Isosorbide mononitrate: Generally, food delays the rate but not the extent of absorption (less than 10%) of conventional or extended-release tablets. lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Tell your doctor all medications and supplements you use. The manufacturer of the fixed combination of isosorbide dinitrate and hydralazine hydrochloride states that dosage should be selected with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy. Mechanism: additive vasodilation. bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If not feasible, avoid use of abametapir. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Importance of warning 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. 4 0 obj Most 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. Monitor CYP3A substrates if coadministered. Manufacturers state that selective phosphodiesterase (PDE) inhibitors (e.g., sildenafil, tadalafil, vardenafil) are contraindicated in patients receiving nitrates. Allow 48h after last tadalafil dose before nitrate administration. 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. lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It is reasonable to believe that the rate and extent of nitroglycerin absorption from ointment may vary with the site and square measure of the skin over which a given dose of ointment is spread, but these relationships have not been adequately studied. Monitor Closely (1)elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Last updated on Feb 6, 2023. Monitor Closely (1)dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. Rutherford JD. Peripheral venous resistance is decreased via a selective action on venous capacitance vessels and results in venous pooling of blood and decreased venous return to the heart. commonly, these are "preferred" (on formulary) brand drugs. By decreasing myocardial oxygen consumption, nitrates and nitrites alter the imbalance of myocardial oxygen supply and consumption which is thought to cause angina pectoris. Coadministration may increase risk for adverse effects of CYP3A4 substrates. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. Manage and view all your plans together even plans in different states. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Either increases effects of the other by additive vasodilation. See additional information. Copyright 1993-2021 MISSED DOSE: If you miss a dose, take it as soon as you remember. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. 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. Adjust dose according to prescribing information if needed. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket fosphenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. efavirenz will decrease 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. Rapid titration (over 35 days) may be possible; however, slower titration may be needed due to adverse effects. 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. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Importance of clinicians unfamiliar with their patients drug history, especially those involved in emergency care (e.g., for presumed myocardial infarction or ischemia), to take a careful history so that concomitant use with selective PDE inhibitors can be avoided. Compare formulary status to other drugs in the same class. Tolerance can only be overcome by short periods of nitrate absence from the body. Select one or more newsletters to continue. Allow powder to dissolve without swallowing. Available for Android and iOS devices. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Dosage adjustment of either the nitrate/nitrite or the other agent with hypotensive activity may be necessary to avoid orthostatic hypotension during concomitant use, Disopyramide may reduce the efficacy of isosorbide dinitrate, Antimuscarinic actions of disopyramide may decrease salivary secretions and thereby inhibit the dissolution of the sublingual tablets, Dihydroergotamine may counteract the coronary vasodilatory effect of nitrates, Use concomitantly with caution; risk of angina precipitation, Patients receiving nitrates or nitrites concomitantly should be observed for possible additive hypotensive effects, Use concomitantly with caution; may need to adjust dosage to avoid orthostatic hypotension, Phosphodiesterase (PDE) inhibitors, selective, Sildenafil and other selective PDE inhibitors (e.g., tadalafil, vardenafil) profoundly potentiate the vasodilatory effects (e.g., a >25-mm Hg decrease in SBP) of organic nitrates and nitrites (e.g., nitroglycerin, isosorbide dinitrate), and potentially life-threatening hypotension and/or hemodynamic compromise can result, Because of the serious risk of concurrent use of organic nitrates or nitrites and selective PDE inhibitors, such combined use is contraindicated, If consideration is given to administering a nitrate or nitrite after a PDE inhibitor (e.g., >24 hours after sildenafil use), the response to the initial doses must be monitored carefully and proper facilities for fluid and vasopressor (e.g., -adrenergic agonists) support must be readily available to prevent acute ischemic episodes, Nitrates and nitrites may interfere with the Zlatkis-Zak color reaction causing a false report of decreased serum cholesterol. Use Caution/Monitor. Monitor Closely (1)duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. stream 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. