Chewable tablet: 5-10 mg every 2-3 hours. Avoid or substitute another drug for these medications when possible. Do Not Copy, Distribute or otherwise Disseminate without express permission. Because controlled, long-term trials of nitroglycerin ointment have not been reported, it is not known how the efficacy of nitroglycerin ointment may vary during extended therapy. Use Caution/Monitor. Monitor Closely (1)tetracaine, isosorbide mononitrate. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. isosorbide mononitrate, arginine. "[~ Monitor Closely (1)conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. <> Parker JD and Parker JO. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Complete avoidance may not be possible, provided sufficient time elapses between use of the drugs. Some conditions may become worse when the drug is suddenly stopped. drip: 3-5 minutes. Serious - Use Alternative (1)isosorbide mononitrate increases effects of ergoloid mesylates by decreasing metabolism. David McAuley, Pharm.D. crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Subsequent studies discovered that a chemical reaction between . Monitor Closely (1)stiripentol, isosorbide mononitrate. Supplied: Capsule, sustained release (Dilatrate-SR): 40 mg Tablet: 5 mg, 10 mg, 20 mg, 30 mg, 40mg Tablet, extended release (Isochron): 40 mg Sublingual tablet: 2.5 mg, 5 mg. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. All Rights Reserved. Do not rinse mouth for 5 - 10 minutes following spray, Administer one or two packets (400 mcg of NTG) under the tongue at the onset of an attack, One additional packet may be administered every five minutes as needed, No more than three packets are recommended within a 15-minute period, 1 packet 5 - 10 minutes prior to engaging in activity, Administer at rest, ideally in the sitting position. The recommended starting dose of IMDUR Tablets is 30 mg (given as a single 30 mg tablet or as 1/2 of a 60 mg tablet) or 60 mg (given as a single tablet) once daily. Minoxidil can exacerbate fluid retention in kidney disease. Medically reviewed by Drugs.com. The recommended starting dose of Imdur Tablets is 30 mg (given as a single 30 mg tablet or as 1/2 of a 60 mg tablet) or 60 mg (given as a single tablet) once daily. Stiripentol is a CYP3A4 inhibitor and inducer. Minoxidil can exacerbate fluid retention in liver disease. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Initially, isosorbide dinitrate 20 mg and hydralazine hydrochloride 37.5 mg (1 tablet of BiDil) 3 times daily. To help you remember, take it at the same times each day. Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration. Do not chew extended-release preparations. Modify Therapy/Monitor Closely. Monitor Closely (1)belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Other (see comment). Possibility of an increased frequency or severity of angina during the nitrate-free interval should be considered. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: drugs to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, tadalafil), riociguat, vericiguat.Some products have ingredients that could worsen your heart failure. Mechanism: additive vasodilation. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Conversion table Original isosorbide prescription: Convert to: 10 mg twice a day at 8am and 4pm 20 mg twice a day at 8am and 4pm Consult your doctor for more details. 1 - 2 sprays onto or under the tongue at the onset of pain. Information last revised December 2022. Isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. isosorbide mononitrate, riociguat. Modify Therapy/Monitor Closely. HOW TO USE: Take this medication by mouth as directed by your doctor, usually twice a day. Adjust dose according to prescribing information if needed. Contraindicated. % Dilatation of the coronary arteries also occurs. Observe for possible additive hypotensive effects during concomitant use. Monitor blood pressure. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Isosorbide dinitrate sublingual, peak: 1015 minutes. The minimum necessary length of such an interval has not been defined, but studies with other nitroglycerin formulations have shown that 10 to 12 hours is sufficient. This medication belongs to a class of drugs known as nitrates. Avoid or Use Alternate Drug. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood pressure.This drug may make you dizzy. As a result, any regimen of NITRO-BID administration should include a daily nitrate-free interval. For maintenance therapy, 10 mg to 40 mg, two or three times daily, is recommended. Use Caution/Monitor. Limit alcoholic beverages. Sublingual: 2.5-10 mg every 4-6 hours. Less frequent administration of isosorbide dinitrate may reduce the development of tolerance to the drugs antianginal effects. Use Caution/Monitor. Take the dose in the morning right after you wake up. It is recommended that minoxidil be taken with a diuretic and beta blocker (see minoxidil side effects) May take without regard to food Hair loss (off-label) Dosing: 0.25 - 5 mg once daily See low-dose oral minoxidil for hair loss May take without regard to food Kidney disease Minoxidil can exacerbate fluid retention in kidney disease. Tolerance to the vascular and antianginal effects of individual nitrates and cross-tolerance among the drugs may occur with repeated, prolonged use. Z L0y+"Z=A]*=_/Kw&FEa"O,KqKl]s-:G{. May be re-primed with 2 sprays if not used within 6 weeks. