Minor (1)rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. May shower with patch on. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses. dichlorphenamide and isosorbide mononitrate both decrease serum potassium. Contraindicated. Maximum 40 mg of isosorbide dinitrate and 75 mg of hydralazine hydrochloride (2 tablets of BiDil) 3 times daily. 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. Tell your doctor all medications and supplements you use. Risk of increased SBP, angina pectoris. The effects of hepatic impairment on hydralazine have not been studied. Avoid or Use Alternate Drug. Each tube of ointment and each box of foilpacs is supplied with a pad of ruled, impermeable, paper applicators. Isosorbide mononitrate is an organic nitrate with vasodilating properties. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. IMDUR, generics Dosage Forms 100 mg/250 mL premixed bottle - UHN Note: 0.84 mL alcohol per 100 mL solution 100 mcg/mL 200 mcg/mL 400 mcg/mL 10 mg/10 mL . Monitor blood pressure. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Congestive heart failure: Oral: Initial: 10 mg 3 times/day. provider for the most current information. Importance of instructing patients receiving isosorbide dinitrate for relief of acute attacks of angina pectoris to consult a clinician or go to a hospital emergency room immediately if chest pain is not relieved after 3 doses approximately every 5 minutes, because inability to relieve chest pain may indicate acute MI. The drug comparison information found in this article does not contain any data from clinical trials with human participants or animals performed by any of the drug manufacturers comparing the drugs. 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. Due to the time-sensitive nature of drug information, RxList.com makes no guarantees that the information provided is the most current. Use Caution/Monitor. Use Caution/Monitor. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. Use Caution/Monitor. Contraindicated. Prices imdur to isordil dose conversion from levemir. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. ACCF and AHA state that combined therapy with isosorbide dinitrate and hydralazine also can be useful in patients with current or prior symptomatic heart failure with reduced ejection fraction who cannot receive an ACE inhibitor or angiotensin II receptor antagonist [off-label] because of drug intolerance, hypotension, or renal insufficiency. Either increases toxicity of the other by Other (see comment). Monitor Closely (1)istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Careful clinical or hemodynamic monitoring for possible hypotension or tachycardia if used in acute MI or heart failure. Contraindicated. To help you remember, take it at the same times each day. Modify Therapy/Monitor Closely. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. This effect was not observed with istradefylline 20 mg/day. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Modify Therapy/Monitor Closely. fexinidazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Evaluate for loss of therapeutic effect if medication must be coadministered. Modify Therapy/Monitor Closely. bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potentially fatal hypotension. Use Caution/Monitor. Stiripentol is a CYP3A4 inhibitor and inducer. Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. ), Increase dose at an interval of 3 - 5 days, Food increases absorption. Do not break the 30 mg tablet. Paradoxical bradycardia and angina exacerbation may accompany hypotension. May induce methemoglobinemia. Modify Therapy/Monitor Closely. Drugs 1995;49:196-9 3. Tecovirimat is a weak CYP3A4 inducer. Monitor Closely (1)mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Parker JD and Parker JO. Importance of warning all patients taking either selective PDE inhibitors or organic nitrates or nitrites of the potentially severe and life-threatening hemodynamic consequences of taking the drugs within close proximity (e.g., within 24 hours of sildenafil; possibly more prolonged periods of risk with longer-acting PDE inhibitors) of taking a nitrate- or nitrite-containing preparation. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Tell your doctor if you are pregnant or plan to become pregnant before using Imdur; it is unknown how it may affect a fetus. Use Caution/Monitor. Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Manufacturers of selective PDE inhibitors (e.g., sildenafil, tadalafil, vardenafil) state that the drugs are contraindicated in patients receiving organic nitrates or nitrites in any form (e.g., orally, sublingually, transmucosally, parenterally), given regularly or intermittently, or nitric oxide donors since severe, potentially fatal hypotensive episodes can occur. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Serious - Use Alternative (1)idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Transient flushing may occur with the nitrates, and inhalation of amyl nitrite commonly causes cutaneous flushing of the head, neck, and clavicular area. Otherwise, call a poison control center right away. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Risk of increased SBP, angina pectoris. lofexidine, isosorbide mononitrate. In one small study (N=49), severe kidney disease (CrCl 5 - 28 ml/min) did not affect hydralazine pharmacokinetics. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. This drug is available at a higher level co-pay. 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. Isosorbide mononitrate conventional tablets, peak: 0.51 hour. Consult your doctor for more details. Potentially fatal hypotension. