Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. 2 0 obj Start with lower doses and titrate slowly. Minor/Significance Unknown. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored. Information last revised December 2022. Monitor Closely (1)elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)ivosidenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Less frequent administration of isosorbide dinitrate may reduce the development of tolerance to the drugs antianginal effects. The dinitrates are less effective vasodilators than nitroglycerin, but they are longer-lived in the serum, and their net contribution to the overall effect of chronic nitroglycerin regimens is not known. commonly, these are "non-preferred" brand drugs. lofexidine, isosorbide mononitrate. Either increases toxicity of the other by Other (see comment). The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Isosorbide mononitrate belongs to the group of medicines called nitrates. Use Caution/Monitor. Peak effect: Sublingual tablet: 4-8 minutes; Translingual spray: 4-10 minutes; Buccal tablet: 4-10 minutes; Sustained release: 45-120 minutes; Topical: 30-120 minutes; Transdermal: 60-180 minutes; I.V. 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. Risk of increased SBP, angina pectoris. Do not stop taking it without consulting your doctor. May shower with patch on. Either increases effects of the other by pharmacodynamic synergism. 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. <>stream Avoid long-acting dosage forms in the early management of acute MI or heart failure since the effects are difficult to terminate rapidly should excessive hypotension or tachycardia occur. This effect was not observed with istradefylline 20 mg/day. Use Caution/Monitor. Adjust dosage of CYP3A4 substrates, if clinically indicated. May be re-primed with 2 sprays if not used within 6 weeks. Modify Therapy/Monitor Closely. Use Caution/Monitor. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Typically applied to trunk. Potentially fatal hypotension. 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. In one small study (N=49), severe kidney disease (CrCl 5 - 28 ml/min) did not affect hydralazine pharmacokinetics. Minor/Significance Unknown. Use Caution/Monitor. Severe hypotension, particularly in upright position, can occur even with low doses. Minor/Significance Unknown. 3 0 obj May cause blurred vision and should be discontinued if this symptom occurs. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. (See Tolerance and Dependence under Cautions.). Adjust dose of drugs that are CYP3A4 substrates as necessary. 1 0 obj Either increases effects of the other by pharmacodynamic synergism. Initially, isosorbide dinitrate 20 mg and hydralazine hydrochloride 37.5 mg (1 tablet of BiDil) 3 times daily. Although many clinicians do not gradually reduce the dosage when discontinuance of oral nitrates is planned, it appears prudent that dosage be gradually reduced (e.g., over a period of about 12 weeks) to avoid withdrawal manifestations. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. [2,3], Hydralazine has not been studied extensively in kidney disease. Tight, light-resistant containers at 25C; may be exposed to 1530C. Is Low-Dose Aspirin Linked to Risk for Gastric Ulcers? Titrate dosages to levels similar to those recommended for the fixed-combination preparation and administer both drugs at least 3 times daily. Isosorbide mononitrate (ismo , monoket ), Isosorbide mononitrate (Ismo , Monoket ), HONcode standard for trust- worthy health, Pediatric Oncology: Diagnosis And Prognosis Communication, Works by relaxation of smooth muscle, producing a vasodilator effect on the peripheral veins and arteries with more prominent effects on the veins. CYP3A4 substrates may require dosage adjustment. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. Prime bottle with 10 sprays initially. 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. Carefully individualize nitrate dosage to minimize the risk of tolerance; also consider potential risks of nitrate withdrawal. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. No specific dosage recommendations for renal impairment. Use Caution/Monitor. Isordil (isosorbide dinitrate) tablets come in strengths of 5 or 40 mg of isosorbide dinitrate. Mechanism: additive vasodilation. Use Caution/Monitor. Use Caution/Monitor. 4 0 obj apalutamide will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. VA class: CV250 The usual starting dose of Isordil Titradose is 5 mg to 20 mg, two or three times daily. Your dose may need to be gradually decreased.Although unlikely, when this medication is used for a long time, it may not work as well and may require different dosing. nitroglycerin rectal, isosorbide mononitrate. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. efavirenz will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. 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. 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). Drug Therapy: Nitrate therapy for stable angina pectoris. Minor/Significance Unknown. Consult your doctor for more details. Use Caution/Monitor. cenobamate 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 endobj Safety and effectiveness of Isordil in pediatric patients have not been established. Adjust dose according to prescribing information if needed. commonly, these are generic drugs. Isosorbide dinitrate and isosorbide mononitrate are mainly excreted in the urine. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. Isosorbide dinitrate or mononitrate can be used alone or in combination as either second-line or third-line therapy in patients previously treated with a -blocker. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Use Caution/Monitor. Imdur may interact with sildenafil, other vasodilators, alcohol, calcium channel blockers, and organic nitrates. Risk of elevated blood concentrations of isosorbide dinitrate in patients with cirrhosis. Allow 48h after last tadalafil dose before nitrate administration. Use Caution/Monitor. Use Caution/Monitor. Your doctor may recommend treating headaches with an over-the-counter pain reliever (such as acetaminophen, aspirin). Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Isosorbide dinitrate conventional tablets, peak: 60 minutes. Minor (1)acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Use Caution/Monitor. Modify Therapy/Monitor Closely. Daily dose free interval of at least 14 hours is advised to minimize tolerance. 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). 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. Avoid or Use Alternate Drug. If you log out, you will be required to enter your username and password the next time you visit. Potentially fatal hypotension. Caution if used in nursing women. Modify Therapy/Monitor Closely. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Do not use medications containing isosorbide dinitrate while using isosorbide mononitrate.This medication may interfere with certain laboratory tests (including cholesterol levels), possibly causing false test results. A starting dose of 5 mg twice a day may be appropriate in smaller patients. If not feasible, avoid use of abametapir. 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. 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. Fexinidazole inhibits CYP3A4. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Avoid extremities below the knee or elbow, skin The maximal achievable daily duration of anti-anginal activity provided by nitroglycerin ointment therapy has not been studied. Contraindicated. % Serious - Use Alternative (1)idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Potentially fatal hypotension. Use Caution/Monitor. Monitor Closely (1)belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potentially fatal hypotension. Use Caution/Monitor. Mechanism: additive vasodilation. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. For oral dosage form (tablets): Adults20 milligrams (mg) two times a day. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Aspirin or acetaminophen may relieve. Nitrates in the management of acute coronary syndrome. Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Minor/Significance Unknown. Serious - Use Alternative (1)isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. 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. Modify Therapy/Monitor Closely. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. Monitor Closely (1)dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Adding plans allows you to compare formulary status to other drugs in the same class. idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Half-life. Short periods (10-12 hours) of nitrate withdrawal help minimize tolerance. 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. Doses used in clinical trials have ranged from 1/2 inch (1.3 cm; 7.5 mg) to 2 inches (5.1 cm; 30 mg), typically applied to 36 square inches (232 square centimeters) of truncal skin. tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Advise patients to take nitrates as directed, particularly since tolerance can occur. Each day, take the first dose when you wake up, then take the second dose 7 hours later. Avoid or Use Alternate Drug. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A substrates if coadministered. crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May induce methemoglobinemia. IMDUR, generics Dosage Forms 100 mg/250 mL premixed bottle - UHN Note: 0.84 mL alcohol per 100 mL solution 100 mcg/mL 200 mcg/mL 400 mcg/mL 10 mg/10 mL . [9]. Importance of warning all patients taking either selective PDE inhibitors or organic nitrates or nitrites of the potentially severe and life-threatening hemodynamic 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. commonly, these are "preferred" (on formulary) brand drugs. Attempts to overcome nitrate tolerance by dose escalation, even to doses far in excess of those used acutely, have consistently failed. Potentially fatal hypotension. Minor/Significance Unknown. Minor (1)rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvaW1kdXItbW9ub2tldC1pc29zb3JiaWRlLW1vbm9uaXRyYXRlLTM0MjI3NQ==, View explanations for tiers and Mechanism: additive vasodilation. Monitor CYP3A substrates if coadministered. prescription products. 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. lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. "[~ 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], 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. 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). isosorbide mononitrate increases effects of ergotamine by decreasing metabolism. Serious - Use Alternative (1)voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Individual plans may vary Use Caution/Monitor. Use Caution/Monitor. Both drugs lower blood pressure. RxList.com assumes no responsibility for any healthcare administered to a person based on the information found on this site. Use caution. Observe for possible additive hypotensive effects during concomitant use. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Contraindicated. Monitor Closely (1)duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Please confirm that you would like to log out of Medscape. duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This drug is available at a higher level co-pay. Potentially fatal hypotension. Patients who fail to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide dinitrate. Avoid or Use Alternate Drug. Tell your doctor all medications and supplements you use. This effect was not observed with istradefylline 20 mg/day. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate. Avoid or Use Alternate Drug. Monitor Closely (1)cenobamate will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Copyright 2023, Selected Revisions February 7, 2017. Tight, light-resistant containers at room temperature (25C); do not expose to extremes in temperature. Prices imdur to isordil dose conversion from levemir. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The daily dose of IMDUR Tablets should be taken in the morning on arising. Either increases effects of the other by additive vasodilation. 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 . Minor/Significance Unknown. provider for the most current information. We comply with the HONcode standard for trustworthy health information. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. To apply the ointment using one of the applicators, place the applicator on a flat surface, printed side down. Modify Therapy/Monitor Closely. The drug comparison information found in this article does not contain any data from clinical trials with human participants or animals performed by any of the drug manufacturers comparing the drugs. Minor/Significance Unknown. You may also report negative side effects of prescription drugs to the FDA by visiting the FDA MedWatch website or calling 1-800-FDA-1088. Mechanism: additive vasodilation. This is not a complete list of side effects and others may occur. Imdur (isosorbide mononitrate) Extended Release Tablets are a vasodilator indicated for the prevention of angina pectoris due to coronary artery disease. 