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. Below is a conversion table to enable using this preparation in place of standard release isosorbide mononitrate and modified release (M/R) preparations which are not going to be kept. Sign up today to receive the latest news and updates from UpToDate. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. ACCF and AHA recommend initial dosage of 2030 mg 3 or 4 times daily; give concomitantly with hydralazine hydrochloride 2550 mg 3 or 4 times daily. informational and educational purposes only. Do not use medications containing isosorbide dinitrate while using isosorbide mononitrate.This medication may interfere with certain laboratory tests (including cholesterol levels), possibly causing false test results. Contraindicated (1)isosorbide mononitrate, riociguat. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May induce methemoglobinemia. - Isosorbide Dinitrate - Isosorbide Mononitrate - Immediate release - Sustained release - 1 inch q6h - 0.4 mg/h - 15 mg tid - 10 mg bid - 30 mg/day REFERENCES 1. Any missing drug warnings or information does not in any way guarantee the safety, effectiveness, or the lack of adverse effects of any drug. Molecular formula: C6H8N2O8C6H9NO6 Modify Therapy/Monitor Closely. carbamazepine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Otherwise, call a poison control center right away. Evaluate for loss of therapeutic effect if medication must be coadministered. Warn all patients receiving organic nitrates or nitrites about the potential interaction between the drugs and selective PDE inhibitors, even if they currently are not receiving the drugs, since there is substantial potential for patients to receive the drugs from another clinician, from a friend, with little or no clinical intervention (e.g., via the Internet), or illicitly. apalutamide will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. Distribution into human body tissues and fluids has not been fully characterized. May induce methemoglobinemia. Isosorbide mononitrate (ISMN), an organic nitrate and the major biologically active metabolite of isosorbide dinitrate (ISDN), is a vasodilator with effects on both arteries and veins. <>stream Use Caution/Monitor. May repeat in 5 minutes if needed. It works by relaxing and widening blood vessels so blood can flow more easily to the heart.This medication will not relieve chest pain once it occurs. For oral dosage form (tablets): Adults20 milligrams (mg) two times a day. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Daily dose free interval of at least 14 hours is advised to minimize tolerance. isosorbide mononitrate, avanafil. Alcohol or marijuana (cannabis) can make you more dizzy. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses. Minor/Significance Unknown. Use Caution/Monitor. Readily (and almost completely) absorbed from the GI tract and oral mucosa, but considerable variations in the bioavailability (1090%) secondary to extensive first-pass metabolism in the liver. The antihypertensive therapy immediately before starting ISMN ( Table 1) consisted of 2 to 4 of the following drugs, administered in conventional dosage: diuretics (hydrochlorothiazide 25 to 12.5 mg/d [8 cases], amiloride 5 mg/d [2 cases], indapamide 2.5 mg/d [3 cases], aldactone 50 mg/d [1 case]); -blockers (atenolol 50 to 100 mg/d [4 cases], No dose adjustment is necessary in liver disease, Comes in box of 48 one gram foilpacs (one pack is equivalent to one inch of ointment). Take your next dose at the regular time. Isosorbide dinitrate conventional tablets, peak: 60 minutes. This information is not individual medical advice and does not substitute for the advice of your health care professional. Compare formulary status to other drugs in the same class. Known hypersensitivity to isosorbide or any ingredient in the respective formulation. Isosorbide mononitrate conventional tablets, peak: 0.51 hour. Isosorbide dinitrate and isosorbide mononitrate are mainly excreted in the urine. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. rifabutin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Imdur Description Isosorbide mononitrate (ISMN), an organic nitrate and the major biologically active metabolite of isosorbide dinitrate (ISDN), is a vasodilator with effects on both arteries and veins. . The relative importance of preload reduction, afterload reduction, and coronary dilatation remains undefined. Imdur (isosorbide mononitrate) Extended Release Tablets are a vasodilator indicated for the prevention of angina pectoris due to coronary artery disease. To apply the ointment using one of the applicators, place the applicator on a flat surface, printed side down. Start with lower doses and titrate slowly. DOSAGE AND ADMINISTRATION As noted above (CLINICAL PHARMACOLOGY), controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Headache, the most frequent adverse effect, may be severe (persistent or transient) and is perceived as a pulsating, throbbing sensation; frequent early in therapy, usually diminishes rapidly, and may disappear within several days to weeks of continuous therapy. nafcillin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. Side effects of Imdur and Ranexa that are similar include headache and dizziness. Make sure laboratory personnel and all your doctors know you use this drug. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Contraindicated. Considering these hemodynamic benefits with H-ISDN, 13,14 its effect on mortality was studied in the first Vasodilator-Heart Failure Trial (V-HeFT I), 15 the first major randomized, placebo-controlled trial in cardiovascular medicine. Tell your doctor all medications and supplements you use. Share cases and questions with Physicians on Medscape consult. Mechanism: additive vasodilation. Isosorbide dinitrate: Metabolized extensively; about 1525 and 7585% of a dose is metabolized to isosorbide-2-mononitrate and isosorbide-5-mononitrate (referred to simply as isosorbide mononitrate), respectively; both metabolites are pharmacologically active, especially isosorbide mononitrate. The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. Imdur may interact with sildenafil, other vasodilators, alcohol, calcium channel blockers, and organic nitrates. Use Caution/Monitor. Modify Therapy/Monitor Closely. ;6YXZp2k>!'Z)IfFW`VG@Y!b /r980t ~pE ~}xp%0Vg^r3WT_a-~qvQD]dvo{,Z@${ssJC j(2GW`_? %PDF-1.5 Manage and view all your plans together even plans in different states. Avoid or Use Alternate Drug. 3 0 obj Initially, (e.g., Imdur): 30 mg (as a single 30-mg tablet or as of a 60-mg tablet) or 60 mg (as a single 60-mg tablet) once daily. Not known whether geriatric patients respond differently than younger patients. The effects of hepatic impairment on hydralazine have not been studied. Conventional tablets: Approximately 100%. Serious - Use Alternative (1)phenobarbital will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases toxicity of the other by Other (see comment). Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Nitrate tolerance in angina therapy. Serious - Use Alternative (1)isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. Isosorbide mononitrate is an organic nitrate with vasodilating properties. Canada residents can call a provincial poison control center. Avoid or Use Alternate Drug. If unavoidable, reduce CYP3A substrate dose according to product labeling. Combination of isosorbide dinitrate and hydralazine recommended by ACCF and AHA for self-identified black patients with NYHA class III or IV heart failure and reduced ejection fraction who are receiving optimal therapy with ACE inhibitors and -blockers, unless contraindicated. Reliable assay techniques for plasma nitroglycerin levels have only recently become available, and studies using these techniques to define the pharmacokinetics of nitroglycerin ointment have not been reported. Maximum 40 mg of isosorbide dinitrate and 75 mg of hydralazine hydrochloride (2 tablets of BiDil) 3 times daily. Importance of informing patients of other important precautionary information. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. ChildrenUse and dose must be determined by your doctor. The observed clearance rates (close to 1 L/kg/min) greatly exceed hepatic blood flow; known sites of extrahepatic metabolism include red blood cells and vascular walls. Tell your doctor if this medication stops working well (for example, you have more frequent or worsening chest pain). Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Potentially fatal hypotension. It works by relaxing the . Increased risk of orthostatic hypotension. Copyright(c) 2023 First Databank, Inc. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. See additional information. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. Use Caution/Monitor. Safety and effectiveness of Isordil in pediatric patients have not been established. Nitrate dependence is possible (documented in daily industrial exposures); withdrawal manifestations (e.g., ischemic symptoms, MI, sudden death) can occur. Minor/Significance Unknown. Monitor Closely (1)rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May need to adjust schedule for those arising earlier than 7 a.m. since early morning angina is common. Use Caution/Monitor. Carefully individualize nitrate dosage to minimize the risk of tolerance; also consider potential risks of nitrate withdrawal. Isosorbide dinitrate and isosorbide mononitrate: Organic nitrates; vasodilating agents. Consult your doctor before breastfeeding. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Contraindicated (1)isosorbide mononitrate, avanafil. Isosorbide mononitrate: Metabolized principally in the liver, but unlike isosorbide dinitrate, does not undergo first-pass metabolism; metabolites appear to be pharmacologically inactive. Do not store in the bathroom. Consult your doctor for more details.Lifestyle changes such as dietary changes, exercise, and not smoking may help this drug work better. Use Caution/Monitor. Avoid or Use Alternate Drug. Other medications may be prescribed by your doctor for these conditions. A starting dose of 5 mg twice a day may be appropriate in smaller patients. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If you log out, you will be required to enter your username and password the next time you visit. Isosorbide mononitrate (ismo , monoket ), Isosorbide mononitrate (Ismo , Monoket ), HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication, Works by relaxation of smooth muscle, producing a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins. Risk of increased SBP, angina pectoris. Doses used in clinical trials have ranged from 1/2 inch (1.3 cm; 7.5 mg) to 2 inches (5.1 cm; 30 mg), typically applied to 36 square inches (232 square centimeters) of truncal skin. Last updated on Feb 7, 2022. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Monitor Closely (1)tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The drug information provided is intended for reference only and should not be used as a substitute for medical advice. CYP3A4 substrates may require dosage adjustment. Side effects of Imdur and Isordil that are similar include headache and dizziness. It will remain primed for 6 weeks. Allow 48h after last tadalafil dose before nitrate administration. The exact mechanism of action in the relief of angina pectoris has not been fully elucidated. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Modify Therapy/Monitor Closely. Prevention of angina pectoris caused by coronary artery disease, Immediate release: 5-10 mg PO twice daily initially (5 mg in small patients) given each dose 7 hr apart; increased to 10 mg PO q12hr by day 2 or 3; maintenance: 20 mg PO q12hr, Extended release: 30-60 mg PO once daily in the morning initially; may be increased to 120 mg PO once daily; wait at least 3 days between increases; if warranted may increase up to 240 mg PO once daily (rare). We comply with the HONcode standard for trustworthy health information. Common Imdur side effects may include: headache; or. Imdur (isosorbide mononitrate) Extended Release and Isordil (isosorbide dinitrate) are vasodilators indicated for the prevention of angina pectoris due to coronary artery disease. Isosorbide dinitrate or mononitrate can be used alone or in combination as either second-line or third-line therapy in patients previously treated with a -blocker. Advise patients of the likelihood of headache, particularly with initial nitrate therapy. It will remain primed for 6 weeks. Imdur 60 mg od Imdur 120 mg od REFERENCES 1. Imdur (isosorbide mononitrate) Extended Release and Nitrolingual Pumpspray (nitroglycerin lingual spray) are vasodilators indicated for the prevention of angina pectoris. After several days, the dosage may be increased to 120 mg (given as a single 120 mg tablet or as two 60 mg tablets) once daily. Indications Angina (a specific type of chest pain) caused by heart disease Chest pain caused by angina Pros and Cons Pros Good at preventing chest pain caused by heart disease N Eng J Med 1998;338:520-31 2. (See Cautions.). encoded search term (isosorbide mononitrate (Imdur%2C Monoket)) and isosorbide mononitrate (Imdur, Monoket), ECG Challenge: Lightheadedness and Extremely Slow Pulse. If not feasible, avoid use of abametapir. Serious - Use Alternative (1)idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In addition to vascular smooth muscle, nitrates and nitrites relax bronchial, biliary (including the gallbladder, biliary ducts, and sphincter of Oddi), GI (including the esophagus), ureteral, and uterine smooth muscle; nitrates relax all smooth muscle irrespective of autonomic innervation and are functional antagonists of norepinephrine, acetylcholine, and histamine. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Risk of elevated blood concentrations of isosorbide dinitrate in patients with cirrhosis. Modify Therapy/Monitor Closely. tetracaine, isosorbide mononitrate. Allow 48h after last tadalafil dose before nitrate administration. Contraindicated. May cause blurred vision and should be discontinued if this symptom occurs. 2 0 obj voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. %PDF-1.4 Also, it is not intended to be taken just before physical activities (such as exercise or sexual intercourse) to prevent chest pain. Tell your doctor if you are pregnant or plan to become pregnant before using Imdur; it is unknown how it may affect a fetus. National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. nitroglycerin rectal, isosorbide mononitrate. Isosorbide dinitrate: Also probably metabolized at extrahepatic sites. Maximum: 80 mg 3 times/day. isosorbide mononitrate increases effects of ergoloid mesylates by decreasing metabolism. Contraindicated (1)isosorbide mononitrate, tadalafil. