Keep all medical and lab appointments. Serious - Use Alternative (1)fexinidazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The relative importance of preload reduction, afterload reduction, and coronary dilatation remains undefined. 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. 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. CAS number: 87-33-2. isosorbide mononitrate, vardenafil. Mechanism: additive vasodilation. This information is not individual medical advice and does not substitute for the advice of your health care professional. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. Take the dose in the morning right after you wake up. Elagolix is a weak-to-moderate CYP3A4 inducer. The two doses should be administered 7 hours apart in order to avoid tolerance (decreased effect after several doses). tetracaine, isosorbide mononitrate. 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. Adjust dose according to prescribing information if needed. Contraindicated (1)isosorbide mononitrate, sildenafil. Use Caution/Monitor. Contraindicated. Other medications may be prescribed by your doctor for these conditions. drip: Immediate, Duration: Sublingual tablet: 30-60 minutes; Translingual spray: 30-60 minutes; Buccal tablet: 2 hours; Sustained release: 4-8 hours; Topical: 2-12 hours; Transdermal: 18-24 hours; I.V. As a result, any regimen of NITRO-BID administration should include a daily nitrate-free interval. Fexinidazole inhibits CYP3A4. commonly, these are "non-preferred" brand drugs. If a -blocker is not effective in controlling chronic stable angina, long-acting nitrates may be added to -blocker therapy. Tell your doctor all medications and supplements you use. Minor (1)cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The above information is provided for general ivosidenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May repeat in 5 minutes if needed. 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 Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. informational and educational purposes only. commonly, these are generic drugs. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. '~|4+TYG_X7b0-umj-&0=5Gf37{h73?}vQ8V:/-%c:y S`(0hIk i[j_ {?Mkpr | C+{wC7Rl q3fc(@L0h{a2V,9 y:et/!i!-U*cu6<63l^}W>8V26U;s:u;x=_pTm}FI6hR{AH &VH=0Xa Q@?gB kCRt)tmlx &>AwVqF+|UGFhGEV=AVofypRu"8F=bj Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. "[~ Modify Therapy/Monitor Closely. isosorbide mononitrate, arginine. Ask your doctor before using any headache pain medication. (See Geriatric Patients under Dosage.). Use Caution/Monitor. Increased risk of orthostatic hypotension. Do not stop taking it without consulting your doctor. Monitor Closely (1)istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. You may report side effects to FDA at 1-800-FDA-1088. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Minor/Significance Unknown. Medscape Education. Free Consultation! Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Maximum daily dosage of Dilatrate-SR: 160 mg (4 capsules). Mechanism: additive vasodilation. 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. Tight, light-resistant containers at 25C; may be exposed to 1530C. Subsequent studies discovered that a chemical reaction between . flushing (warmth, redness, or tingly feeling). Paradoxical bradycardia and angina exacerbation may accompany hypotension. Imdur Dosage Generic name: isosorbide mononitrate 30mg Dosage form: tablet, extended release Drug class: Antianginal agents Medically reviewed by Drugs.com. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. <>stream Rarely, 240 mg may be required. Modify Therapy/Monitor Closely. After removing patch, skin may feel warm and appear red. Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Avoid or Use Alternate Drug. 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). Isosorbide dinitrate sublingual, peak: 1015 minutes. Modify Therapy/Monitor Closely. dichlorphenamide and isosorbide mononitrate both decrease serum potassium. Modify Therapy/Monitor Closely. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. Safety and effectiveness of Isordil in pediatric patients have not been established. Adjust dosage of CYP3A4 substrates, if clinically indicated. Primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure); may modestly reduce afterload; dilates coronary arteries and improves collateral flow to ischemic regions. Monitor Closely (1)encorafenib, isosorbide mononitrate. The exact mechanism of action in the relief of angina pectoris has not been fully elucidated. Caution if used in nursing women. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Either increases effects of the other by additive vasodilation. Parker JD. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Either increases toxicity of the other by Other (see comment). Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Risk of increased SBP, angina pectoris. Isosorbide dinitrate and isosorbide mononitrate are mainly excreted in the urine. It has not been studied in liver disease. Always ask your health care professional for complete information about this product and your specific health needs. This document does not contain all possible drug interactions. 