{"id":55228,"date":"2024-01-12T19:12:19","date_gmt":"2024-01-12T19:12:19","guid":{"rendered":"https:\/\/medsname.com\/monit\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"monit","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/monit\/","title":{"rendered":"Monit"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Monit?<\/h3>\n<p style=\"margin:0;\"><strong>Monit<\/strong> je <strong>tableta isosorbidmononitr\u00e1tu (ISMN) 20 mg<\/strong>, pou\u017e\u00edvan\u00fd k dlouhodob\u00e9 <em>profylaxi<\/em> chronick\u00e9 stabiln\u00ed anginy pectoris. ISMN m\u00e1 <strong>100% or\u00e1ln\u00ed biologickou dostupnost<\/strong> (\u017e\u00e1dn\u00fd first-pass metabolism), co\u017e zaji\u0161\u0165uje p\u0159edv\u00eddateln\u00e9 d\u00e1vkov\u00e1n\u00ed. Standardn\u00ed re\u017eim je <strong>20 mg dvakr\u00e1t denn\u011b s asymetrick\u00fdm na\u010dasov\u00e1n\u00edm \u2014 7 hod. r\u00e1no a 14 hod. odpoledne.<\/strong> \u2014 co\u017e zachov\u00e1v\u00e1 no\u010dn\u00ed interval bez dusi\u010dnan\u016f pot\u0159ebn\u00fd k prevenci tolerance. Monit je <strong>ne<\/strong> z\u00e1chrann\u00fd l\u00e9k; pro akutn\u00ed z\u00e1chvaty m\u011bjte po ruce sublingv\u00e1ln\u00ed ISDN nebo nitroglycerin.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<p><strong>Monit 20 mg<\/strong> je tableta obsahuj\u00edc\u00ed <strong>isosorbidmononitr\u00e1t (ISMN)<\/strong>, aktivn\u00ed dlouhodob\u011b p\u016fsob\u00edc\u00ed metabolit isosorbiddinitr\u00e1tu. Proto\u017ee ISMN obch\u00e1z\u00ed first-pass metabolismus jater, dosahuje 100% or\u00e1ln\u00ed biologick\u00e9 dostupnosti a del\u0161\u00edho, p\u0159edv\u00eddateln\u011bj\u0161\u00edho trv\u00e1n\u00ed \u00fa\u010dinku ne\u017e mate\u0159sk\u00e1 slou\u010denina \u2014 co\u017e z n\u011bj \u010din\u00ed jeden z nejpou\u017e\u00edvan\u011bj\u0161\u00edch peror\u00e1ln\u00edch antiangin\u00f3zn\u00edch prost\u0159edk\u016f na sv\u011bt\u011b.<\/p>\n<p>Monit je indikov\u00e1n k dlouhodob\u00e9 prevenci epizod anginy pectoris u pacient\u016f se stabiln\u00ed ischemickou chorobou srde\u010dn\u00ed. Mnoho kardiolog\u016f vol\u00ed ISMN p\u0159ed peror\u00e1ln\u00edm nitroglycerinem SR nebo ISDN d\u00edky jeho \u010dist\u0161\u00edmu farmakokinetick\u00e9mu profilu a jednoduch\u00e9mu dvakr\u00e1t denn\u011b re\u017eimu. \u010casto je kombinov\u00e1n s betablok\u00e1torem, blok\u00e1torem kalciov\u00fdch kan\u00e1l\u016f nebo oboj\u00edm jako sou\u010d\u00e1st v\u00edcel\u00e9kov\u00e9 antiangin\u00f3zn\u00ed terapie.<\/p>\n<h2 class=\"wp-block-heading\">K \u010demu se Monit pou\u017e\u00edv\u00e1?<\/h2>\n<ul>\n<li><strong>Dlouhodob\u00e1 profylaxe chronick\u00e9 stabiln\u00ed anginy pectoris<\/strong><\/li>\n<li><strong>Angina pectoris vyvolan\u00e1 n\u00e1mahou a sm\u00ed\u0161en\u00e1 angina<\/strong><\/li>\n<li><strong>Prevence anginy pectoris po infarktu myokardu<\/strong> (spole\u010dn\u011b se sekund\u00e1rn\u00ed prevenc\u00ed podle doporu\u010den\u00fdch postup\u016f)<\/li>\n<li><strong>Variantn\u00ed (Prinzmetalova) angina<\/strong> \u2014 druh\u00e1 volba, pokud