Sormo 20mg Tablet - Isosorbide Mononitrate (20mg) medicine

Ismo 20 Tablet: Complete Guide To Uses, Side Effects, And Safety

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🏭 Mano Pharma Pvt Ltd 📦 strip of 10 tablets 💊 Allopathy 📅 Updated: Oct 28, 2026
📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for angina prevention.
Reviewed by
SaathiMed Expert Panel | Oct 28, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026

When to Call Your Doctor IMMEDIATELY

  • Severe chest pain that does not go away with rest or fast-acting nitrates
  • Fainting or loss of consciousness
  • Severe dizziness or lightheadedness
  • Bluish lips or skin, confusion, or shortness of breath
  • Severe headache that does not improve
  • Signs of an allergic reaction such as rash, itching, or swelling of the face, lips, or throat

If experiencing severe symptoms, call emergency services immediately.

What is Sormo 20mg Tablet used for?

This medicine is a nitrate used to prevent chest pain (angina) in people with heart conditions. It works by relaxing blood vessels to improve blood flow to the heart. It is not for immediate relief of an ongoing angina attack.

  • Generic Name: Isosorbide Mononitrate (20mg)
  • Manufacturer: Mano Pharma Pvt Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 Sormo 20mg Tablet के बारे में (Hindi Summary)

उपयोग: यह दवा एंजाइना (सीने में दर्द) को रोकने के लिए इस्तेमाल की जाती है। यह रक्त वाहिकाओं को फैलाकर दिल तक रक्त का प्रवाह बढ़ाती है और दिल पर दबाव कम करती है। यह दवा तीव्र एंजाइना के दौरे के इलाज के लिए नहीं है, बल्कि दौरे पड़ने की आवृत्ति को कम करने के लिए नियमित रूप से ली जाती है।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में सिरदर्द, चक्कर आना, और चेहरे पर गर्मी लगना शामिल हैं। ये आमतौर पर शुरुआत में होते हैं और धीरे-धीरे कम हो जाते हैं। गंभीर दुष्प्रभाव दुर्लभ हैं, लेकिन अगर आपको बहुत कम रक्तचाप, बेहोशी, या दिल की धड़कन तेज होने का अनुभव हो, तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। दवा की खुराक खुद से न बदलें और न ही बंद करें। शराब का सेवन न करें क्योंकि इससे चक्कर आ सकते हैं। उठते समय धीरे-धीरे उठें। यदि आपको तीव्र एंजाइना का दौरा पड़े तो तुरंत अपनी तेज काम करने वाली दवा लें और डॉक्टर से संपर्क करें।

💡 Did You Know? India is the largest provider of generic medicines globally, supplying over 50% of global vaccine demand.

💊 Sormo 20mg Tablet Uses & Benefits

[{"condition":"Prevention of angina pectoris","description":"This medicine is used to reduce the frequency and severity of angina attacks in patients with coronary artery disease.","evidence":"Well-established"},{"condition":"Chronic stable angina","description":"It helps improve exercise tolerance and reduces the need for short-acting nitrates in patients with stable angina.","evidence":"Well-established"},{"condition":"Vasospastic angina","description":"It may be used to prevent coronary artery spasms in patients with vasospastic angina.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Heart failure","description":"Sometimes used in combination with hydralazine for heart failure, especially in certain patient populations.","evidence":"Moderate"},{"condition":"Esophageal spasm","description":"May be used off-label to relieve esophageal spasm-related chest pain.","evidence":"Limited"}]

Primary treatment for: Angina pectoris

Also treats: Coronary artery disease, Heart failure (off-label)

