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Package leaflet: Information for the patient

Monigen XL 60
prolonged-release tablets
(isosorbide mononitrate)
Read all of this leaflet carefully before you start taking this medicine because it contains
important information for you.
Keep this leaflet. You may need to read it again.
If you have any further questions, ask your doctor or pharmacist.
This medicine has been prescribed for you only. Do not pass it on to others. It may
harm them, even if their signs of illness are the same as yours.
If you get any side effects, talk to your doctor or pharmacist. This includes any possible
side effects not listed in this leaflet. See section 4.
What is inthis leaflet:
What Monigen XL 60 is and what it is used for
What you need to know before you take Monigen XL 60
How to take Monigen XL 60
Possible side effects
How to store Monigen XL 60
Contents of the pack and other information


What Monigen XL 60 is and what it is used for

Monigen XL 60 contains isosorbide mononitrate which belongs to a family of medicines
known as nitrates. These medicines allow the blood vessels around the heart to relax and
widen, allowing more blood to flow to the heart and around the body. Your medicine is in the
form of a ‘prolonged release’ tablet, which slowly releases the medicine into your body.
Monigen XL 60 can be used to help prevent angina (a muscle cramp of the heart). However,
Monigen XL 60 is not a suitable treatment for the relief of acute angina. If you suffer from an
acute attack of angina, a more suitable medicine should be taken. Do not stop taking
Monigen XL 60 without first consulting your doctor or pharmacist.


What you need to know before you take Monigen XL 60

Do not take Monigen XL 60 if:
 you areallergic to isosorbide mononitrate, other nitrates, or any of the other ingredients of
this medicine (listed in section 6.1).
 if you have heart conditions such as swelling of the lining that surrounds the heart,
problems with your heart muscle or valves.
 if you are taking sildenafil or similar medicines called “phosphodiesterase type-5
inhibitors” normally used to treat male impotence (erectile dysfunction).
 if you have very low blood pressure or problems with blood flow to the brain which may
be due to blood pressure or blood vessel problems e.g. a stroke or a brain injury.
 if you have a condition called “cardiogenic shock” which may occur after a heart attack
when the body cannot pump enough blood around the body.
Warnings and precautions
Talk to your doctor or pharmacist before taking Monigen 60 XL

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if you have severe anaemia.
if you have hypothyroidism (underactive thyroid).
if you have raised pressure in the head (intra-cranial pressure).
if you have severe liver or kidney problems.
if you are malnourished or are unable to regulate body temperature (hypothermia) or
develop these during treatment.

 if you have hypoxaemia (low oxygen level in your blood, due to lung disease for
Other medicines and Monigen XL 60
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other
medicines including medicines obtained without a prescription. Do not take Monigen XL 60
with sildenafil or other phosphodiesterase type-5 inhibitors normally used to treat male
impotence. If you take one of these medicines for erectile dysfunction, taking
Isosorbidmononitrat Mylan as well can cause a severe and possibly dangerous fall in blood
pressure. This could result in fainting, or even a heart attack.
If you are taking and of the following medicines which lower the blood pressure and may
decrease your blood pressure by a potentially significant amount. It is important you talk to
your doctor or pharmcist.
 medicines for heart problems such as beta-blockers e.g. sotalol, carvedilol
 diuretics, used to increase urination e.g. furosemide, hydrochlorothiazide
 medicines for depression (called tricyclic antidepressants) e.g. mirtazapine, trimipramine

medicines used to treat anxiety and mental health conditions e.g. tranquillisers
alprostadil (a prostaglandin), another drug used for the treatment of male impotence
dihydroergotamine (used to treat migraines)
medicines that lower the blood pressure as their effect may become more pronounced
(including vasodilators, antihypertensives, calcium channel blockers and angiotensin II
receptor antagonists)
 aldesleukin, a medicine used for the treatment of cancer
Monigen XL 60 with alcohol
Alcohol may increase the effect of reducing your blood pressure and may also make you
drowsy. The use of alcohol should therefore be avoided.
Pregnancy and breast-feeding
If you are pregnantor breast-feeding, think you may be pregnant or are planning to have a
baby, ask your doctor or pharmacist for advice before taking this medicine.