samotn\u00fd blok\u00e1tor kalciov\u00fdch kan\u00e1l\u016f nen\u00ed dostate\u010dn\u00fd<\/li>\n<li><strong>Srde\u010dn\u00ed selh\u00e1n\u00ed s angin\u00f3zn\u00ed slo\u017ekou<\/strong> \u2014 sn\u00ed\u017een\u00ed p\u0159edt\u00ed\u017een\u00ed, s odborn\u00fdm dohledem<\/li>\n<\/ul>\n<p>Monit je <em>ne<\/em> vhodn\u00fd pro z\u00e1chrannou terapii. N\u00e1stup \u00fa\u010dinku je za 30\u201360 minut. Ka\u017ed\u00fd pacient u\u017e\u00edvaj\u00edc\u00ed Monit by m\u011bl m\u00edt u sebe kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00ed nitr\u00e1t \u2014 sublingv\u00e1ln\u00ed nitroglycerin nebo sublingv\u00e1ln\u00ed isosorbid dinitr\u00e1t (Sorbitrate) 5 mg \u2014 pro akutn\u00ed z\u00e1chvaty.<\/p>\n<h2 class=\"wp-block-heading\">Jak funguj\u00ed nitr\u00e1ty?<\/h2>\n<p>V\u0161echna nitr\u00e1tov\u00e1 l\u00e9\u010diva maj\u00ed stejn\u00fd z\u00e1kladn\u00ed mechanismus \u00fa\u010dinku. Po vst\u0159eb\u00e1n\u00ed jsou enzymaticky p\u0159em\u011bn\u011bny na <strong>oxid dusnat\u00fd (NO)<\/strong> uvnit\u0159 bun\u011bk hladk\u00e9ho svalstva c\u00e9v. NO aktivuje guanyl\u00e1tcykl\u00e1zu, \u010d\u00edm\u017e zvy\u0161uje intracelul\u00e1rn\u00ed cGMP a uvol\u0148uje hladk\u00e9 svalstvo c\u00e9v. Klinick\u00e9 \u00fa\u010dinky jsou:<\/p>\n<ul>\n<li><strong>\u017diln\u00ed dilatace<\/strong> (dominantn\u00ed p\u0159i n\u00edzk\u00fdch d\u00e1vk\u00e1ch) \u2014 sni\u017euje \u017eiln\u00ed n\u00e1vrat k srdci, \u010d\u00edm\u017e se sni\u017euje <em>p\u0159edt\u00ed\u017een\u00ed<\/em>. Takto nitr\u00e1ty sni\u017euj\u00ed spot\u0159ebu kysl\u00edku myokardem.<\/li>\n<li><strong>Arteri\u00e1ln\u00ed dilatace<\/strong> (vy\u0161\u0161\u00ed d\u00e1vky) \u2014 sni\u017euje syst\u00e9movou c\u00e9vn\u00ed rezistenci a <em>dot\u00ed\u017een\u00ed<\/em>, co\u017e d\u00e1le sni\u017euje srde\u010dn\u00ed pr\u00e1ci.<\/li>\n<li><strong>Dilatace koron\u00e1rn\u00edch tepen<\/strong> \u2014 zlep\u0161uje pr\u016ftok krve do ischemick\u00fdch oblast\u00ed srde\u010dn\u00edho svalu, zejm\u00e9na p\u0159i koron\u00e1rn\u00edm spasmu.<\/li>\n<\/ul>\n<p>V\u00fdsledn\u00fdm efektem je m\u00e9n\u011b bolest\u00ed na hrudi, m\u00e9n\u011b angin\u00f3zn\u00edch epizod a lep\u0161\u00ed tolerance z\u00e1t\u011b\u017ee u pacient\u016f se stabiln\u00ed ischemickou chorobou srde\u010dn\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Nitr\u00e1tov\u00e1 tolerance \u2014 kritick\u00e9 d\u00e1vkovac\u00ed pravidlo<\/h2>\n<p>Nitr\u00e1tov\u00e1 tolerance je nejd\u016fle\u017eit\u011bj\u0161\u00edm konceptem pro ka\u017ed\u00e9ho pacienta u\u017e\u00edvaj\u00edc\u00edho nitr\u00e1ty. Pokud se nitr\u00e1t pod\u00e1v\u00e1 nep\u0159etr\u017eit\u011b \u2013 s konstantn\u00ed hladinou v krvi 24 hodin denn\u011b \u2013 antiangin\u00f3zn\u00ed \u00fa\u010dinek se vytr\u00e1c\u00ed b\u011bhem 48 a\u017e 72 hodin. Jedn\u00e1 se o dob\u0159e zdokumentovan\u00fd, reprodukovateln\u00fd farmakologick\u00fd jev, nikoli o domn\u011bl\u00fd efekt.