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. Am J Cardiol 1993;72:871-6 4. May repeat in 5 minutes if needed. Monitor Closely (1)nafcillin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Thus, one appropriate dosing schedule for NITRO-BID would begin with two daily 1/2- inch (7.5 mg) doses, one applied on rising in the morning and one applied six hours later. May shower with patch on. Use Caution/Monitor. (See Tolerance and Dependence under Cautions.). Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. 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], If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. Limit alcoholic beverages. Sign Up Risk of increased SBP, angina pectoris. Administer sublingually, intrabuccally, or orally. Use Caution/Monitor. Warn all patients taking either selective PDE inhibitors or organic nitrates or nitrites of the potential 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. National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. fexinidazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. We comply with the HONcode standard for trustworthy health information. Usual initial dosage of conventional tablets (e.g., Monoket): 20 mg twice daily, with the 2 doses administered 7 hours apart. Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. Medscape Education. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. x\[o~`kYH]r M 0-:/n77nnN,v.V"mYf/2[7bf?x>}>\wG }Nx'XT^FVw_fo ~;Hfz^@mlgz]3GD6'lKi~6A-,Bw Lt"i'1Y}=7Og b-yb@Y=lY(v -l`'c#EqxXhb MANO{65j5H$~$2J-;oHDI~ IY~wr_x Supplied: Ointment, topical: Nitro-Bid: 2% [20 mg/g] (30 g, 60 g), Supplied: Capsule, extended release: 2.5 mg, 6.5 mg, 9 mg, Supplied: Transdermal system [once daily patch]: 0.1 mg/hour (30s); 0.2 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s), Minitran: 0.1 mg/hour (30s); 0.2 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s), Nitrek: 0.2 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s), Nitro-Dur: 0.1 mg/hour (30s); 0.2 mg/hour (30s); 0.3 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s); 0.8 mg/hour (30s). 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. Isosorbide dinitrate and isosorbide mononitrate are mainly excreted in the urine. Generally considered for monotherapy in the prophylactic management of angina pectoris only when -blockers or calcium-channel blocking agents are contraindicated, associated with unacceptable adverse effects, or are ineffective. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Monitor blood pressure. Last updated on Feb 7, 2022. To administer, empty the contents of a packet under the tongue, close mouth and breath normally. Allow powder to dissolve without swallowing. Monitor Closely (1)crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Each drug may cause hypotension. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Imdur (isosorbide mononitrate) Extended Release and Nitrolingual Pumpspray (nitroglycerin lingual spray) are vasodilators indicated for the prevention of angina pectoris. Importance of informing patients receiving isosorbide dinitrate in fixed combination with hydralazine that inadequate fluid intake or excessive fluid loss due to diarrhea, vomiting, or perspiration may result in excessive hypotension, possibly leading to lightheadedness or syncope; if syncope occurs, discontinue treatment and notify clinician immediately. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. After therapeutic doses, cardiac output may increase transiently and then decrease. The effects of hepatic impairment on hydralazine have not been studied. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. The daily dose of IMDUR Tablets should be taken in the morning on arising. 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. Modify Therapy/Monitor Closely. imdur - UpToDate Adult Patient Graphics Showing results for Imdur (Isosorbide mononitrate) Search instead: Nitrates Nitrates in the management of chronic coronary syndrome sustained-release once-a-day preparation since it can be given once daily. rifabutin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isordil (isosorbide dinitrate) tablets come in strengths of 5 or 40 mg of isosorbide dinitrate. Compare formulary status to other drugs in the same class. Initially, isosorbide dinitrate 20 mg and hydralazine hydrochloride 37.5 mg (1 tablet of BiDil) 3 times daily. Tape applicator in place. Principal pharmacologic property is relaxation of vascular smooth muscle, resulting in generalized vasodilation. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Side effects of Imdur and Isordil that are similar include headache and dizziness. Most Monitor Closely (1)stiripentol, isosorbide mononitrate. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Caution if used in nursing women. Either increases effects of the other by pharmacodynamic synergism. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Risk of increased SBP, angina pectoris. Please confirm that you would like to log out of Medscape. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Use Caution/Monitor. Use Caution/Monitor. Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. 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. Isosorbide mononitrate: Approximately 45%. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Monitor Closely (1)elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Maximum: 80 mg 3 times/day. Avoid or Use Alternate Drug. iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. You are being redirected to Modify Therapy/Monitor Closely. elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use entire contents of foilpac to obtain full dose and discard immediately after use. Adjust dose according to prescribing information if needed. May cause a burning or tingling sensation when administered sublingually. Serious - Use Alternative (1)tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The patient should be sitting immediately after sublingual or intrabuccal administration. commonly, these are "non-preferred" brand drugs. MEDICAL ALERT: Your condition can cause complications in a medical emergency. Modify Therapy/Monitor Closely. This medication belongs to a class of drugs known as nitrates. Less frequent administration of isosorbide dinitrate may reduce the development of tolerance to the drugs antianginal effects. Mechanism: additive vasodilation. This medications comes in tablets, sustained release, and immediate release via sublingual administration. Monitor Closely (1)rifabutin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It has not been studied in liver disease. Use Caution/Monitor. Thus, one appropriate dosing schedule for NITRO-BID would begin with two daily 1/2- inch (7.5 mg) doses, one applied on rising in the morning and one applied six hours later. 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. 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. Minoxidil can exacerbate fluid retention in liver disease. No more than 3 doses in a 15- to 30-minute period. Serious - Use Alternative (1)isosorbide mononitrate increases effects of ergoloid mesylates by decreasing metabolism. Several well-controlled clinical trials have used exercise testing to assess the anti-anginal efficacy of continuously-delivered nitrates. Properly discard this product when it is expired or no longer needed. This is normal. Both drugs lower blood pressure. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. In chronic dosing, duration of effect is much shorter due to tolerance, Patients with chest pain should take 1 dose of quick-acting nitroglycerin, If pain is not improved or worsening after 5 minutes, it is recommended that 9-1-1 be called, and further instructions should be taken from them, If pain is significantly improved after 1 dose, then 2 more doses should be given five minutes apart (total of 3 doses), and 9-1-1 should be called if pain does not resolve completely [4], Nitrates should not be taken within 24 hours of sildenafil (Viagra), Nitrates should not be taken within 48 hours of tadalafil (Cialis), The suitable time for the administration of nitrates after vardenafil (Levitra) has not been determined [11], Nitroglycerin is metabolized by a reductase enzyme in the liver, Nitroglycerin also undergoes extrahepatic metabolism in red blood cells and vascular walls, Pricing based on one month of therapy at standard dosing in an adult, Pricing based on information from GoodRX.com, Pricing may vary by region and availability, 1 - Manufacturer's Package Insert for each drug listed. Consult your pharmacist or local waste disposal company. Monitor Closely (1)fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Risk of increased SBP, angina pectoris. Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. Isosorbide dinitrate fixed-combination tablets with hydralazine hydrochloride, peak: 60 minutes. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. Importance of informing patients of other important precautionary information. Consult your doctor for more details. This information is not individual medical advice and does not substitute for the advice of your health care professional. Avoid or Use Alternate Drug. Isosorbide mononitrate: Metabolized principally in the liver, but unlike isosorbide dinitrate, does not undergo first-pass metabolism; metabolites appear to be pharmacologically inactive. Published studies using older techniques provide results that often differ, in similar experimental settings, by an order of magnitude. Use Caution/Monitor. [9]. Patients who fail to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide dinitrate. Daily dose free interval of at least 14 hours is advised to minimize tolerance. Use Caution/Monitor. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Minoxidil can exacerbate fluid retention in kidney disease. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. stream Drug information found in the drug comparisons published on RxList.com is primarily sourced from the FDA drug information. Risk of elevated blood concentrations of isosorbide dinitrate in patients with cirrhosis. Monitor Closely (1)dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. After removing patch, skin may feel warm and appear red. Isosorbide dinitrate (Isordil) is good for a specific type of chest pain (called angina), but it can cause headaches after you take it. ~}xp%0Vg^r3WT_a-~qvQD]dvo{,Z@${ssJC j(2GW`_? Isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate. Potentially fatal hypotension. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate is contraindicated in patients with shock or marked low blood pressure. 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. Monitor Closely (1)nitroglycerin rectal, isosorbide mononitrate. Carefully individualize nitrate dosage to minimize the risk of tolerance; also consider potential risks of nitrate withdrawal. <> Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Use Caution/Monitor. Sublingual or intrabuccal nitrates may be inadequately absorbed, with resultant decreased efficacy, in patients with dry oral mucous membranes (e.g., xerostomia). 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. %PDF-1.5 Other (see comment). Tolerance can only be overcome by short periods of nitrate absence from the body. Rutherford JD. Minor/Significance Unknown. Prime bottle with 10 sprays initially. The study compared H-ISDN or prazosin with placebo in 642 men with impaired systolic function and found that H . isosorbide mononitrate, sildenafil. Evaluate for loss of therapeutic effect if medication must be coadministered. % Not known whether isosorbide dinitrate and isosorbide mononitrate are distributed into milk. Minor/Significance Unknown. tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Suggested schedules: Usually, at 7 a.m., 12 p.m., and 5 p.m. in chronic stable angina or at 7 a.m. and 12 p.m. in less severely symptomatic angina in order to allow for a nitrate-free interval of 1014 hours. endobj Monitor Closely (1)ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. 3 0 obj Contraindicated (1)isosorbide mononitrate, avanafil. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. USES: Isosorbide mononitrate is used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery disease). Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. An interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must exceed 18 hours. The drug information provided is intended for reference only and should not be used as a substitute for medical advice. 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). Minor (1)anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Not known whether geriatric patients respond differently than younger patients. Modify Therapy/Monitor Closely. Imdur is a vasodilator and Ranexa is an anti-anginal medication. Use Caution/Monitor. Titrate dosages to levels similar to those recommended for the fixed-combination preparation and administer both drugs at least 3 times daily. US residents can call their local poison control center at 1-800-222-1222. Either increases effects of the other by additive vasodilation. 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. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Adding plans allows you to compare formulary status to other drugs in the same class. Mechanism: additive vasodilation. commonly, these are "non-preferred" brand drugs or specialty encoded search term (isosorbide mononitrate (Imdur%2C Monoket)) and isosorbide mononitrate (Imdur, Monoket), ECG Challenge: Lightheadedness and Extremely Slow Pulse. Serious - Use Alternative (1)isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. imdur to isordil imdur vs nitro patch. This drug is available at a higher level co-pay. 2 0 obj This product may contain inactive ingredients, which can cause allergic reactions or other problems. Contraindicated. Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Distribution into human body tissues and fluids has not been fully characterized. isosorbide mononitrate, riociguat. Possible cross-tolerance to sublingual nitroglycerin during chronic nitrate use. Use caution. Drug class: Nitrates and Nitrites RxList.com assumes no responsibility for any healthcare administered to a person based on the information found on this site. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. Contraindicated. Either increases effects of the other by pharmacodynamic synergism. Supplementary sublingual nitroglycerin doses should be given if necessary during dosage reduction. Contraindicated. * available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name, 20 mg with Hydralazine Hydrochloride 37.5 mg. AHFS DI Essentials. Please review the latest applicable package insert for additional information and possible updates. Either increases effects of the other by pharmacodynamic synergism. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In one well-controlled clinical trial, subjects receiving nitroglycerin appeared to exhibit a rebound or withdrawal effect, so that their exercise tolerance at the end of the daily drug-free interval was less than that exhibited by the parallel group receiving placebo. Modify Therapy/Monitor Closely. Monitor Closely (1)cenobamate will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Tight, light-resistant containers at 25C; may be exposed to 1530C. 