How does it work?
This medicine contains the active ingredient isosorbide mononitrate, which is a type of medicine used to enable the heart to work more easily.
Isosorbide mononitrate works by releasing a chemical called nitric oxide. This chemical is also made naturally by the body and has the effect of making the veins and arteries relax and widen (dilate). This increases the space within the blood vessels and therefore reduces the resistance within the blood vessels, which makes it easier for the heart to pump blood around the body.
Widening the veins also decreases the volume of blood that returns to the heart in the veins with each heartbeat, and this makes it easier for the heart to pump that blood out again. As a result of both these actions, the heart requires less energy to pump the blood around the body and therefore does not need as much oxygen.
The medicine also widens the arteries within the heart, and this increases the blood and oxygen supply to the heart muscle.
The pain of angina is caused by too little oxygen reaching the heart when its workload increases, such as during exercise. Isosorbide mononitrate makes it easier for the heart to pump blood and so decreases the amount of oxygen that the heart needs, as well as improving the oxygen supply to the heart. This means that isosorbide mononitrate prevents the pain that would be caused when the heart works harder during exercise.
Since this medicine enables the heart to pump blood more easily it can also be used in heart failure, where the heart's ability to pump blood is reduced.
Trangina XL 60mg Tablets may be used for:
the prevention of angina (chest pain).
Dosage: Usually one tablet (60mg) once daily in the morning. To reduce the possibility of headaches you may initially be given half a tablet (30mg) once daily for the first 2-4 days. The dose may be increased to two tablets (120mg) once daily in the morning.
Not to be used in:
Allergy to nitrates
Bleeding in the brain (cerebral haemorrhage)
Blood in the sac surrounding the heart which prevents the heart beating properly (cardiac tamponade)
Closed angle glaucoma
Failure of the blood circulatory system (circulatory collapse)
Failure of the heart to maintain adequate circulation of blood (cardiogenic shock)
Heart disease in which the muscle of the heart grows abnormally (hypertrophic obstructive cardiomyopathy)
Inflammation of the sac surrounding the heart which stops the heart from beating properly (constrictive pericarditis)
Low volume of circulating blood (hypovolaemia)
Narrowing of one of the valves in the heart (mitral valve stenosis)
Narrowing of the main artery coming from the heart (aortic stenosis)
Very low blood pressure (severe hypotension)
Usually one tablet (60mg) once daily in the morning. To reduce the possibility of headaches you may initially be given half a tablet (30mg) once daily for the first 2-4 days. The dose may be increased to two tablets (120mg) once daily in the morning.
The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.
Nausea and vomiting
A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension)
Weakness or loss of strength (asthenia)
Increased heart rate (tachycardia)
The side effects listed above may not include all of the side effects reported by the drug's manufacturer.
How can this medicine affect other medicines?
Sildenafil (Viagra) should not be taken with this medicine, as this combination can produce a significant drop in blood pressure resulting in dizziness, fainting, or even a heart attack.
There may be a risk of a drop in blood pressure causing dizziness or fainting if this medicine is taken with any of the following, which also decrease blood pressure:
- medicines to treat high blood pressure (antihypertensives), eg beta-blockers, ACE inhibitors, alpha-blockers, diuretics, calcium-channel blockers
- tricyclic antidepressants, eg amitriptyline
- MAOI antidepressants, eg phenelzine
- certain antipsychotic medicines
- sublingual apomorphine (Uprima).