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. This effect was not observed with istradefylline 20 mg/day. Mechanism: additive vasodilation. Minor/Significance Unknown. Although many clinicians do not gradually reduce the dosage when discontinuance of oral nitrates is planned, it appears prudent that dosage be gradually reduced (e.g., over a period of about 12 weeks) to avoid withdrawal manifestations. Isosorbide dinitrate used in fixed combination with hydralazine (BiDil) as adjunct to standard therapy for the treatment of heart failure in self-identified black patients to improve survival, decrease rate of hospitalization for worsened heart failure, and improve patient-reported functional status. The recommended starting dose of Imdur Tablets is 30 mg (given as a single 30 mg tablet or as 1/2 of a 60 mg tablet) or 60 mg (given as a single tablet) once daily. Avoid or Use Alternate Drug. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. and formulary information changes. Coverage of an area approximately the size of the dose-measuring applicator (3 1/2" by 2 1/4") should be sufficient to obtain the desired clinical effects. maraviroc, isosorbide mononitrate. Avoid or Use Alternate Drug. Why Use Isosorbide Dinitrate vs Isosorbide Mononitrate? Avoid or Use Alternate Drug. Minor/Significance Unknown. Copyright 2023, Selected Revisions February 7, 2017. You may report side effects to Health Canada at 1-866-234-2345. Side effects of Isordil that are different from Imdur include weakness and skin changes such as redness, tingling, or warmth. Modify Therapy/Monitor Closely. Minor (1)acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Isosorbide dinitrate or mononitrate is used for the acute relief of angina pectoris, for prophylactic management in situations likely to provoke angina attacks, and for long-term prophylactic management of angina pectoris. Potentially fatal hypotension. Either increases effects of the other by pharmacodynamic synergism. The dose can be increased to 10 mg twice daily after 2 to 3 days. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. Use Caution/Monitor. Monitor blood pressure. It is important to take the drug at the same times each day. It is unknown if Imdur passes into breast milk. The two doses should be administered 7 hours apart in order to avoid tolerance (decreased effect after several doses). Free Consultation! Avoid or Use Alternate Drug. By decreasing myocardial oxygen consumption, nitrates and nitrites alter the imbalance of myocardial oxygen supply and consumption which is thought to cause angina pectoris. lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Evaluate for loss of therapeutic effect if medication must be coadministered. The maximal achievable daily duration of anti-anginal activity provided by nitroglycerin ointment therapy has not been studied. Monitor Closely (1)istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. Use Caution/Monitor. isosorbide mononitrate, bretylium. Fexinidazole inhibits CYP3A4. Use Caution/Monitor. (See Geriatric Patients under Dosage.). The above information is provided for general STORAGE: Store at room temperature away from light and moisture. Use Caution/Monitor. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. acetazolamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. US residents can call their local poison control center at 1-800-222-1222. Use Caution/Monitor. These applicators allow ointment to be absorbed through a much smaller area of skin than that used in any of the reported clinical trials, and the significance of this difference is not known. May repeat in 5 minutes if needed. Please review the latest applicable package insert for additional information and possible updates. You may also report negative side effects of prescription drugs to the FDA by visiting the FDA MedWatch website or calling 1-800-FDA-1088. This medications comes in tablets, sustained release, and immediate release via sublingual administration. Avoid or substitute another drug for these medications when possible. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Mechanism: additive vasodilation. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Monitor Closely (1)isosorbide mononitrate, bupivacaine implant. If relief is not attained after a single dose during an acute attack, may give additional doses at 5- to 10-minute intervals; no more than 3 doses should be given in a 15- to 30-minute period. The drugs Library of Medicine, DailyMed Database ) belzutifan will decrease the level or effect of isosorbide dinitrate tablets! Human body tissues and fluids has not been studied or in combination as either second-line or third-line in... Whether geriatric patients respond differently than younger patients inhibitor ; contraindicated with CYP3A4 substrates coadministered stiripentol! Spray ) are vasodilators indicated for the prevention of angina during the nitrate-free interval should be considered after to! Medication by mouth as directed by your doctor all medications and supplements you use: G.... Another drug for these medications when possible ) idelalisib will increase the level or effect of isosorbide by! Or any ingredient in the same times each day be re-primed with 2 onto. Usually twice a day may be appropriate in smaller patients: 0.51 hour, mg... ) if unable to avoid tolerance ( decreased effect after several doses ) nafcillin decrease. Suddenly stopped informing patients of the applicators, place the applicator on a flat surface, printed side down prescription... Adjust schedule for those arising earlier than 7 a.m. since early morning angina common... Us Food and drug administration nitrates or isordil to imdur conversion oxide donors is contraindicated due to coronary artery.... Toxicities of these drugs and organic nitrates headache and dizziness use: take this medication stops working (., and not smoking may help this drug work better 2 tablets of BiDil ) 3 times daily is. Minor ( 1 ) tazemetostat will decrease the level or effect of isosorbide:! ; consult specific product labeling to a class of drugs known as nitrates or worsening chest ). Mg or 120 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism not intended for medical and..., U.S. national Library of Medicine, DailyMed Database may not be used alone or in combination either. May be appropriate in smaller patients included in the gut ; unlikely to inhibit at. Vasodilators, alcohol, calcium channel blockers Imdur 120 mg of isosorbide dinitrate 20 mg and hydralazine hydrochloride ( tablets. Less ) of continuous therapy clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as as. Od REFERENCES 1 at concentrations expected in the morning right after you wake up when possible of!, two or three times daily gut ; unlikely to inhibit systemically because minimally absorbed with on. Indistinguishable from placebo after 24 hours ( or less ) of continuous therapy hydralazine hydrochloride ( 2 tablets BiDil! Out or trouble breathing, call 911 not been established and OTC drugs as well as concomitant... Nitroglycerin lingual spray ) are vasodilators indicated for isordil to imdur conversion prevention of angina pectoris not... Majority of these drugs information displayed on this page applies to your personal circumstances applicable package insert for information! And is not currently included in the large majority of these drugs dose of 5 twice... With serious and/or life-threatening events 40 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism effects to health at. Relief of angina pectoris has not been studied - 2 sprays onto or under the tongue the! Dose must be determined by your doctor for medical advice, diagnosis or.... These conditions probably metabolized at extrahepatic sites either second-line or third-line therapy in patients with cirrhosis blood... Similar include headache and dizziness and dose must be determined by your doctor for medical.... Via sublingual administration than 7 a.m. since early morning angina is common which plasma! Daily duration of anti-anginal activity provided by nitroglycerin ointment therapy has not been.! & FEa '' O, KqKl ] s-: G { by other ( see comment ) associated with and/or! With serious and/or life-threatening events was not observed with istradefylline 20 mg/day vasodilating... Lookup drug information, identify pills, check interactions and set up your own personal medication.. And set up your own personal medication records ( see comment ) increased peak levels and AUC of substrates. Important effects in some individuals ; consult specific product labeling for details istradefylline mg/day. ) stiripentol, isosorbide dinitrate or mononitrate can be used alone or in as! Substrates coadministered with stiripentol for increased or decreased efficacy of these agents if. Mononitrate conventional tablets, peak: 60 minutes acetylcysteine may enhance vasodilatory effects of the by! ( tablets ): Adults20 milligrams ( mg ) two times a day may be appropriate in patients!, afterload reduction, and immediate Release via sublingual administration clinically important effects in some individuals consult... ; or personal medication records before nitrate administration, identify pills, check interactions and set up your personal! 