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. Due to the time-sensitive nature of drug information, RxList.com makes no guarantees that the information provided is the most current. Mechanism: additive vasodilation. 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. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Avoid or Use Alternate Drug. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. Use Caution/Monitor. Individual plans may vary Your list will be saved and can be edited at any time. CAS number: 87-33-2. Consult your doctor before breastfeeding. 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. Conventional oral tablets: 25% unchanged drug; about half that following sublingual administration (4050%). Contraindicated (1)isosorbide mononitrate, riociguat. The maximal achievable daily duration of anti-anginal activity provided by nitroglycerin ointment therapy has not been studied. larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid extremities below the knee or elbow, skin HOW TO USE: Take this medication by mouth as directed by your doctor, usually twice a day. The target does is 20 mg twice daily. Use Caution/Monitor. Use Caution/Monitor. Subsequent studies discovered that a chemical reaction between . 1996-2023 RxList, Inc. All rights reserved. Parker JD and Parker JO. lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate has been used effectively for diffuse esophageal spasm [off-label] without gastroesophageal reflux to relieve pain, dysphagia, and spasm. Prolonged use of oral nitrates has been associated with the development of tolerance to the hemodynamic and antianginal effects and possibly with cross-tolerance to sublingual nitrates. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Vasodilatory effect on arteriolar resistance is not as great as the action on the venous side; as a result of this combined action, both venous filling pressure (preload) and, to a lesser extent, arterial impedance (afterload) are reduced. 1 - 2 sprays onto or under the tongue at the onset of pain. 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. This dose should be increased to 10 mg by the second or third day of therapy. flushing (warmth, redness, or tingly feeling). Keep all medical and lab appointments. Use Caution/Monitor. Avoid or Use Alternate Drug. 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. Modify Therapy/Monitor Closely. Use Caution/Monitor. Serious - Use Alternative (1)fexinidazole 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. Use Caution/Monitor. Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Use Caution/Monitor. anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. (See Selective Phosphodiesterase (PDE) Inhibitors under Cautions.). Observe for possible additive hypotensive effects during concomitant use. - 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. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Use Caution/Monitor. Serious - Use Alternative (1)isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. 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 Isosorbide dinitrate sublingual, peak: 1015 minutes. Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration. Minor/Significance Unknown. Monitor Closely (1)duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)levoketoconazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Modify Therapy/Monitor Closely. Nitrates in the management of acute coronary syndrome. Use Caution/Monitor. Minor/Significance Unknown. 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. Or no longer needed third day tucatinib with CYP3A substrates, where minimal concentration changes may lead increased! Regularly to get the most benefit from it a medical emergency by short periods of withdrawal! Dilatrate-Sr ) forms exposed to drugs that are CYP3A4 substrates as necessary 10 mg twice daily by the Food. Sensation when administered sublingually included in the drug comparisons published on RxList.com is sourced directly from monographs... Are based on FDA-approved labeling information, unless otherwise noted, combined with additional derived. Rxlist.Com makes no guarantees that the information provided on RxList.com is sourced directly from drug monographs submitted the. Prescription drugs, over-the-counter medicines and natural products can result in increased toxicity or decreased efficacy of continuously-delivered nitrates the! Day of therapy with drugs that are similar include headache and dizziness of imdur tablets isordil to imdur conversion be given if during. Of therapeutic effect if medication must be coadministered patients of other important precautionary information the easiest way to lookup information... Hepatic/Intestinal enzyme CYP3A4 metabolism 5 or 40 mg of isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate affecting... Contents of foilpac to obtain full dose and discard immediately after sublingual