROS-responsive NO releasing ability for targeted therapy of myocardial infarction. (PubMed, J Nanobiotechnology) - "Besides, controlled release of NO prodrug isosorbide mononitrate (ISN) was achieved by pathological ROS triggered hydrolysis of boronate ester...These findings prove that the synergic ROS regulation is essential in maximizing therapeutic effects of NO. Our CTP-PBA-ISN may serve as a valuable inspiration for development of other treatments of myocardial infarction and other ischemic diseases."

Journal • Cardiovascular • Myocardial Infarction

LACunar Intervention Trial 3 (LACI-3): EFFICACY AND SAFETY OF CILOSTAZOL AND Isosorbide mononitrate TO PREVENT ADVERSE OUTCOMES IN SMALL VESSEL (LACUNAR) ISCHAEMIC STROKE (ESOC 2025) - "LACI-3 is being conducted with MHRA Scientific Advice to facilitate future licensing, has ethical and MHRA approval, started Site Initiation Visit, and will start randomisation in Spring 2025. 54 centres have expressed interest to participate."

Adverse events • Clinical • Late-breaking abstract • Cardiovascular • Ischemic stroke

κ-Carrageenan and Hyaluronic acid Composite Injectable Hydrogel-Containing Isosorbide mononitrate-loaded Liposomes for Treatment of Myocardial Infarction. (PubMed, Biomed Phys Eng Express) - "Furthermore, Masson's staining results revealed that the injectable hydrogel system reduced myocardial infarct size and increased left ventricular wall thickness post-myocardial infarction. Immunofluorescence staining results indicated the upregulating expression of vascular hemophilic factor (VWF) and α-actinin, suggesting that the injectable hydrogel system to promote vascular proliferation and enhance cardiac systolic and diastolic function following myocardial infarction."

Journal • Cardiovascular • Myocardial Infarction

Methemoglobinemia Due to Isosorbide Mononitrate (ATS 2025) - "While there are congenital causes, acquired cases from drug or environmental exposures, including benzocaine, phenazopyridine, dapsone, and nitrates/nitrites, are more common...Her current medications included isosorbide mononitrate 30 mg daily, hydralazine, carvedilol, and trimethoprim-sulfamethoxazole 320 mg once daily...In our case, the combination of renal failure, trimethoprim-sulfamethoxazole, and isosorbide mononitrate resulted in clinically significant methemoglobinemia. Cessation of isosorbide mononitrate and treatment with methylene blue resulted in dramatic improvement and allowed continued therapy for pneumocystis with trimethoprim-sulfamethoxazole."

Hematological Disorders • Infectious Disease • Metabolic Disorders • Pneumonia • Renal Disease • Respiratory Diseases

A case report of Kounis syndrome presenting with coronary angina pectoris and coronary microcirculatory disturbance, resulting in takotsubo cardiomyopathy-like changes. (PubMed, Eur Heart J Case Rep) - "We started a calcium channel blocker, isosorbide mononitrate, and antihistamines...We report a case of takotsubo-like wall motion abnormality due to CSA and CMD in a patient with Kounis syndrome. Simultaneous binuclear myocardial scintigraphy, assessment of the coronary microcirculation, and ACh stress test were useful in the diagnosis, and the coexistence of CSA and CMD suggested her clinical images similar to takotsubo cardiomyopathy."

Journal • Acute Coronary Syndrome • Cardiomyopathy • Cardiovascular • Dermatology • Hematological Disorders • Immunology • Thrombosis • Urticaria

UNUSUAL CASE OF DOUBLE WHAMMY- VENTRICULAR FIBRILLATION & STEMI - Lalith Namburu (ACC 2025) - "Intravascular ultrasound (IVUS) revealed a 45% residual lesion [4 ].Decision-making: Pt was discharged on amlodipine & Isosorbide mononitrate with no intervention as no significant lesion was identified to intervene. CAS can lead to both V-Fib and STEMI. CAS can lead to both V-Fib and STEMI. LHC with intracoronary nitroglycerin and provocative testing using acetylcholine or ergonovine can aid in diagnosis, while IVUS helps assessing lesion stability and severity. Treatment includes calcium channel blockers and long-acting nitrates."

Clinical • Cardiovascular • Coronary Artery Disease • Myocardial Infarction • Pain

A RARE CASE OF CORONARY-CAMERAL FISTULA BETWEEN LEFT ANTERIOR DESCENDING ARTERY AND LEFT VENTRICLE - Erasmus Mutabi (ACC 2025) - "She was compliant with metoprolol succinate, isosorbide mononitrate, and ranolazine. LAD to LV CCF is a rare etiology of chest pain. Cardiac CT and coronary angiography are key diagnostic tools. Complications may include heart failure, ischemia, or endarteritis."

Clinical • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Dyslipidemia • Heart Failure • Hypertension • Pain

DEFYING NOMENCLATURE - A CASE OF ATYPICAL POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME WITH BRAINSTEM AFFECTATION - Daniel Yow (ACC 2025) - "Nicardipine drip was started and shifted to oral amlodipine, hydralazine, isosorbide mononitrate, labetalol, and nifedipine. PRES predominantly affects posterior parietal and occipital lobes. It rarely affects the brainstem, cerebellum, and cerebrum. Correlated conditions include pre-eclampsia, eclampsia, HELLP, autoimmune diseases, and chemotherapy."