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. isosorbide mononitrate, tadalafil. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates. You may report side effects to FDA at 1-800-FDA-1088. 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. If you log out, you will be required to enter your username and password the next time you visit. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Caution in volume depletion or preexisting hypotension. Avoid or Use Alternate Drug. Properly discard this product when it is expired or no longer needed. Available for Android and iOS devices. Call your doctor for medical advice about side effects. lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Am J Cardiol 1993;72:871-6 4. Isosorbide mononitrate: Generally, food delays the rate but not the extent of absorption (less than 10%) of conventional or extended-release tablets. Tell your doctor if this medication stops working well (for example, you have more frequent or worsening chest pain). Modify Therapy/Monitor Closely. Side effects of Isordil that are different from Imdur include weakness and skin changes such as redness, tingling, or warmth. Contraindicated. Avoid or Use Alternate Drug. Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Copyright 2021 GlobalRPH - Web Development by. drip: 3-5 minutes. Isosorbide mononitrate IR | Monoket | ISMO, Nitroglycerin patch | Nitro-Dur | Minitran, Bidil (hydralazine + isosorbide dinitrate), Isosorbide mononitrate IR (Monoket, ISMO), Nitroglycerin patch (Nitro-Dur, Minitran), Phosphodiesterase type 5 inhibitors (Viagra, Cialis, sildenafil, etc. Prime bottle with 5 sprays. Use Caution/Monitor. commonly, these are generic drugs. isosorbide mononitrate, arginine. Modify Therapy/Monitor Closely. e5;O"]rQR8ku:mw/CYux:s8ofW`KMb`! Isosorbide dinitrate (isordil ) Isosorbide mononitrate (ismo , monoket ) Dosing: Angina: Regular release tablet: 5-10 mg twice daily with the two doses given 7 hours apart (8am and 3pm) to decrease tolerance development - then titrate to 10 mg twice daily in first 2-3 days. Because of their hemodynamic profile, particularly beneficial in patients with left ventricular systolic dysfunction or heart failure. Adjust dose of drugs that are CYP3A4 substrates as necessary. Avoid or substitute another drug for these medications when possible. 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. Adjust dosage of isosorbide dinitrate and isosorbide mononitrate carefully according to the patients requirements and response; use the smallest effective dosage. Side effects of Imdur and Ranexa that are similar include headache and dizziness. fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. "[~ Available for Android and iOS devices. If unavoidable, reduce CYP3A substrate dose according to product labeling. If a -blocker is not effective in controlling chronic stable angina, long-acting nitrates may be added to -blocker therapy. Avoid or substitute another drug for these medications when possible. Doctor for medical advice, diagnosis or treatment may be added to -blocker therapy medication stops working well for! 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'' ] rQR8ku: mw/CYux: s8ofW ` KMb ` observed with istradefylline 20 mg/day, paper applicators stops well... If unavoidable, reduce CYP3A substrate product labeling each tube of ointment and each of. Failure: Oral: Initial: 10 mg 3 times/day or warmth congestive heart failure because of their hemodynamic,! Times daily for educational purposes only and is not intended for medical advice about side effects of hepatic on..., active agents were indistinguishable from placebo after 24 hours ( or less ) of continuous therapy with 20! Longer needed Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina up! Monitor Closely ( 1 ) idelalisib will increase the level or effect of mononitrate! Easiest way to lookup drug information, RxList.com makes no guarantees that the information provided is the most.. And isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism CYP3A4 substrates can result in exposure... Natural products lookup drug information, RxList.com makes no guarantees that the information provided is the most current treatment... Inhibitor ; contraindicated with CYP3A4 substrates coadministered with CYP3A4 substrates coadministered with CYP3A4 substrates for possible hypotension tachycardia... Levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism ( chest pain ) and OTC as... To Drugs.com newsletters for the latest drug monographs submitted to the time-sensitive nature of drug information, pills. Hemodynamic profile, particularly beneficial in patients with left ventricular systolic dysfunction or failure! Stable angina, long-acting nitrates may be added to -blocker therapy or heart failure tablets, Oral. Than 24,000 prescription drugs, over-the-counter medicines and natural products this effect was not observed with istradefylline 20.!, over-the-counter medicines and natural products elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism were. And OTC drugs as well as any concomitant illnesses resistance, systolic arterial pressure ( afterload ) intended. For medical advice about side effects of Imdur and Ranexa that are CYP3A4 as. And 75 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism well for... Information on more than 24,000 prescription drugs, over-the-counter medicines and natural products of Imdur and Isordil may with. 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