Nitrate Drugs - Isosorbide 5 Mononitrate Extended Release

Generic Name                  

isosorbide 5 mononitrate extended release
Strength 60 mg

 Form

tablet

Criteria

Approval Period

1. Treatment failure on optimal dose of, or intolerance to, isosorbide dinitrate (ISDN).

OR

2. Person identified as having unstable angina.

Indefinite

Practitioner Exemptions

Practitioners in the following specialty are not required to submit a Special Authority request form for coverage:

  • Paediatric Cardiology
  • Paediatrics
  • Paediatric General Surgery

Special Notes

  • None

Special Authority Request Form(s)