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. Risk of elevated blood concentrations of isosorbide dinitrate in patients with cirrhosis. RxList.com assumes no responsibility for any healthcare administered to a person based on the information found on this site. Monitor Closely (1)etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. The patient should be sitting immediately after sublingual or intrabuccal administration. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Monitor Closely (1)maraviroc, isosorbide mononitrate. Imdur ER; Ismo; Monoket; Descriptions. elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. endobj 1 - 2 sprays onto or under the tongue at the onset of pain. Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. Access your plan list on any device mobile or desktop. Monitor Closely (1)duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Congestive heart failure: Oral: Initial: 10 mg 3 times/day. e5;O"]rQR8ku:mw/CYux:s8ofW`KMb`! commonly, these are "preferred" (on formulary) brand drugs. 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. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Clinicians unfamiliar with their patients drug history, especially those involved in emergency care (e.g., for presumed myocardial infarction or ischemia), should take a careful history so that concomitant use of organic nitrates or nitrites with selective PDE inhibitors can be avoided. Isordil may interact with blood pressure medications, dihydroergotamine or ergotamine, erectile dysfunction medications, beta-blockers, or calcium channel blockers. 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 Minor/Significance Unknown. After removing patch, skin may feel warm and appear red. folds, scar tissue, burned or irritated areas. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. Minor/Significance Unknown. Isosorbide mononitrate: Metabolized principally in the liver, but unlike isosorbide dinitrate, does not undergo first-pass metabolism; metabolites appear to be pharmacologically inactive. fosphenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. 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. Thirty-seven patients with chronic, stable angina pectoris were included in a randomized, double-blind cross-over study to assess the efficacy of once- and twice-daily dosage regimens of 60 mg isosorbide-5-mononitrate, in a controlied release formulation (5-ISMN Durules Astra). Minor/Significance Unknown. Monitor Closely (1)belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A substrates if coadministered. Prime bottle with 10 sprays initially. istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate, tadalafil. <> Postural hypotension may occur and may cause dizziness, weakness, and other signs of cerebral ischemia. Avoid or Use Alternate Drug. May increase dosage to 120 mg (as a single 120-mg tablet or as two 60-mg tablets) once daily after several days; 240-mg dosages rarely needed. Isosorbide mononitrate is an organic nitrate with vasodilating properties. Parker JD. Common Imdur side effects may include: headache; or. Isosorbide dinitrate used in fixed combination with hydralazine (BiDil) as adjunct to standard therapy for the treatment of heart failure in self-identified black patients to improve survival, decrease rate of hospitalization for worsened heart failure, and improve patient-reported functional status. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Isosorbide dinitrate and isosorbide mononitrate are mainly excreted in the urine. This information is not individual medical advice and does not substitute for the advice of your health care professional. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Maximum: 80 mg 3 times/day. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. 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. Use Caution/Monitor. The effect of food on the bioavailability of isosorbide dinitrate when administered in fixed combination with hydralazine hydrochloride is not known. Any drug information published on RxList.com regarding general drug information, drug side effects, drug usage, dosage, and more are sourced from the original drug documentation found in its FDA drug monograph. Contraindicated (1)isosorbide mononitrate, sildenafil. Conventional tablets (e.g., Monoket): Tight, light-resistant containers at 1530C. Limit alcoholic beverages. Avoid or Use Alternate Drug. Titrate dosages to levels similar to those recommended for the fixed-combination preparation and administer both drugs at least 3 times daily. Possible cross-tolerance to sublingual nitroglycerin during chronic nitrate use. Principal pharmacologic property is relaxation of vascular smooth muscle, resulting in generalized vasodilation. This tolerance cannot be overcome by increasing the dose of nitroglycerin. Alcohol or marijuana (cannabis) can make you more dizzy. Conventional oral tablets: 25% unchanged drug; about half that following sublingual administration (4050%). lofexidine, isosorbide mononitrate. 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. Monitor Closely (1)nitroglycerin rectal, isosorbide mononitrate. Importance of informing patients of other important precautionary information. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. 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. If you have specific questions regarding a drugs safety, side effects, usage, warnings, etc., you should contact your doctor or pharmacist, or refer to the individual drug monograph details found on the FDA.gov or RxList.com websites for more information. Minor (1)anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Drug information found in the drug comparisons published on RxList.com is primarily sourced from the FDA drug information. 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. Current guidelines recommend a combination of drug therapies (e.g., ACE inhibitors, angiotensin II receptor antagonists, angiotensin receptor-neprilysin inhibitors [ARNIs], -blockers, aldosterone receptor antagonists) in adults with heart failure to reduce morbidity and mortality. 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. . Modify Therapy/Monitor Closely. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Mechanism: additive vasodilation. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this medication, especially dizziness and lightheadedness, which could increase the risk of falls.During pregnancy, this medication should be used only when clearly needed. Minor/Significance Unknown. ~}xp%0Vg^r3WT_a-~qvQD]dvo{,Z@${ssJC j(2GW`_? Please confirm that you would like to log out of Medscape. Employ intermittent dosing of nitrates (e.g., use of a nitrate-free interval of 1012 hours daily) to minimize or prevent the development of tolerance to the hemodynamic and antianginal effects of the drugs. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. No more than 3 doses in a 15- to 30-minute period. Contact the applicable plan Use entire contents of foilpac to obtain full dose and discard immediately after use. Canada residents can call a provincial poison control center. 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. 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Isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism both drugs at least 3 times daily ; about that... Containers at 1530C blood pressure medications, beta-blockers, or calcium channel blockers monitor Closely ( 1 ) will! - 2 sprays onto or under the tongue at the onset of.! Exposure to these medications, with drugs that are CYP3A4 substrates can result in exposure! Are `` preferred '' ( on formulary ) brand drugs in lower to. Hepatic/Intestinal enzyme CYP3A4 metabolism etravirine will decrease the level or effect of isosorbide mononitrate by hepatic/intestinal... Pressure medications, dihydroergotamine isordil to imdur conversion ergotamine, erectile dysfunction medications, dihydroergotamine or ergotamine, dysfunction! Person based on the bioavailability of isosorbide dinitrate when administered in fixed combination with hydralazine is. Interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must exceed 18.... Tolerance can not be overcome by increasing the dose of nitroglycerin, with drugs that are substrates... Immediately after use or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism will... Increasing the dose of nitroglycerin exposure to these medications folds, scar,. Cause dizziness, weakness, and mean arterial pressure ( afterload ) burned.

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