📋 Drug Information

Generic Name(s)Isosorbide Mononitrate (20mg)
Brand NameSormo 20mg Tablet
ManufacturerMano Pharma Pvt Ltd
Packaging / Formstrip of 10 tablets (Allopathy)
Therapeutic Class
Action Class
Route of AdministrationOral
StorageStore at room temperature (15-30°C) in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Shelf LifeNot established from the available information. Refer to the packaging for the expiry date.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine exactly as prescribed, usually once or twice daily.
2
To prevent tolerance, follow your doctor's advice on a nitrate-free interval, often at night.
3
Avoid alcohol while taking this medicine to prevent dizziness and low blood pressure.
4
Stand up slowly from sitting or lying positions to avoid lightheadedness.
5
Do not use this medicine for an acute angina attack; use your fast-acting nitrate instead.
6
Inform your doctor if you experience persistent headaches or dizziness.
7
Do not stop this medicine suddenly without consulting your doctor.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Chest pain (angina)
This medicine is commonly prescribed to prevent angina.
Likely Use
❌
Fever
This medicine is not a fever reducer.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionIsosorbide mononitrate is rapidly and completely absorbed from the gastrointestinal tract after oral administration. It is not subject to first-pass metabolism, which contributes to its high bioavailability.
DistributionIsosorbide mononitrate is widely distributed in the body. It has a volume of distribution of approximately 0.6 L/kg.
Protein BindingIsosorbide mononitrate is less than 5% bound to plasma proteins.
MetabolismIsosorbide mononitrate is metabolized in the liver, primarily by denitration, to inactive metabolites. It does not undergo significant first-pass metabolism.
Half-LifeThe elimination half-life of isosorbide mononitrate is approximately 4 to 5 hours.
ExcretionIsosorbide mononitrate and its metabolites are excreted primarily in the urine.
BioavailabilityThe oral bioavailability of isosorbide mononitrate is nearly 100%.
Onset of ActionThe onset of action for angina prevention is within 30 to 60 minutes after oral administration.
Peak Plasma TimePeak plasma concentrations are reached within 30 to 60 minutes after oral administration.
Duration of ActionThe duration of action is approximately 8 to 12 hours, depending on the dose and individual response.

How It Works

This medicine works by releasing nitric oxide, which activates an enzyme called guanylate cyclase in smooth muscle cells. This leads to an increase in cyclic guanosine monophosphate (cGMP), which causes relaxation of vascular smooth muscle. The relaxation of veins and arteries reduces the workload on the heart and improves blood flow to the heart muscle, thereby preventing angina.

Mechanism Steps

1
Release of nitric oxide: This medicine is metabolized in the body to release nitric oxide, a powerful vasodilator.
2
Activation of guanylate cyclase: Nitric oxide activates the enzyme guanylate cyclase in smooth muscle cells.
3
Increase in cGMP: Activation of guanylate cyclase leads to increased production of cyclic guanosine monophosphate (cGMP).
4
Smooth muscle relaxation: Elevated cGMP causes relaxation of vascular smooth muscle, leading to vasodilation.
5
Reduced cardiac workload: Vasodilation reduces preload and afterload, decreasing the heart's oxygen demand and preventing angina.

💡 How to Take Sormo 20mg Tablet

Strength: Isosorbide Mononitrate 20 mg immediate-release tablet

1Take this medicine by mouth with a glass of water.
2You may take it with or without food, but taking it with food may reduce stomach upset.
3Swallow the tablet whole. Do not crush or chew it.
4Follow your doctor's instructions regarding the timing of doses to allow a nitrate-free interval.
5Do not stop taking this medicine suddenly without consulting your doctor.

Dosage Information

Adult DosageThe usual adult dose of this medicine is 20 mg taken once or twice daily, depending on the indication and your doctor's assessment. The dose may be increased gradually to a maximum of 40 mg twice daily, but the exact dose must be individualized by a qualified clinician based on your condition, age, and other medications. Do not change the dose without consulting your doctor.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the blood pressure-lowering effects of this medicine. Your doctor may start with a lower dose and monitor you closely.
Renal ImpairmentNo specific dose adjustment is established from the available information. Use with caution in patients with severe renal impairment.
Hepatic ImpairmentNo specific dose adjustment is established from the available information. Use with caution in patients with severe hepatic impairment.
Maximum Daily DoseThe maximum recommended daily dose is 80 mg (40 mg twice daily), but this must be determined by your doctor.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset.
Grapefruit
Avoid
May increase drug levels and effects.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of Sormo 20mg Tablet