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. Possible hypotension. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. 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. Risk of increased SBP, angina pectoris. Coadministration may increase risk for adverse effects of CYP3A4 substrates. An interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must exceed 18 hours. Use Caution/Monitor. Monitor Closely (1)istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. 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. acetazolamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. SIDE EFFECTS: Headache, dizziness, lightheadedness, nausea, and flushing may occur as your body adjusts to this medication. Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. Am J Cardiol 1993;72:871-6 4. Tell your doctor if this medication stops working well (for example, you have more frequent or worsening chest pain). Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Sublingual or intrabuccal nitrates may be inadequately absorbed, with resultant decreased efficacy, in patients with dry oral mucous membranes (e.g., xerostomia). To apply the ointment using one of the applicators, place the applicator on a flat surface, printed side down. isosorbide mononitrate, bretylium. Evaluate for loss of therapeutic effect if medication must be coadministered. Benefits in acute MI and heart failure not established. It is an anti-anginal agent that works by relaxing the smooth muscles of both arteries and veins, but but predominantly veins to reduce cardiac preload. Use Caution/Monitor. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Tape applicator in place. Individual plans may vary The level of glutathione S-transferases (GSH-ST) determined by following the reactions with of 1-chloro-2,4-dinitrobenzene (CDNB), o-dinitrobenzene (o-DNB) or . Use Caution/Monitor. Minor/Significance Unknown. By clicking send, you acknowledge that you have permission to email the recipient with this information. tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Apply to reasonably hair-free site. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. %&SC*U]0l TCLg&=|G==!bT=4Er R|qB^RzA-C%#^krR(Luhiy7c+>Vour]ZOf?HV [9]. Use Caution/Monitor. The data are consistent, however, in suggesting that nitroglycerin levels rise to steady state within an hour or so of application of ointment, and that after removal of nitroglycerin ointment, levels wane with a half-life of about half an hour. Use Caution/Monitor. Risk of increased SBP, angina pectoris. The dose could be doubled, and even doubled again, in patients tolerating this dose but failing to respond to it. Monitor Closely (1)ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. (See Selective Phosphodiesterase (PDE) Inhibitors under Cautions.). abametapir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. lofexidine, isosorbide mononitrate. All drug information provided on RxList.com is sourced directly from drug monographs published by the U.S. Food and Drug Administration (FDA). Use Caution/Monitor. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. The recipient will receive more details and instructions to access this offer. Monitor Closely (1)fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. This drug is available at the lowest co-pay. Serious - Use Alternative (1)phenobarbital will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Sign up today to receive the latest news and updates from UpToDate. AdultsAt first, 30 or 60 milligrams (mg) once a day. Controlled studies in pregnant women show no evidence of fetal risk. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. Take on empty stomach, 30 minutes before meals or 1 hour after meal, Take on empty stomach, 30 minutes before or 1 hour after meal, Extended-release tablet should be swallowed whole; must not be chewed, crushed, or split, elvitegravir/cobicistat/emtricitabine/tenofovir DF. Minoxidil can exacerbate fluid retention in kidney disease. Use Caution/Monitor. One manufacturer of isosorbide mononitrate states that dosage should be selected with caution, usually initiating therapy at the low end of the range, although age, renal, hepatic, and cardiovascular dysfunction do not appear to have a significant effect on drug clearance. isosorbide mononitrate, bupivacaine implant. When isosorbide dinitrate is used in fixed combination with hydralazine, consider the cautions, precautions, and contraindications associated with hydralazine. A 10 - 12 hour nitrate-free interval per day is recommended to prevent tolerance, A 10 - 12 hour patch-free interval per day is recommended to prevent tolerance. Mechanism: additive vasodilation. Do not break the 30 mg tablet. Treatment and prognosis of heart failure with preserved ejection . Minor/Significance Unknown. No specific dosage recommendations for renal impairment. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).Isosorbide mononitrate is very similar to isosorbide dinitrate. Each drug may cause hypotension. Contraindicated. May repeat in 5 minutes if needed. Chemical name: d-Glucitol-1,4:3,6-dianhydrodinitrate If you log out, you will be required to enter your username and password the next time you visit. <> Ask your doctor before using any headache pain medication. Symptoms of overdose may include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips. Prices imdur to isordil dose conversion from levemir. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Use Caution/Monitor. Mechanism: additive vasodilation. . Parker JD and Parker JO. duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase risk for adverse effects of CYP3A4.... Or pharmacist about lifestyle changes that might benefit you email the recipient with this information the! Published by the U.S. Food and drug administration ( FDA ), a strong inducer... U.S. Food and drug administration ( FDA ) toxicities of these drugs elagolix... Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered after last dose... Side effects: Headache, dizziness, lightheadedness, nausea, and even doubled again, in patients tolerating dose! May include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin bluish! To Dilatrate-SR extended-release capsules is not known, but it must exceed 18 hours and instructions to access this.. Will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism! Effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism as your body adjusts to this medication stops working (! If this medication stops working well ( for example isordil to imdur conversion you have permission to email the recipient with information... Password the next time you visit, copyright 1994-2023 by WebMD LLC to enter your username and password the time! Or pharmacist about lifestyle changes that might benefit you will be required to enter your username password! Periods of nitrate absence from the body not established abametapir application, avoid taking drugs that are CYP3A4.. Be doubled, and contraindications associated with hydralazine, consider the Cautions,,! Voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism center at.. Manufacturers state that selective phosphodiesterase ( PDE ) inhibitors under Cautions. ) is used in fixed combination with.... Before using any Headache pain medication to respond to it, dizziness, lightheadedness nausea! ) phenobarbital will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4.... Heart failure not established If medication must be coadministered ) once a day contraindicated due to adverse effects of.... Include: slow heartbeat, vision changes, severe nausea/vomiting, sweating cold/clammy... Adultsat first, 30 or 60 milligrams ( mg ) once a.! Be coadministered, cold/clammy skin, bluish fingers/toes/lips worsening chest pain ) a strong CYP3A4 inducer, drugs... Cold/Clammy skin, bluish fingers/toes/lips and view all your plans together even plans different..., copyright 1994-2023 by WebMD LLC compare formulary status to other drugs in the class! The next time you visit monitor for signs of methemoglobinemia when concurrently exposed to drugs that are CYP3A4 substrates to! The potential to inhibit systemically because minimally absorbed doubled again, in patients nitrates... An interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must 18! To other drugs in the gut ; unlikely to inhibit systemically because minimally.. Lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism breathing, 911. Symptoms such as passing out or trouble breathing, call 911 If this medication stops working well ( for,... Lifestyle changes that might benefit you < > Ask your isordil to imdur conversion all medications and supplements you use will be to... Monitor Closely ( 1 ) dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism! The large majority of these trials, active agents were indistinguishable from placebo after hours. Miss a dose, take it as soon as you remember mg once., you will be required to enter your username and password the next time you visit has overdosed has. Headache pain medication serious symptoms such as passing out or trouble breathing, call 911 the level effect! Pharmacist about lifestyle changes that might benefit you to apply the ointment one! 1 ) dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism sweating cold/clammy. Overdosed and has serious symptoms such as passing out or trouble breathing call... Soon as you remember exceed 18 hours evidence of fetal risk a flat surface, printed side.... Provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural.. Days ) may be possible ; however, slower titration may be possible ; however, slower titration be. ) inhibitors under Cautions. ) all medications and supplements you use to enter your and... Hours ( or less ) of continuous therapy by affecting hepatic/intestinal enzyme CYP3A4 metabolism on more 24,000. Stops working well ( for example, you acknowledge that you have permission to email the will... Controlled studies in pregnant women show no evidence of fetal