Driving and using machines
Do not drive or operate machines if you feel dizzy or weak.
Monigen XL 60 contains lactose.
If you have been told by your doctor that you have an intolerance to some sugars, contact
your doctor before taking this medicines.

How to take Mongien XL 60

Always take this medicine exactly as your doctor has told you. Check with your doctor or
pharmacist if you are not sure.

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The recommended starting dose is half a tablet (30 mg) a day for the first two to four days.
The tablet can be divided into equal doses.
After this, the recommended dose is one tablet (60 mg) a day, taken in the morning. When
necessary the dose may be increased to two tablets (120 mg) a day, taken together in the
Swallow the tablets with half a glass of water, in the morning.
Do not crush or chew the tablets, although you can divide them into equal doses if required .
During treatment
When you are taking this medicine, you may notice the remains of the tablet in your faeces.
This is not a sign that this medicine is less effective. The medicine is released from the tablet
leaving behind part of the tablet which you may pass in faeces.
Use in children and adolescents
Do not give these tablets to children and adolescents.
If you take more Monigen XL 60 than you should
The signs of an overdose may include headache, excitation flushing, cold sweat, feeling sick
(nausea), vomiting, fast heart rate, palpitations, confusion, dizziness and fainting, which may
be due to low blood pressure. Very rarely, a large amount of this medicine may cause a
‘blurring’ of the skin e.g. lips. If you suddenly experience any of the above, lie down with
your legs raised slightly as this may help to ease the symptoms.
Contact your doctor or pharmacist immediately or go to the accident and emergency
department of your local hospital at once. Take the carton or container with you, even if it is
If you forget to take Monigen XL 60
Do not take a double dose to make up for a forgotten dose. If it is almost time for your next
dose simply carry on as before.
If you stop taking Monigen XL 60
Do not stop taking these tablets without consulting your doctor or pharmacist as your chest
pains may re-occur or get worse.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.


Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.
Side effects due to Monigen XL 60 are more likely to occur at the start of treatment.

Very common (may affect more than 1 in 10 people)
 headache
Common (may affect up to 1 in 10 people)
 dizziness

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low blood pressure
fast heartbeat
feeling sick (nausea)

Uncommon (may affect up to 1 in 100 people)
 vomiting
 diarrhoea
Rare (may affect up to 1 in 1,000 people)
 fainting
 skin rash or itching
Very rare (may affect up to 1 in 10,000 people)
 aching muscles, muscle tenderness or weakness, not caused by exercise (myalgia
Reporting of these side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side
effects not listed in this leaflet.


How to store Monigen XL 60

Keep this medicine out of the sight and reach of children.
This medicine does not require any special storage conditions.
Do not use this medicine after the expiry date which is stated on the blister and the carton
after “EXP”. The expiry date refers to the last day of that month.
Do not throw any medicine via wastewater or household waste. Ask your pharmacist how to
throw away of medicines you no longer use. These measures will help protect the


Contents of the pack and other information

What Monigen XL 60 contains
Each tablet contains 60 mg of Isosorbide mononitrate.
The other ingredients are cellulose microcrystalline, kaolin heavy, magnesium stearate, silica
colloidal anhydrous, synthetic paraffin wax and hard paraffin wax. The coating contains
hypromellose, titanium dioxide (E171), lactose monohydrate (see section 2 ‘Monigen XL 60
contains lactose’), macrogol, iron oxide yellow (E172), iron oxide black (E172) and iron
oxide red (E172))
What Monigen XL 60 looks like and contents of the pack
Monigen XL 60 are pale yellow, elliptical, film-coated tablets, marked with ‘IM’ breakline
‘60’ on one side and a break line on the reverse.
Monigen XL 60 are available in plastic containers with an optional plastic spacer at the top of
the pack and blister packs of 7, 14, 28, 30, 60, 90, 98, 100, 100 x1, 250 tablets.
Not all pack sizes may be marketed.

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Marketing Authorisation Holder
Generics [UK] Ltd t/a Mylan, Station Close, Potters Bar, Hertfordshire, EN6 1TL, United

Gerard Laboratories, 35/36 Baldoyle Industrial Estate, Grange Road, Dublin 13, Ireland

This leaflet was last revised in July 2014

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.