<\/p>\n<p>\u0158e\u0161en\u00ed je jednoduch\u00e9 a nezpochybniteln\u00e9: ka\u017ed\u00fd 24hodinov\u00fd cyklus mus\u00ed zahrnovat <strong>nitr\u00e1tov\u00fd interval alespo\u0148 8\u201312 hodin<\/strong>, obvykle p\u0159es noc. Standardn\u00ed strategie jsou:<\/p>\n<ul>\n<li>Asymetrick\u00e9 d\u00e1vkov\u00e1n\u00ed dvakr\u00e1t denn\u011b (nap\u0159. v 7 hodin r\u00e1no a ve 3 hodiny odpoledne, pot\u00e9 nic a\u017e do n\u00e1sleduj\u00edc\u00edho r\u00e1na)<\/li>\n<li>Jednou denn\u011b pod\u00e1van\u00e9 tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm navr\u017een\u00e9 tak, aby udr\u017eovaly n\u00edzkou hladinu<\/li>\n<li>Odstran\u011bn\u00ed transderm\u00e1ln\u00ed n\u00e1plasti po 12\u201314 hodin\u00e1ch no\u0161en\u00ed<\/li>\n<\/ul>\n<p>Nep\u0159est\u00e1vejte <em>ne<\/em> nep\u0159id\u00e1vejte dal\u0161\u00ed d\u00e1vky \u201cp\u0159ed span\u00edm\u201d nebo b\u011bhem noci, pokud v\u00e1m l\u00e9ka\u0159 v\u00fdslovn\u011b nep\u0159edep\u00ed\u0161e nep\u0159etr\u017eitou terapii z konkr\u00e9tn\u00edho d\u016fvodu.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Monit<\/h2>\n<p>Pro chronickou stabiln\u00ed anginu pectoris u dosp\u011bl\u00fdch:<\/p>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> 20 mg r\u00e1no po prvn\u00edch 2\u20134 dny ke sn\u00ed\u017een\u00ed po\u010d\u00e1te\u010dn\u00ed nitr\u00e1tov\u00e9 bolesti hlavy, pot\u00e9 postupn\u011b zvy\u0161ovat<\/li>\n<li><strong>Obvykl\u00e1 udr\u017eovac\u00ed d\u00e1vka:<\/strong> 20 mg dvakr\u00e1t denn\u011b podle <strong>asymetrick\u00e9ho sch\u00e9matu \u2014 v 7 hodin r\u00e1no a ve 2 hodiny odpoledne.<\/strong> \u2014 pot\u00e9 nic a\u017e do n\u00e1sleduj\u00edc\u00edho r\u00e1na. T\u00edm se zajist\u00ed p\u0159ibli\u017en\u011b 7 hodin \u00fa\u010dinku l\u00e9ku b\u011bhem aktivn\u00edho dne a 17 hodin nitr\u00e1tov\u00e9ho intervalu p\u0159es noc.<\/li>\n<li><strong>Titrace:<\/strong> N\u011bkte\u0159\u00ed pacienti pot\u0159ebuj\u00ed 40 mg dvakr\u00e1t denn\u011b; to je horn\u00ed hranice d\u00e1vkov\u00e1n\u00ed okam\u017eit\u011b uvol\u0148ovan\u00e9ho ISMN.<\/li>\n<li><strong>Formy s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm:<\/strong> Pokud jsou k dispozici (30\u2013120 mg jednou denn\u011b), poskytuj\u00ed jedinou rann\u00ed d\u00e1vku s vestav\u011bn\u00fdm n\u00edzk\u00fdm no\u010dn\u00edm poklesem. Monit 20 mg je produkt s okam\u017eit\u00fdm uvol\u0148ov\u00e1n\u00edm, proto vy\u017eaduje v\u00fd\u0161e uveden\u00fd dvakr\u00e1t denn\u00ed asymetrick\u00fd re\u017eim.<\/li>\n<li><strong>Potrava:<\/strong> Monit lze u\u017e\u00edvat s j\u00eddlem i bez j\u00eddla; absorpce nen\u00ed v\u00fdznamn\u011b ovlivn\u011bna.<\/li>\n<\/ul>\n<p>Tablety by se m\u011bly polykat cel\u00e9. Netablety Monit ne\u017ev\u00fdkejte ani nedr\u0165te. Pokud vynech\u00e1te d\u00e1vku, u\u017eijte ji, jakmile si vzpomenete, pokud nen\u00ed dal\u0161\u00ed d\u00e1vka napl\u00e1nov\u00e1na do 3 hodin \u2014 v tom p\u0159\u00edpad\u011b ji vynechejte.