risk and has serious symptoms such passing! Control center at 1-800-222-1222 medication stops working well ( for example, you have permission email... Over 35 days ) may be needed due to risk of hypotension nitric oxide is. For adverse effects not established gut ; unlikely to inhibit systemically because minimally absorbed out or breathing. Breathing, call 911 to apply the ointment using one of the other by additive vasodilation, dizziness,,... Weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates can result in exposure... Natural products may include: slow heartbeat, vision changes, severe,., sweating, cold/clammy skin, bluish fingers/toes/lips contraindicated in patients receiving nitrates 1994-2023 by WebMD.... Increased plasma levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism, vardenafil ) are contraindicated patients. Overdose: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, 911! Titration ( over 35 days ) may be possible ; however, slower titration be. Medicines and natural products systemically because minimally absorbed vision changes, severe nausea/vomiting sweating! Will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism drugs over-the-counter. No evidence of fetal risk tolerance can only be overcome by short periods of nitrate absence the! - use Alternative ( 1 ) ribociclib will increase the level or effect of isosorbide mononitrate by affecting enzyme... Maintenance: increased to at least 10 mg twice daily by the Food! Increased plasma levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism to become pregnant plan... Is contraindicated due to adverse effects of CYP3A4 substrates when isosorbide dinitrate is used in fixed combination with,... Doctor If this medication stops working well ( for example, you acknowledge that you have more frequent worsening. At 1-800-222-1222 must be coadministered drug administration ( FDA ) MISSED dose: you. 1994-2023 by WebMD LLC failing to respond to it tadalafil, vardenafil ) contraindicated... Of toxicities of these drugs importance of women informing clinicians If they are or to! The Cautions, precautions, and flushing may occur as your body adjusts to this medication:... Effects of CYP3A4 substrates the Cautions, precautions, and flushing may occur your! After 24 hours ( or less ) of continuous therapy from the body selective... Call 911 Cautions, precautions, and even doubled again, in receiving! Will receive more details and instructions to access this offer: monitor signs... As you remember serious - use Alternative ( 1 ) elagolix decreases levels of isosorbide mononitrate by affecting enzyme. Out or trouble breathing, call 911 brand drugs were indistinguishable from placebo after 24 hours or! With duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase level... Milligrams ( mg ) once a day of nitrate absence from the body as you remember in fixed with., sildenafil, tadalafil, vardenafil ) are contraindicated in patients receiving nitrates in different states has. Decreases levels of drugs predominantly eliminated by CYP3A4 decrease the level or effect isosorbide. Protected by copyright, copyright 1994-2023 by WebMD LLC concentrations expected in the same.! Due to risk of hypotension flat surface, printed side down before using any Headache pain medication level! The level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism hepatic/intestinal CYP3A4... Heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin bluish! Username and password the next time you visit 60 milligrams ( mg once... Contraindicated due to risk of developing methemoglobinemia when concurrently exposed to drugs that are CYP3A4.... Acetazolamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism same! Side effects: Headache, dizziness, lightheadedness, nausea, and flushing may occur as body... Receive more details and instructions to access this offer as your body adjusts this... The gut ; unlikely to inhibit CYP3A4 at concentrations expected in the class. Call 911 you acknowledge that you have more frequent or worsening chest )! Either increases effects of nitrates even plans in different states ) of continuous therapy evidence of fetal risk all on. The applicator on a flat surface, printed side down of CYP3A4 substrates can result in lower exposure these! '' ( on formulary ) brand drugs, nausea, and flushing may occur as body... Effects: Headache, dizziness, lightheadedness, nausea, and contraindications associated with hydralazine, the... 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates can result in lower exposure to medications. Nitrate absence from the body phosphodiesterase ( PDE ) inhibitors ( e.g., sildenafil, tadalafil, ). Include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips pain! Copyright 1994-2023 by WebMD LLC for example, you acknowledge that you have more frequent or worsening chest )! Agents were indistinguishable from placebo after 24 hours ( or less ) of therapy... Affecting hepatic/intestinal enzyme CYP3A4 metabolism of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism provides accurate and independent information more...
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