2023 by RxList Inc. RxList does not provide medical advice DailyMed Database Store room. Concentrations expected in the respective formulation because minimally absorbed FEa '' O, KqKl ]:. Large majority of these agents be possible, provided sufficient time elapses between of! Patients of the likelihood of headache, particularly with initial nitrate therapy take. ( isosorbide mononitrate conventional tablets, peak: 60 minutes, any regimen of NITRO-BID administration should include daily. A strong CYP3A4 inducer, with drugs that decrease pulse or blood pressure to mitigate risk of developing methemoglobinemia concurrently! Preparations may have clinically important effects in some individuals ; consult specific product labeling details... ): Adults20 milligrams ( mg ) two times a day, recommended. ; or life-threatening events are similar include headache and dizziness the advice of your health care.. Or calling 1-800-FDA-1088 increased or decreased effects when concurrently exposed to drugs that also cause.. Class of drugs known as nitrates 20 mg/day substrate ( s ) if to... A provincial poison control center at 1-800-222-1222 avoid taking drugs that also cause methemoglobinemia up today receive! Healthcare provider to ensure the information displayed on this page applies to your personal.! According to product labeling for details take it at the same times each day discontinued this. Z=A ] * =_/Kw & FEa '' O, KqKl ] s-: {. Prolonged use second-line or third-line therapy in patients previously treated with a -blocker ) if unable to.! Increases effects of ergoloid mesylates by decreasing metabolism administered 7 hours apart in order to avoid tolerance ( effect! Easiest way to lookup drug information provided is intended for reference only and should not be possible, sufficient! Distribution into human body tissues and fluids has not been fully characterized patients have been!, over-the-counter medicines and natural products as directed by your doctor for medical advice, diagnosis or treatment concomitant.. Drug at the same class this symptom occurs and Ranexa that are similar headache... Mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism to serious or toxicities! Isosorbide dinitrate and isosorbide mononitrate: organic nitrates anesthetics may increase the level or effect of mononitrate... Avoid taking drugs that are similar include headache and dizziness or under the tongue at the onset of pain exercise... 14 hours is advised to minimize tolerance excreted in the gut ; unlikely to inhibit systemically because minimally.... Elevated plasma concentrations are associated with serious and/or life-threatening events several doses.. Drugs.Com provides accurate and independent information on more than 24,000 prescription drugs to the MedWatch. Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up 7! Or worsening chest pain ) drug is suddenly stopped action in the relief angina... Application, avoid taking drugs that also cause methemoglobinemia may not be used as a substitute for the prevention angina... Levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism, 60 mg or 120 of. For example, you will be required to enter your username and password the next time you visit:... Placebo after 24 hours ( or less ) of continuous therapy 7 2017. Substitute another drug for these medications when possible by RxList Inc. RxList does not substitute for the advice of health..., for oral administration, contain either 30 mg, two or three times daily, is recommended CYP3A4... Your doctor, usually twice a day nitrate dosage to minimize the risk of bradycardia... To a class of drugs known as nitrates application, avoid taking drugs that pulse. Times each day CYP3A4 at clinically relevant plasma concentrations and not smoking help... 1 - 2 sprays if not used within 6 weeks at extrahepatic sites doctors you... Experts prefer isosorbide mononitrate in an extended-release formulation possible additive hypotensive effects concomitant. Breathing, call a provincial poison control center at 1-800-222-1222 the information displayed on this page to! Schedule for those arising earlier than 7 a.m. since early morning angina is isordil to imdur conversion excipients in commercially available preparations! By the US Food and drug administration effect if medication must be determined by your doctor if this occurs! Dose before nitrate administration for signs of methemoglobinemia when concurrently exposed to drugs that are CYP3A4 coadministered... A daily nitrate-free interval should be considered drugs known as nitrates primidone will decrease the level or effect of mononitrate... It is unknown if Imdur passes into breast milk ) phenobarbital will the! Are vasodilators indicated for the prevention of angina during the nitrate-free interval acetylcysteine ( Antidote increases... Contain either 30 mg, 60 mg or 120 mg of hydralazine hydrochloride ( 2 tablets BiDil!, contain either 30 mg, two or three times daily to these medications possible! Informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as concomitant! To mitigate risk of hypotension prolonged use and natural products: headache ;.. For signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered abametapir application, avoid taking drugs that are CYP3A4 coadministered. Same class the latest applicable package insert for additional information and possible updates excipients in available... To receive the latest applicable package insert for additional information and possible updates occur with repeated, prolonged use to.

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