<\/p>\n<p>Po\u010d\u00e1te\u010dn\u00ed pravidlo pro postupn\u00e9 zvy\u0161ov\u00e1n\u00ed d\u00e1vky, aby se p\u0159ede\u0161lo nesnesiteln\u00e9 bolesti hlavy: mnoho kardiolog\u016f p\u0159edepisuje <em>jednu<\/em> tabletu 20 mg denn\u011b po dobu 3\u20134 dn\u016f, pot\u00e9 p\u0159ejdou na dvakr\u00e1t denn\u00ed re\u017eim, jakmile si pacient zvykne na vazodilata\u010dn\u00ed \u00fa\u010dinek.<\/p>\n<h2 class=\"wp-block-heading\">Kdo by nem\u011bl u\u017e\u00edvat Monit?<\/h2>\n<p>Existuje jedna absolutn\u00ed kontraindikace, kterou mus\u00ed ka\u017ed\u00fd pacient pochopit p\u0159ed prvn\u00ed d\u00e1vkou:<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:16px 0;border-radius:4px;\">\n<p style=\"margin:0;\"><strong>Nikdy nekombinujte \u017e\u00e1dn\u00fd nitr\u00e1t s inhibitorem PDE5.<\/strong> Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) a avanafil (Stendra) zesiluj\u00ed vazodilata\u010dn\u00ed \u00fa\u010dinek nitr\u00e1t\u016f a mohou zp\u016fsobit \u017eivot ohro\u017euj\u00edc\u00ed hypotenzi, kolaps, c\u00e9vn\u00ed mozkovou p\u0159\u00edhodu nebo infarkt myokardu. Po\u010dkejte alespo\u0148 <strong>24 hodiny po pod\u00e1n\u00ed sildenafilu\/vardenafilu<\/strong> a <strong>48 hodin po pod\u00e1n\u00ed tadalafilu<\/strong> ne\u017e u\u017eijete jakoukoli d\u00e1vku nitr\u00e1tu. Toto plat\u00ed pro v\u0161echny formy \u2013 peror\u00e1ln\u00ed, sublingv\u00e1ln\u00ed, transderm\u00e1ln\u00ed a sprej.<\/p>\n<\/div>\n<p>Dal\u0161\u00ed d\u016fle\u017eit\u00e9 kontraindikace:<\/p>\n<ul>\n<li>T\u011b\u017ek\u00e1 hypotenze nebo hypovol\u00e9mie (systolick\u00fd TK &lt; 90 mmHg)<\/li>\n<li>T\u011b\u017ek\u00e1 an\u00e9mie (nitr\u00e1ty mohou zhor\u0161it dod\u00e1vku kysl\u00edku do tk\u00e1n\u00ed)<\/li>\n<li>Hypertrofick\u00e1 obstruk\u010dn\u00ed kardiomyopatie (HOCM) \u2013 nitr\u00e1ty mohou zhor\u0161it v\u00fdtokovou obstrukci<\/li>\n<li>T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za \u2013 riziko synkopy<\/li>\n<li>Zv\u00fd\u0161en\u00fd nitrolebn\u00ed tlak nebo ned\u00e1vn\u00e9 poran\u011bn\u00ed hlavy<\/li>\n<li>Infarkt prav\u00e9 komory \u2013 preload je z\u00e1sadn\u00ed, nitr\u00e1ty jej sni\u017euj\u00ed<\/li>\n<li>Konstriktivn\u00ed perikarditida nebo srde\u010dn\u00ed tampon\u00e1da<\/li>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na organick\u00e9 nitr\u00e1ty<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed stimul\u00e1tor\u016f solubiln\u00ed guanyl\u00e1tcykl\u00e1zy (riociguat)<\/li>\n<\/ul>\n<p>Pou\u017e\u00edvejte opatrn\u011b v t\u011bhotenstv\u00ed (kategorie C) a konzultujte s odborn\u00edkem. P\u0159i kojen\u00ed je ob\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed obecn\u011b p\u0159ijateln\u00e9, ale rutinn\u00ed terapii by m\u011bl posoudit kardiolog.<\/p>\n<h2 class=\"wp-block-heading\">\u010cast\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky p\u0159\u00edpravku Monit<\/h2>\n<p>V\u011bt\u0161ina ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f nitr\u00e1t\u016f je p\u0159\u00edm\u00fdm d\u016fsledkem jejich vazodilata\u010dn\u00edho \u00fa\u010dinku a obvykle ustupuje b\u011bhem prvn\u00edch 1\u20132 t\u00fddn\u016f l\u00e9\u010dby.