✅ Common Side Effects

Headache (Common (up to 50%))
Usually resolves with continued use. If persistent or severe, consult your doctor.
Dizziness (Common (10-20%))
Rise slowly from sitting or lying positions. Avoid driving if affected.
Flushing (Common (5-10%))
Usually harmless. Consult doctor if bothersome.
Tachycardia (Uncommon (1-5%))
Report to your doctor if persistent.

🚨 Serious Side Effects

Severe hypotension (Rare (<0.1%))
Seek immediate medical attention if you feel faint or have very low blood pressure.
Syncope (Rare (<0.1%))
Lie down and elevate legs if you feel faint. Contact doctor immediately.
Bradycardia (Rare (<0.1%))
Seek medical attention if you experience a very slow heart rate.

⚠️ Rare Side Effects

Methemoglobinemia
Seek emergency care if you experience bluish lips or skin, confusion, or shortness of breath.
Exfoliative dermatitis
Stop the medicine and seek immediate medical attention if you develop a severe skin rash.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Sildenafil Major
Tadalafil Major
Riociguat Major
Alcohol Moderate
Beta-blockers Moderate
Calcium channel blockers Moderate
Ergot alkaloids Moderate
NSAIDs Minor

🚨 Major Interactions

  • Phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)
  • Riociguat

⚡ Moderate Interactions

  • Alcohol
  • Antihypertensives (e.g., beta-blockers, calcium channel blockers)
  • Ergot alkaloids

🍷 Alcohol Interaction

Alcohol can increase the blood pressure-lowering effect of this medicine and may cause dizziness, lightheadedness, or fainting. It is best to avoid alcohol while taking this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Allergy to isosorbide mononitrate or other nitrates","Severe hypotension (low blood pressure)","Concomitant use with phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil)","Concomitant use with riociguat","Increased intracranial pressure","Severe anemia","Hypovolemia"]

⚠️ Warnings & Precautions

["This medicine may cause severe hypotension, especially when standing up. Rise slowly.","Tolerance to the effects can develop with continuous use. A nitrate-free interval is often recommended.","Avoid alcohol while taking this medicine.","Use with caution in patients with glaucoma.","Use with caution in patients with severe liver or kidney disease.","Do not use this medicine to treat an acute angina attack. Use fast-acting nitrates for acute attacks."]

🤱 Lactation Safety

Not established from the available information. Consult your doctor before using this medicine while breastfeeding.

💊 Overdose Management

Overdose may cause severe hypotension, headache, dizziness, palpitations, and fainting. If you suspect an overdose, seek emergency medical attention immediately. Treatment is supportive and symptomatic, including measures to support blood pressure and heart rate.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not change the dose or stop taking it without medical advice. To reduce the risk of tolerance, your doctor may prescribe a nitrate-free interval, usually at night. Avoid alcohol while taking this medicine, as it can increase the blood pressure-lowering effect and cause dizziness. Stand up slowly from a sitting or lying position to prevent lightheadedness. If you have an acute angina attack, use your fast-acting nitrate (such as sublingual nitroglycerin) as instructed, and seek emergency help if the pain persists. Inform all your healthcare providers that you are taking this medicine, especially before surgery or dental procedures. Store this medicine at room temperature, away from moisture and heat.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to the blood pressure-lowering effects of this medicine. Your doctor may start with a lower dose and monitor you closely for dizziness and falls.