Clinical • Back Pain • CNS Disorders • Gynecology • Immunology • Lumbar Back Pain • Musculoskeletal Pain • Pain

Athena-cSVD: Antiplatelet Therapy and Endothelial-stabilizing Agents in Cerebral Small Vessel Diseases (clinicaltrials.gov) - P=N/A | N=300 | Recruiting | Sponsor: The First Affiliated Hospital with Nanjing Medical University | Not yet recruiting ➔ Recruiting

Enrollment open • Cardiovascular • CNS Disorders • Ischemic stroke • Vascular Neurology

Effects of Nicorandil, Isosorbide Mononitrate, or Diltiazem on Radial Artery Grafts After CABG: The Randomized ASRAB-Pilot Trial. (PubMed, Circ Cardiovasc Interv) - P4 | "Larger hypothesis-testing trials are warranted. URL: https://www.clinicaltrials.gov; Unique identifier: NCT04310995."

Journal

ASRAB: Effect of Oral Isosorbide Mononitrate Plus Amlodipine Antispasm Therapy on Outcomes of Radial Artery Grafts After CABG (clinicaltrials.gov) - P4 | N=500 | Not yet recruiting | Sponsor: Ruijin Hospital | N=372 ➔ 500

Enrollment change

CORONARY VASOSPASM PRESENTING WITH DIFFUSE ST ELEVATIONS AND POLYMORPHIC VENTRICULAR TACHYCARDIA. (WRMC 2025) - "Patient was started on vasodilatory therapy with amlodipine and isosorbide mononitrate, and bupropion dose was reduced due to its possible association with worsening coronary vasospasm. In addition, smoking cessation and statin therapy are recommended to improve endothelial function and reduce the frequency of vasospastic episodes. Some cases of coronary vasospasm can result in life-threatening arrhythmias such as polymorphic ventricular tachycardia and thus speak to the importance of aggressive management to prevent SCD."

Cardiomyopathy • Cardiovascular • CNS Disorders • Coronary Artery Disease • Depression • Fibrosis • Immunology • Major Depressive Disorder • Mood Disorders • Movement Disorders • Myocardial Ischemia • Obstructive Sleep Apnea • Pain • Parkinson's Disease • Psychiatry • Respiratory Diseases • Sleep Disorder • Tobacco Cessation • Ventricular Tachycardia

Endothelial dysfunction in acute ischemic stroke: a review. (PubMed, J Neurol) - "The role of endothelial dysfunction in acute ischemic stroke has been studied increasingly in recent years. It has been shown that there is a correlation between endothelial dysfunction and parenchymal hematoma after endovascular thrombectomy. Also, early clinical trials are conducted investigating, e.g., endothelial progenitor cells in the treatment of endothelial dysfunction in ischemic stroke. Current research focuses on the integration of novel markers of endothelial dysfunction into routine clinical practice to support decision making in the treatment of acute ischemic stroke."

Journal • Review • Cardiovascular • Ischemic stroke

Can Severe Hypertriglyceridemia Cause Angina in the Absence of Significant Coronary Artery Lesions? (PubMed, Eur J Case Rep Intern Med) - "Understanding the effects of severely elevated triglyceride levels on coronary endothelial function.Prevention of harmful effects resulting from severely elevated triglyceride levels."

Journal • Cardiovascular • Coronary Artery Disease • Dyslipidemia • Heart Failure • Hypertension • Hypertriglyceridemia • Severe Hypertriglyceridemia

Hypoxia Activated Nitric Oxide Donor Compounds for the Prevention and Treatment of Myocardial Hypoxia-Induced Injury. (PubMed, J Med Chem) - "Animal tests demonstrated that N6 showed better therapeutic and preventive effects against myocardial hypoxia injury than the commercial drug isosorbide mononitrate. Our research evidence that N6 has a potent therapeutic potential in treating myocardial hypoxic injury, which can be further investigated as a promising drug candidate for coronary heart disease."

Journal • Cardiovascular • Coronary Artery Disease • Heart Failure

Peripheral edema induced by isosorbide mononitrate in an elderly patient: A case study of dose-related risks and drug interactions. (PubMed, Eur J Clin Pharmacol) - "She had hypertension, diabetes, ischemic heart disease, and chronic obstructive pulmonary disease (COPD).On the third day of therapy, she exhibited peripheral edema, prompting the initiation of furosemide and the cessation of ISMN; the patient's condition markedly improved...The simultaneous administration of other contributing drugs like antifungal agent fluconazole which can potentiate the ADR by elevating plasma levels of ISMN, leading to an enhanced vasodilatory impact. The evaluation conducted using the modified Schumock and Thornton scale classified the adverse medication response as likely, of moderate intensity, and avoidable. This example emphasizes the need of vigilant monitoring of adverse drug responses in the elderly patients, with importance of dosage modifications as well as highlights cautious prescribing of contributing drugs to prevent ADRs."

Journal • Cardiovascular • Chronic Obstructive Pulmonary Disease • Coronary Artery Disease • Diabetes • Heart Failure • Hypertension • Hypoglycemia • Immunology • Metabolic Disorders • Pain • Pulmonary Disease • Respiratory Diseases