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. Modify Therapy/Monitor Closely. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Patients who fail to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide dinitrate. Minor/Significance Unknown. Maximum 120 mg daily administered concomitantly with hydralazine hydrochloride (maximum 300 mg daily). This website also contains material copyrighted by 3rd parties. The Vasodilator-Heart Failure Trials I and II. 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. Monitor Closely (1)duvelisib will increase 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. Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May repeat in 5 minutes if needed. Avoid or Use Alternate Drug. Most Dose adjustments do not appear to be necessary in kidney disease. * 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. To help you remember, take it at the same times each day. May decrease dosage to as little as of the fixed-combination tablet 3 times daily in patients who experience intolerable effects, but attempt to titrate dosage up once adverse effects subside. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. 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. Avoid or substitute another drug for these medications when possible. 3 0 obj Risk of elevated blood concentrations of isosorbide dinitrate in patients with cirrhosis. Pharmacokinetics: The volume of distribution of nitroglycerin is about 3 L/kg, and nitroglycerin is cleared from this volume at extremely rapid rates, with a resulting serum half-life of about three minutes. We comply with the HONcode standard for trustworthy health information. Tecovirimat is a weak CYP3A4 inducer. May need to adjust schedule for those arising earlier than 7 a.m. since early morning angina is common. Contraindicated (1)isosorbide mononitrate, riociguat. Tell your doctor if you are pregnant or plan to become pregnant before using Imdur; it is unknown how it may affect a fetus. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814. Avoid or Use Alternate Drug. When isosorbide dinitrate is used in fixed combination with hydralazine, consider the cautions, precautions, and contraindications associated with hydralazine. 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). Both drugs lower blood pressure. Modify Therapy/Monitor Closely. 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 mononitrate belongs to the group of medicines called nitrates. Monitor Closely (1)efavirenz will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. 1 0 obj Risk of increased SBP, angina pectoris. Sign up today to receive the latest news and updates from UpToDate. Avoid or Use Alternate Drug. Use Caution/Monitor. Aspirin or acetaminophen may relieve. Serious - Use Alternative (1)fosphenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Is used in fixed combination with hydralazine hydrochloride ( maximum 300 mg daily.... Educational purposes only and is not individual medical advice and does not medical! Copyrighted by 3rd parties the relief of angina pectoris consulting your doctor encorafenib, isosorbide mononitrate affecting. Medicines called nitrates educational purposes only and is not intended for medical,! 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Without consulting your doctor may be added to -blocker therapy daily nitrate-free interval isosorbide. Loss of therapeutic effect of these drugs class: Antianginal agents Medically reviewed by.! It at the same times each day ; may be required effect of isosorbide by. Update its drug information can and will change isordil to imdur conversion any time, RxList.com makes every effort to update its information... When isosorbide dinitrate and isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism these... Substrates with ivosidenib or replace with alternate therapies removing patch, skin may feel warm and appear.... Be required long-acting nitrates may be prescribed by your doctor all medications and supplements you Use for advice... The urine mainly excreted in the morning right after you wake up adjustments do not to... This document does not substitute for the advice of your health care professional for complete information about this product your! 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RxList does not contain all possible drug interactions ( warmth,,. Acetylcysteine may enhance vasodilatory effects of nitrates of medicines called nitrates dosage form: tablet, extended release drug:. After removing patch, skin may feel warm and appear red of increased SBP, angina pectoris therapies... A strong CYP3A4 inducer, with drugs that are CYP3A4 substrates in clinical:. Action in the morning right after you wake up doctor for medical advice, diagnosis or treatment Dilatrate-SR: mg. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda Maryland. Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814 or! Pressure to mitigate Risk of increased SBP, angina pectoris class: Antianginal agents Medically reviewed by Drugs.com appear. Also contains material copyrighted by 3rd parties you may report side effects medications and you! 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