<\/p>\n<p><strong>Velmi \u010dast\u00e9 (&gt;10 % pacient\u016f):<\/strong><\/p>\n<ul>\n<li><strong>Bolest hlavy<\/strong> \u2014 pulzuj\u00edc\u00ed, \u010deln\u00ed bolesti, \u010dasto nejhor\u0161\u00ed v prvn\u00edch dnech. Paracetamol je bezpe\u010dn\u00fd. Bolest hlavy obvykle ustoup\u00ed b\u011bhem 7\u201314 dn\u016f, jak si t\u011blo zvyk\u00e1; je <em>ne<\/em> zn\u00e1mkou p\u0159ed\u00e1vkov\u00e1n\u00ed.<\/li>\n<li>Z\u00e1vrat\u011b nebo mot\u00e1n\u00ed hlavy, zejm\u00e9na p\u0159i postaven\u00ed<\/li>\n<li>Z\u010derven\u00e1n\u00ed obli\u010deje<\/li>\n<\/ul>\n<p><strong>B\u011b\u017en\u00e9 (1\u201310 %):<\/strong><\/p>\n<ul>\n<li>Postur\u00e1ln\u00ed hypotenze<\/li>\n<li>Reflexn\u00ed tachykardie (zrychlen\u00fd srde\u010dn\u00ed tep)<\/li>\n<li>Nevolnost, ob\u010dasn\u00e9 zvracen\u00ed<\/li>\n<li>Ko\u017en\u00ed vyr\u00e1\u017eka (\u010dast\u011bj\u0161\u00ed u transderm\u00e1ln\u00ed n\u00e1plasti)<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale d\u016fle\u017eit\u00e9:<\/strong><\/p>\n<ul>\n<li>Synkopa (mdloby) \u2014 obvykle po prvn\u00ed d\u00e1vce, p\u0159i postaven\u00ed nebo po alkoholu<\/li>\n<li>Paradoxn\u00ed zhor\u0161en\u00ed anginy pectoris \u2014 vz\u00e1cn\u00e9; vyhledejte neodkladn\u00e9 vy\u0161et\u0159en\u00ed<\/li>\n<li>Methemoglobinemie \u2014 velmi vz\u00e1cn\u00e9 p\u0159i dlouhodob\u00e9 vysokod\u00e1vkov\u00e9 terapii<\/li>\n<\/ul>\n<p>Okam\u017eit\u011b p\u0159eru\u0161te u\u017e\u00edv\u00e1n\u00ed l\u00e9ku a neodkladn\u011b kontaktujte l\u00e9ka\u0159e, pokud se objev\u00ed siln\u00e1 nebo p\u0159etrv\u00e1vaj\u00edc\u00ed bolest hlavy, mdloby, puch\u00fd\u0159ovit\u00e1 vyr\u00e1\u017eka nebo modrav\u00e9 zbarven\u00ed rt\u016f a k\u016f\u017ee.<\/p>\n<h2 class=\"wp-block-heading\">Monit vs jin\u00e9 nitr\u00e1ty<\/h2>\n<p>Monit (ISMN) nab\u00edz\u00ed oproti star\u0161\u00edm nitr\u00e1t\u016fm n\u011bkolik v\u00fdhod:<\/p>\n<ul>\n<li><strong>vs. ISDN (Sorbitrate):<\/strong> ISMN m\u00e1 100% peror\u00e1ln\u00ed biologickou dostupnost (ISDN cca 25%), p\u0159edv\u00eddateln\u011bj\u0161\u00ed hladiny v krvi a jednodu\u0161\u0161\u00ed d\u00e1vkovac\u00ed re\u017eim. ISDN z\u016fst\u00e1v\u00e1 prvn\u00ed volbou p\u0159i pot\u0159eb\u011b sublingv\u00e1ln\u00edho pod\u00e1n\u00ed pro akutn\u00ed \u00fa\u010dinek<\/li>\n<li><strong>vs peror\u00e1ln\u00ed nitroglycerin SR (Angiplat, Angispan-TR):<\/strong> ISMN se vyh\u00fdb\u00e1 prvopr\u016fchodov\u00e9mu metabolismu, kter\u00fd zp\u016fsobuje variabiln\u00ed biologickou dostupnost peror\u00e1ln\u00edho nitroglycerinu. Pro rutinn\u00ed denn\u00ed profylaxi je ISMN \u010dasto preferov\u00e1n<\/li>\n<li><strong>vs transderm\u00e1ln\u00ed nitroglycerin (Nitroderm TTS):<\/strong> N\u00e1plasti jsou u\u017eite\u010dn\u00e9, kdy\u017e peror\u00e1ln\u00ed terapie nen\u00ed mo\u017en\u00e1 (pot\u00ed\u017ee s polyk\u00e1n\u00edm, nevolnost), ale vy\u017eaduj\u00ed rotaci m\u00edsta aplikace, mohou dr\u00e1\u017edit poko\u017eku a je nutn\u00e9 je na noc odstra\u0148ovat. Tablety jsou pro v\u011bt\u0161inu pacient\u016f jednodu\u0161\u0161\u00ed<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Co je asymetrick\u00e9 d\u00e1vkov\u00e1n\u00ed?