A-Card Tablet 20 mg contains Isosorbide Mononitrate, a long-acting organic nitrate used in the prevention and management of angina pectoris associated with coronary artery disease. It works by relaxing blood vessels, improving blood flow to the heart muscle, and reducing cardiac workload. A-Card Tablet is not intended for the immediate relief of acute anginal attacks but is effective for long-term angina prophylaxis.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Indications

A-Card Tablet 20 mg is indicated for:

• Prophylactic treatment of angina pectoris

• Management of chronic stable angina

• Prevention of ischemic episodes in coronary artery disease

Regular use helps reduce the frequency and severity of anginal attacks and improves exercise tolerance.

Therapeutic Class

Antianginal drugs (Nitrates)

Pharmacology

Isosorbide Mononitrate is a nitric oxide donor that produces vasodilation by relaxing vascular smooth muscle. It predominantly dilates veins, leading to reduced venous return (preload), which decreases myocardial oxygen demand. It also causes moderate dilation of coronary arteries, improving oxygen delivery to ischemic areas of the myocardium.

Unlike isosorbide dinitrate, isosorbide mononitrate has nearly complete oral bioavailability and is not subject to significant first-pass hepatic metabolism. This results in predictable plasma concentrations and sustained therapeutic effects. The drug has a relatively long half-life, allowing for convenient dosing schedules.

Mode of Action

Isosorbide Mononitrate releases nitric oxide, which activates guanylate cyclase in vascular smooth muscle cells. This increases cyclic guanosine monophosphate (cGMP) levels, leading to smooth muscle relaxation and vasodilation. The reduction in preload and myocardial oxygen demand helps prevent anginal pain.

Dosage and Administration

Dosage should be individualized according to patient response and clinical condition:

• Adults: Usually 20 mg taken once or twice daily, as prescribed by a physician

• A nitrate-free interval may be recommended to reduce the risk of tolerance

Tablets should be swallowed whole with water and may be taken with or without food.

Drug Interactions

Concomitant use with phosphodiesterase-5 inhibitors (such as sildenafil, tadalafil, or vardenafil) is contraindicated due to the risk of severe hypotension. Caution is advised when used with other antihypertensive agents or alcohol, as additive blood pressure–lowering effects may occur.

Contraindications

A-Card Tablet 20 mg is contraindicated in patients with:

• Hypersensitivity to nitrates

• Severe hypotension

• Cardiogenic shock

• Constrictive pericarditis

• Concurrent use of phosphodiesterase-5 inhibitors

Side Effects

Common side effects include:

• Headache (most frequent, especially at initiation of therapy)

• Dizziness

• Flushing

• Hypotension

• Nausea

These effects are usually dose-related and may diminish with continued use.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Pregnancy and Lactation

The use of A-Card Tablet during pregnancy and lactation should be based on a physician’s assessment of potential benefits and risks. It should be used with caution in these populations.

Storage Conditions

Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.