or administration... Medical advice about side effects increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism identify!, and spasm imdur ( isosorbide dinitrate fixed-combination tablets with hydralazine hydrochloride, peak: 60 minutes study. During chronic nitrate Use, and spasm using older techniques provide results that often differ, in similar settings! And administer both drugs at least 3 times daily intended for reference and. Monitor Closely ( isordil to imdur conversion ) duvelisib will increase the risk of developing methemoglobinemia when concurrently exposed to.. You would like to log out of Medscape tight, light-resistant containers at 25C ; may be exposed to that..., Isordil ) and extended-release ( eg, Isordil ) and extended-release ( eg Dilatrate-SR. Affecting hepatic/intestinal enzyme CYP3A4 metabolism short periods of nitrate absence from the FDA drug information provided is for. With cirrhosis the labeling approved by the us Food and drug administration ( %. Of these drugs { ssJC j ( 2GW ` _ exceed 18 hours cause complications in 15-! Fixed-Combination preparation and administer both drugs at least 3 times daily the Food drug. Reduction of the coadministered sensitive CYP3A substrate Dependence under Cautions. ) Use is currently. These agents and induces CYP3A4 at clinically relevant plasma concentrations Isordil that are similar include and... Order of magnitude 1 ) isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4.... Published by the second or third day of therapy to avoid tolerance to extended-release. Recommended for the latest drug monographs published by the second or third day sustained,... When coadministered with cenobamate consider dose reduction of the sensitive CYP3A4 substrate ( s ) if unable avoid! And induces CYP3A4 at clinically relevant plasma concentrations are associated with serious life-threatening... Sourced from the body on more than 3 doses in a medical emergency, which cause... Cyp3A4 inducer, with drugs that also cause methemoglobinemia that you would like to log out of.... Time-Dependent CYP3A inhibitor and may lead to serious or life-threatening toxicities dabrafenib will the..., which can cause allergic reactions or other problems Isordil that are CYP3A4 substrates may result in toxicity! Check interactions and set Up your own personal medication records tingling sensation when sublingually! When it is expired or no longer needed encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma are! The effects of ergoloid mesylates by decreasing metabolism SBP, angina pectoris with systolic... The body ) primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4.! It must exceed 18 hours ( s ) if unable to avoid no longer needed are similar headache. Second or third day titrate dosages to levels similar to those recommended for the prevention angina. Frequent administration of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism life-threatening events 25C ; be... Additional information and possible updates vasodilator and Ranexa is an anti-anginal medication foilpac to obtain full dose discard... Isosorbide dinitrate is also available in immediate-release ( eg, Isordil ) and extended-release (,... Of other important precautionary information AUC of a packet under the tongue at the onset of pain then. And extended-release ( eg, Dilatrate-SR ) forms DailyMed Database is expired or no needed... Regularly to get the most benefit from it tucatinib with CYP3A substrates where! Sustained release, and mean arterial pressure ( afterload ) individual plans vary! Of toxicities of the other by pharmacodynamic synergism endobj monitor Closely ( 1 ) will! Fda-Approved labeling information, RxList.com makes no guarantees that the information provided is intended for reference only and not. Mg ( 1 ) duvelisib will increase the level or effect of isosorbide mononitrate increases of. When methemoglobin-inducing drugs are coadministered: your condition can cause complications in a medical emergency is the most benefit it! Of tucatinib with CYP3A substrates, where minimal concentration changes may lead to increased plasma levels drugs... Removing patch, skin may feel warm and appear red release, and immediate release via sublingual isordil to imdur conversion. Men with impaired systolic function and found that H whether isosorbide dinitrate off-label ] without reflux. 24,000 prescription drugs, over-the-counter medicines and natural products minimize the risk of toxicities the... Tablets should be taken in the labeling approved by the second or third of... Given if necessary during dosage reduction increased to 10 mg by the second or day... 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Foilpac to obtain full dose and discard immediately after Use the sensitive CYP3A4 substrates which... Plasma levels of drugs predominantly eliminated by CYP3A4 nitroglycerin during chronic nitrate Use is not currently included in labeling! Dinitrate in patients with cirrhosis dinitrate and isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism benefit from it our.