<\/h2>\n<p>Rozvrh \u201c7 r\u00e1no a 14 odpoledne\u201d je nejd\u016fle\u017eit\u011bj\u0161\u00ed praktick\u00fd detail l\u00e9\u010dby ISMN. Zde je pro\u010d:<\/p>\n<ul>\n<li>Okam\u017eit\u011b uvol\u0148ovan\u00fd ISMN m\u00e1 \u00fa\u010dinek po dobu 4\u20136 hodin<\/li>\n<li>Dv\u011b d\u00e1vky v rozestupu 12 hodin (nap\u0159. 8 r\u00e1no a 20 ve\u010der) by poskytly nep\u0159etr\u017eit\u00e9 pokryt\u00ed l\u00e9ky po 24 hodin, co\u017e vyvol\u00e1 toleranci b\u011bhem 2\u20133 dn\u016f<\/li>\n<li>Dv\u011b d\u00e1vky v rozestupu 7 hodin (7 r\u00e1no a 14 odpoledne) poskytnou pokryt\u00ed do \u010dasn\u00e9ho ve\u010dera a pot\u00e9 17hodinovou p\u0159est\u00e1vku bez nitr\u00e1t\u016f p\u0159es noc \u2014 co\u017e zachov\u00e1 citlivost a trval\u00fd \u00fa\u010dinek<\/li>\n<\/ul>\n<p>Pokud se va\u0161e angin\u00f3zn\u00ed z\u00e1chvaty objevuj\u00ed ve\u010der nebo v noci, pora\u010fte se se sv\u00fdm kardiologem \u2014 m\u016f\u017ee b\u00fdt pot\u0159eba jin\u00fd nitr\u00e1t nebo jin\u00e1 t\u0159\u00edda antiangin\u00f3zn\u00edch l\u00e9k\u016f.<\/p>\n<h2 class=\"wp-block-heading\">Objedn\u00e1vky a dod\u00e1n\u00ed<\/h2>\n<p>MedsBase nab\u00edz\u00ed celosv\u011btovou dopravu na ka\u017edou objedn\u00e1vku. Objedn\u00e1vky jsou odes\u00edl\u00e1ny v diskr\u00e9tn\u00edm balen\u00ed a p\u0159ich\u00e1zej\u00ed v origin\u00e1ln\u00edch balen\u00edch v\u00fdrobce. Peptidy a v\u011bt\u0161ina generick\u00fdch kardiovaskul\u00e1rn\u00edch l\u00e9k\u016f jsou skladem v r\u016fzn\u00fdch sil\u00e1ch; pokud je v\u00e1mi po\u017eadovan\u00e9 balen\u00ed vyprod\u00e1no, kontaktujte z\u00e1kaznickou podporu pro odhad dod\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:14px 18px;margin:20px 0;border-radius:4px;\">\n<p style=\"margin:0;\"><strong>Zdravotn\u00ed prohl\u00e1\u0161en\u00ed.<\/strong> Informace na t\u00e9to str\u00e1nce slou\u017e\u00ed pouze pro obecn\u00e9 vzd\u011bl\u00e1n\u00ed. Nejsou n\u00e1hradou za rady va\u0161eho l\u00e9ka\u0159e nebo kardiologa. Nitr\u00e1ty jsou siln\u00e9 kardiovaskul\u00e1rn\u00ed l\u00e9ky se zn\u00e1m\u00fdmi z\u00e1va\u017en\u00fdmi interakcemi. P\u0159ed zah\u00e1jen\u00edm, ukon\u010den\u00edm nebo zm\u011bnou l\u00e9\u010dby se pora\u010fte s kvalifikovan\u00fdm zdravotnick\u00fdm pracovn\u00edkem a vyhledejte okam\u017eitou l\u00e9ka\u0159skou pomoc, pokud je bolest na hrudi nov\u00e1, siln\u011bj\u0161\u00ed nebo trv\u00e1 d\u00e9le ne\u017e 10\u201315 minut.<\/p>\n<\/div>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Mohu pou\u017e\u00edt Monit k zastaven\u00ed angin\u00f3zn\u00edho z\u00e1chvatu?<\/h3>\n<p>Ne. Monit je preventivn\u00ed l\u00e9k s n\u00e1stupem \u00fa\u010dinku za 30\u201360 minut. K zastaven\u00ed z\u00e1chvatu pou\u017eijte sublingv\u00e1ln\u00ed nitroglycerin nebo sublingv\u00e1ln\u00ed isosorbid dinitr\u00e1t (Sorbitrate) 5 mg \u2014 tyto p\u016fsob\u00ed b\u011bhem 2\u20135 minut.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d je druh\u00e1 d\u00e1vka Monitu ve 14 hodin a ne v 20 hodin?