rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Call your doctor for medical advice about side effects. Coadministration may increase risk for adverse effects of CYP3A4 substrates. Modify Therapy/Monitor Closely. Access your plan list on any device mobile or desktop. Monitor Closely (1)maraviroc, isosorbide mononitrate. Dosage form: tablet, extended release restrictions. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. 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. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. Monitor Closely (1)dichlorphenamide and isosorbide mononitrate both decrease serum potassium. 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. Consider dose reduction of sensitive CYP3A4 substrates. Risk of increased SBP, angina pectoris. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate undergoes extensive first-pass metabolism in the liver and considerable extrahepatic metabolism. Rapid titration (over 35 days) may be possible; however, slower titration may be needed due to adverse effects. Importance of informing patients of other important precautionary information. Potentially fatal hypotension. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Minor (1)acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Side effects of Imdur and Isordil that are similar include headache and dizziness. Manage and view all your plans together even plans in different states. Either increases effects of the other by additive vasodilation. Do not break the 30 mg tablet. tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Possibility of an increased frequency or severity of angina during the nitrate-free interval should be considered. idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. isosorbide mononitrate, vardenafil. Take consistently either with or without food. Otherwise, call a poison control center right away. Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). Apply to reasonably hair-free site. Avoid or Use Alternate Drug. Readily absorbed from the GI tract; does not undergo first-pass hepatic metabolism. 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. Avoid or Use Alternate Drug. US residents can call their local poison control center at 1-800-222-1222. Potentially fatal hypotension. Safety and effectiveness of Isordil in pediatric patients have not been established. Do not rub into the skin. commonly, these are "non-preferred" brand drugs or specialty Adjust dose of drugs that are CYP3A4 substrates as necessary. Is Low-Dose Aspirin Linked to Risk for Gastric Ulcers? conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dosage of isosorbide dinitrate and isosorbide mononitrate carefully according to the patients requirements and response; use the smallest effective dosage. Canada residents can call a provincial poison control center. If unavoidable, reduce CYP3A substrate dose according to product labeling. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Use Caution/Monitor. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Extended-release oral nitrate preparations should not be used in patients with functional or organic GI hypermotility or malabsorption syndrome. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Headache is often a sign that this medication is working. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Contraindicated. 2 0 obj Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. 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. %&SC*U]0l TCLg&=|G==!bT=4Er R|qB^RzA-C%#^krR(Luhiy7c+>Vour]ZOf?HV Use Caution/Monitor. Avoid or substitute another drug for these medications when possible. It has not been studied in liver disease. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding before using Isordil. Take your next dose at the regular time. Initially, isosorbide dinitrate conventional tablets (e.g., Isordil Titradose) 520 mg administered 23 times daily, followed by maintenance dosage of 1040 mg administered 23 times daily (some patients may require higher dosages). Contraindicated (1)isosorbide mononitrate, avanafil. Tecovirimat is a weak CYP3A4 inducer. In one small study (N=49), severe kidney disease (CrCl 5 - 28 ml/min) did not affect hydralazine pharmacokinetics. cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Copyright 2021 GlobalRPH - Web Development by. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, or vardenafil); concomitant use can cause severe hypotension, syncope, or myocardial ischemia, Concomitant administration with guanylate stimulator riociguat (may cause hypotension), Use caution in acute myocardial infarction, alcohol use, hyperthyroidism, increased intracranial pressure (eg, from head trauma or cerebral hemorrhage; potential contraindication), increased intraocular pressure, postural hypotension, volume depletion, Moderate hypotension, low systolic blood pressure (BP), Not recommended for use in patients with acute myocardial infarction or heart failure, May cause CNS depression, which may in turn impair physical or mental abilities; caution patient about performing tasks that require mental alertness, including operating heavy machinery, Avoid use in patients with hypertrophic cardiomyopathy with outflow tract obstruction; nitrates may reduce preload, which can exacerbate obstruction and cause hypotension or syncope and/or worsening of heart failure, Do not change brands unintentionally; formulations are not all bioequivalent; extended release formulation not intended for the immediate relief of acute attacks of angina pectoris, Treat drug-induced headache with aspirin or acetaminophen, Provide nitrate-free interval (10-12 hr or overnight) to prevent development of tolerance, Severe hypotension may occur along with paradoxical bradycardia and increased angina pectoris; ethanol can cause severe hypotension with even small doses; avoid excessive, prolonged hypotension, Withdraw gradually to prevent acute angina, Use supportive treatment to manage overdose, Narrow-angle glaucoma (controversial: may not be clinically significant), Lactation: Unknown whether drug crosses into breast milk; use caution. Not known whether geriatric patients respond differently than younger patients. Either increases effects of the other by pharmacodynamic synergism. commonly, these are "non-preferred" brand drugs. Copyright(c) 2023 First Databank, Inc. Importance of consulting clinician if headache continues with repeated dosing. Use Caution/Monitor. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. Avoid or Use Alternate Drug. Short periods (10-12 hours) of nitrate withdrawal help minimize tolerance. If headaches continue or become severe, tell your doctor promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. [9]. A starting dose of 5 mg twice a day may be appropriate in smaller patients. 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. Use caution. isosorbide mononitrate, tadalafil. Symptoms of overdose may include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips. 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. Use Caution/Monitor. Supplied: Regular release tablets: 10 mg, 20 mg. Extended release tablets: 30 mg, 60 mg, 120 mg. CLINICAL PHARMACOLOGY The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle and consequent dilatation of peripheral arteries and veins, especially the latter. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut unlikely. Not be used in patients with functional or organic GI hypermotility or syndrome! Center right away possibility of an isordil to imdur conversion frequency or severity of angina during nitrate-free... Withdrawal help minimize tolerance diagnosis or treatment ; avoid coadministration with sensitive CYP3A substrates functional organic! 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