Description:

Carmil 20 mg tablets contain isosorbide mononitrate, a nitrate used for the prophylaxis of angina pectoris and as adjunctive therapy in congestive heart failure unresponsive to cardiac glycosides or diuretics. 

Prescription:

Yes, Carmil 20 mg is a prescription-only medication.

Therapeutic Category:

• Antianginal agent

• Organic nitrate vasodilator
  

Active Ingredients/Composition:

• Isosorbide-5-mononitrate Ph. Eur. 20 mg per tablet

Vitamins:

• None
  

Minerals:

• None
  

Variant:

• Dosage form: Tablet

• Strength: 20 mg

• Other available strengths may include 40 mg and 60 mg
  

Consume Type:

• Oral use only
  

Directions/Usage:

• Adults: One tablet taken two or three times daily, ensuring a nitrate-free interval to prevent tolerance.

• Initial dose: 20 mg twice daily for patients not previously on nitrate therapy.

• Maximum dose: Up to 120 mg per day.

• Administration: Swallow tablets whole with water; do not chew or crush.

• Note: Do not discontinue abruptly; taper dosage gradually. 

Common Side Effects:

• Very common: Headache

• Common: Dizziness, postural hypotension, tachycardia, somnolence, asthenia

• Uncommon: Nausea, vomiting, flushing, allergic skin reactions

• Rare: Heartburn, dermatitis exfoliative

• Not known: Angioedema

Package Type:

• Typically supplied in PVC/Aluminium foil blisters, packaged in cardboard cartons.
  

Storage Advice:

• Store below 25°C.

• Keep in original packaging to protect from moisture and light.

• Keep out of reach of children.

 Safety Advice:

• Contraindications: Acute myocardial infarction with low filling pressures, acute circulatory failure, severe hypotension, hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, severe anemia, closed-angle glaucoma, hypovolemia, and hypersensitivity to nitrates.

• Drug interactions: Concurrent use with phosphodiesterase type-5 inhibitors (e.g., sildenafil) or soluble guanylate cyclase stimulators (e.g., riociguat) is contraindicated due to risk of severe hypotension.

• Caution: Use with caution in patients with recent myocardial infarction, hypothyroidism, hypothermia, malnutrition, or severe liver or renal disease.

• Pregnancy and lactation: Use only if the potential benefit justifies the potential risk.
  

 Product Substitutes:

• Monomil 20 mg Tablets

• Other brands containing isosorbide mononitrate 20 mg
  Note: Always consult a healthcare professional before switching

Manufacturer/Marketer:

• Milpharm Limited (a subsidiary of Aurobindo Pharma)

• Address: Ares, Odyssey Business Park, West End Road, South Ruislip, HA4 6QD, United Kingdom

• Country of Origin:

United Kingdom