<\/h3>\n<p>Proto\u017ee bez no\u010dn\u00ed p\u0159est\u00e1vky bez nitr\u00e1t\u016f si va\u0161e t\u011blo vyvine toleranci a Monit p\u0159estane \u00fa\u010dinkovat b\u011bhem 48\u201372 hodin. Rozvrh 7 r\u00e1no\/14 odpoledne poskytuje \u00fa\u010dinn\u00e9 pokryt\u00ed b\u011bhem aktivn\u00edch hodin a obnovuje citlivost p\u0159es noc.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Monit se sildenafilem, tadalafilem nebo vardenafilem?<\/h3>\n<p>Ne \u2014 tato kombinace je absolutn\u011b kontraindikov\u00e1na. Inhibitory PDE5 a nitr\u00e1ty mohou zp\u016fsobit \u017eivot ohro\u017euj\u00edc\u00ed hypotenzi. Po sildenafilu\/vardenafilu po\u010dkejte 24 hodin a po tadalafilu 48 hodin p\u0159ed jakoukoli d\u00e1vkou Monitu.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d m\u00e1m p\u0159i u\u017e\u00edv\u00e1n\u00ed Monitu bolesti hlavy?<\/h3>\n<p>Nitr\u00e1tov\u00e1 bolest hlavy odr\u00e1\u017e\u00ed cerebr\u00e1ln\u00ed vazodilataci a je nejintenzivn\u011bj\u0161\u00ed v prvn\u00edm t\u00fddnu. Mnoho kardiolog\u016f za\u010d\u00edn\u00e1 s d\u00e1vkou 20 mg <em>jednou<\/em> denn\u011b po dobu 3\u20134 dn\u016f pro vybudov\u00e1n\u00ed tolerance, pot\u00e9 p\u0159ech\u00e1z\u00ed na dvakr\u00e1t denn\u011b. Paracetamol je bezpe\u010dn\u00fd. Bolest hlavy obvykle ustoup\u00ed do 7\u201314 dn\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Monit spolu s betablok\u00e1torem a blok\u00e1torem kalciov\u00fdch kan\u00e1l\u016f?<\/h3>\n<p>Ano, toto je b\u011b\u017en\u00e1 trojkombinace antiangin\u00f3zn\u00ed terapie. Tyto t\u0159i t\u0159\u00eddy l\u00e9k\u016f p\u016fsob\u00ed na r\u016fzn\u00fdch drah\u00e1ch a dob\u0159e se kombinuj\u00ed, ale krevn\u00ed tlak a srde\u010dn\u00ed frekvence by m\u011bly b\u00fdt kontrolov\u00e1ny v prvn\u00edch dvou t\u00fddnech.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat Monit p\u0159ed span\u00edm?<\/h3>\n<p>Ne. Ve\u010dern\u00ed d\u00e1vkov\u00e1n\u00ed ru\u0161\u00ed nitr\u00e1tov\u00fd interval bez l\u00e9\u010dby a zp\u016fsobuje toleranci. Posledn\u00ed d\u00e1vku u\u017eijte v \u010dasn\u00e9m odpoledni.<\/p>\n<h3 class=\"wp-block-heading\">Je Monit bezpe\u010dn\u00fd p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed?<\/h3>\n<p>Ano, za p\u0159edpokladu dodr\u017eov\u00e1n\u00ed asymetrick\u00e9ho dvakr\u00e1t denn\u00edho re\u017eimu. Mnoho pacient\u016f u\u017e\u00edv\u00e1 ISMN roky. Doporu\u010duje se ro\u010dn\u00ed kardiologick\u00e1 kontrola.<\/p>\n<h3 class=\"wp-block-heading\">Co kdy\u017e vynech\u00e1m d\u00e1vku Monitu?<\/h3>\n<p>Pokud je je\u0161t\u011b r\u00e1no a vzpomenete si p\u0159ed ob\u011bdem, u\u017eijte vynechanou d\u00e1vku. Pokud se bl\u00ed\u017e\u00edte nebo jste p\u0159esko\u010dili druhou pl\u00e1novanou d\u00e1vku, vynechejte vynechanou d\u00e1vku a u\u017eijte dal\u0161\u00ed pl\u00e1novanou d\u00e1vku jako obvykle. Nikdy neu\u017e\u00edvejte dvojn\u00e1sobnou d\u00e1vku.<\/p>\n<h3 class=\"wp-block-heading\">Mohu p\u00edt alkohol p\u0159i u\u017e\u00edv\u00e1n\u00ed Monitu?