🤰 Pregnancy Planning (TTC)

If you are planning pregnancy or are pregnant, consult your doctor before using this medicine. The safety of this medicine during pregnancy is not well established.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist that you are taking this medicine. It may interact with medications used during surgery and affect blood pressure.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine, as it may affect blood pressure during dental procedures. Your dentist may take precautions.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce the workload on your heart.
🥗
Engage in regular low-impact exercise as advised by your doctor.
😴
Avoid smoking and limit alcohol consumption.
💧
Eat a heart-healthy diet rich in fruits, vegetables, and whole grains.
🧘
Manage stress through relaxation techniques like deep breathing or meditation.
🌞
Get adequate sleep to support heart health.

🏋️ Exercise Considerations

This medicine may cause dizziness or lightheadedness, especially when you start treatment or change doses. Avoid strenuous exercise until you know how the medicine affects you. Consult your doctor before starting any new exercise program.

🥗 Diet Recommendations

Include omega-3 rich foods like fish and flaxseeds.
Reduce intake of processed and high-sodium foods.
Stay well hydrated.
Avoid grapefruit and grapefruit juice.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or lightheadedness, which can affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. Inform your employer if your job involves such tasks.

🛑 When to Stop This Medicine

Do not stop taking this medicine without consulting your doctor. If you experience severe side effects or your condition changes, your doctor may adjust or stop the medicine. Always follow medical advice.

📅 Long-Term Use Effects

Long-term use of this medicine may lead to tolerance, where the medicine becomes less effective. To prevent this, doctors often recommend a nitrate-free interval. Regular monitoring of blood pressure and heart rate is advised. Do not stop the medicine suddenly without consulting your doctor.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Lifestyle modifications

Heart-healthy diet, regular exercise, and stress management can complement medicine for angina.

Evidence: Well-established
Other antianginal medicines

Beta-blockers, calcium channel blockers, or ranolazine may be alternatives or additions.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

Not established from the available information. Consult your doctor regarding vaccinations while on this medicine.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

Carry this medicine in its original packaging with a copy of your prescription. If traveling across time zones, adjust the timing of doses gradually as advised by your doctor. Store at room temperature and protect from moisture. Keep enough supply for the entire trip. Check customs regulations for carrying prescription medicines.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 60-year-old man with a history of coronary artery disease
He was prescribed this medicine to prevent angina attacks. Initially, he experienced headaches, but they subsided after a week. He learned to take the medicine at the same time each day and to avoid alcohol. His angina attacks became less frequent, and he could walk longer distances without chest pain.
💡 Lesson: Consistent use and following doctor's advice on timing and lifestyle can significantly improve outcomes.
👤 A 55-year-old woman with stable angina
She was started on this medicine and advised to keep a nitrate-free interval at night. She initially took the medicine with grapefruit juice, not knowing it could interact. After her doctor explained the interaction, she switched to water and felt more stable. She also started a gentle exercise program.
💡 Lesson: Avoiding food interactions and adhering to the prescribed schedule are key to safety and efficacy.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within 30 to 60 minutes after taking a dose, but its full preventive effect may take a few days of regular use.

Q: Can I take this medicine with food?

A: Yes, you can take it with or without food. Taking it with food may reduce stomach upset.

Q: What should I do if I miss a dose?

A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for Sormo 20mg Tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be taken to relieve an acute angina attack.
    Fact: This medicine is for prevention, not for immediate relief of an ongoing attack. Use fast-acting nitrates for acute attacks.
  • Myth: You can take this medicine with erectile dysfunction drugs.
    Fact: Combining this medicine with erectile dysfunction drugs can cause a dangerous drop in blood pressure and is contraindicated.

🔄 Alternative Options

Generic Alternatives

  • Isosorbide Mononitrate 20 mg tablet

Brand Alternatives

  • Ismo 20 Tablet

📊 Comparison with Similar Medicines

[{"medicine":"Isosorbide Mononitrate","class":"Nitrate","half_life":"4-5 hours","bioavailability":"~100%","notes":"No first-pass metabolism."},{"medicine":"Isosorbide Dinitrate","class":"Nitrate","half_life":"1-2 hours","bioavailability":"20-25%","notes":"Extensive first-pass metabolism."}]

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