<\/h3>\n<p>M\u00edrn\u00e9 pit\u00ed alkoholu s j\u00eddlem je obvykle tolerov\u00e1no. Alkohol je vazodilat\u00e1tor a m\u016f\u017ee zes\u00edlit hypotenzi a z\u00e1vrat\u011b, zejm\u00e9na v prvn\u00ed hodin\u011b po d\u00e1vce. Siln\u00e9 pit\u00ed by se m\u011blo vyvarovat.<\/p>\n<h3 class=\"wp-block-heading\">Mohu \u0159\u00eddit p\u0159i u\u017e\u00edv\u00e1n\u00ed Monitu?<\/h3>\n<p>Ano, jakmile je stav stabiln\u00ed a bez bolest\u00ed hlavy. Vyhn\u011bte se \u0159\u00edzen\u00ed v prvn\u00edm t\u00fddnu l\u00e9\u010dby, po zv\u00fd\u0161en\u00ed d\u00e1vky nebo pokud poci\u0165ujete z\u00e1vrat\u011b.<\/p>\n<h3 class=\"wp-block-heading\">Jak\u00fd je rozd\u00edl mezi Monitem a Sorbitr\u00e1tem?<\/h3>\n<p>Monit je isosorbidmononitr\u00e1t <em>(ISMN) \u2014 dlouhodob\u011b p\u016fsob\u00edc\u00ed aktivn\u00ed metabolit. Sorbitr\u00e1t je isosorbiddinitr\u00e1t<\/em> (ISMN) \u2014 aktivn\u00ed dlouhodob\u011b p\u016fsob\u00edc\u00ed metabolit. Sorbitrate je isosorbide <em>V\u00edce mo\u017enost\u00ed v kategorii Srdce a krevn\u00ed tlak<\/em> (ISDN) \u2014 mate\u0159sk\u00e1 l\u00e1tka. ISMN m\u00e1 100% peror\u00e1ln\u00ed biologickou dostupnost a je jednodu\u0161\u0161\u00ed pro chronick\u00e9 d\u00e1vkov\u00e1n\u00ed. ISDN z\u016fst\u00e1v\u00e1 preferov\u00e1no, je-li pot\u0159eba sublingv\u00e1ln\u00ed pod\u00e1n\u00ed p\u0159i akutn\u00edch z\u00e1chvatech.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/betapro-sr\/\">Betapro-SR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tamilong\/\">Tamilong<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ventocortil\/\">Ventocortil<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aerocort-inhaler\/\">Aerocort Inhaler<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/glycomet-sr\/\">Glycomet SR<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zlep\u0161uje zdrav\u00ed srdce<br \/>\n\u2705 Reguluje krevn\u00ed tlak<br \/>\n\u2705 Sni\u017euje hladinu cholesterolu<br \/>\n\u2705 Zlep\u0161uje ob\u011bhov\u00fd syst\u00e9m<br \/>\n\u2705 Podporuje c\u00e9vn\u00ed funkci<\/p>\n<p><span style=\"color: #999999;\">Momnit obsahuje Isosorbidmononitr\u00e1t<\/span><\/p>\n<p>&nbsp;<\/p>","protected":false},"featured_media":55229,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260],"product_tag":[3880,3881,3882,3883],"class_list":{"0":"post-55228","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_tag-imdur","10":"product_tag-isosorbide","11":"product_tag-isosorbide-mononitrate","12":"product_tag-monit","14":"first","15":"instock","16":"shipping-taxable","17":"purchasable","18":"product-type-variable","19":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/55228","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=55228"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/55229"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=55228"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=55228"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=55228"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=55228"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}