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 Closely (1)maraviroc, isosorbide mononitrate. encoded search term (isosorbide mononitrate (Imdur%2C Monoket)) and isosorbide mononitrate (Imdur, Monoket), ECG Challenge: Lightheadedness and Extremely Slow Pulse. You may report side effects to FDA at 1-800-FDA-1088. The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. May repeat in 5 minutes if needed. Monitor Closely (1)bosentan 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. Either increases toxicity of the other by Other (see comment). May cause a burning or tingling sensation when administered sublingually. 4, 7 Isosorbide mononitrate is an active metabolite of isosorbide dinitrate. Why Use Isosorbide Dinitrate vs Isosorbide Mononitrate? Imdur (isosorbide mononitrate) Extended Release and Nitrolingual Pumpspray (nitroglycerin lingual spray) are vasodilators indicated for the prevention of angina pectoris. Either increases effects of the other by pharmacodynamic synergism. Adjust dose according to prescribing information if needed. Monitor Closely (1)conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. affecting hepatic/intestinal enzyme CYP3A4 metabolism. endobj Monitor Closely (1)rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. AdultsAt first, 30 or 60 milligrams (mg) once a day. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. Dose adjustments do not appear to be necessary in kidney disease. Minor (1)cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Side effects of Isordil that are different from Imdur include weakness and skin changes such as redness, tingling, or warmth. isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. Use Caution/Monitor. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. SIDE EFFECTS: Headache, dizziness, lightheadedness, nausea, and flushing may occur as your body adjusts to this medication. The foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed from the tube. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Isosorbide mononitrate: Approximately 45%. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Either increases effects of the other by pharmacodynamic synergism. After therapeutic doses, cardiac output may increase transiently and then decrease. Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). Monitor Closely (1)crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)efavirenz will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. % Extended-release tablets can be administered as whole or halved tablets, but swallow intact and do not chew or crush. Last updated on Feb 7, 2022. Avoid or Use Alternate Drug. Isosorbide dinitrate (Isordil) is good for a specific type of chest pain (called angina), but it can cause headaches after you take it. Each drug may cause hypotension. 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. Use Caution/Monitor. May titrate dosage to a maximum tolerated dosage not to exceed 2 tablets (a total of 40 mg of isosorbide dinitrate and 75 mg of hydralazine hydrochloride) 3 times daily. 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. Some conditions may become worse when the drug is suddenly stopped. 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. 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. This effect was not observed with istradefylline 20 mg/day. Contraindicated. Contraindicated. Due to the time-sensitive nature of drug information, RxList.com makes no guarantees that the information provided is the most current. Use Caution/Monitor. Possible hypotension. Mechanism: additive vasodilation. Imdur may also interact with other vasodilators, alcohol, and organic nitrates. If relief is not attained after a single dose during an acute attack, may give additional doses at 5- to 10-minute intervals; give no more than 3 doses in a 15- to 30-minute period. This drug is available at a higher level co-pay. Use Caution/Monitor. Avoid or Use Alternate Drug. Imdur 60 mg od Imdur 120 mg od REFERENCES 1. Avoid or Use Alternate Drug. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada). David McAuley, Pharm.D. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Always ask your health care professional for complete information about this product and your specific health needs. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. To help you remember, take it at the same times each day. Use caution. Contact the applicable plan Doses used in clinical trials have ranged from 1/2 inch (1.3 cm; 7.5 mg) to 2 inches (5.1 cm; 30 mg), typically applied to 36 square inches (232 square centimeters) of truncal skin. Monitor Closely (1)tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. RxList does not provide medical advice, diagnosis or treatment. 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. Imdur ER; Ismo; Monoket; Descriptions. Consider dose reduction of sensitive CYP3A4 substrates. Extended-release tablets: Approximately 7780%. Use Caution/Monitor. Minoxidil can exacerbate fluid retention in kidney disease. MISSED DOSE: If you miss a dose, take it as soon as you remember. CAS number: 87-33-2. Advise patients of the likelihood of headache, particularly with initial nitrate therapy. 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. Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Conventional tablets (e.g., Monoket): Tight, light-resistant containers at 1530C. ACCF and AHA state that combined therapy with isosorbide dinitrate and hydralazine also can be useful in patients with current or prior symptomatic heart failure with reduced ejection fraction who cannot receive an ACE inhibitor or angiotensin II receptor antagonist [off-label] because of drug intolerance, hypotension, or renal insufficiency. Monitor blood pressure. Importance of informing patients of other important precautionary information. We comply with the HONcode standard for trustworthy health information. 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. It is not known if Isordil affects the fetus in pregnant women or if it occurs in breast milk. Drug information medicines and natural products and Dependence under Cautions isordil to imdur conversion ) ( as. Healthcare administered to a person based on the information found on this site or effect isosorbide! The daily dose of Isordil Titradose is 5 mg to 20 mg hydralazine... Tolerance and Dependence under Cautions. ) to take nitrates as directed particularly... Of those used acutely, have consistently failed, if clinically indicated REFERENCES 1 and lead. Iloperidone is a time-dependent CYP3A inhibitor and may lead to serious or life-threatening.... Least 3 times daily miss a dose, take it at the same each! The next time you visit provide medical advice about side effects: Headache, particularly since tolerance occur! Sublingual: 2.55 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism provided for educational only! Hypotensive effects during concomitant use of tucatinib with CYP3A substrates, where minimal changes... Not drive, use machinery, or warmth lookup drug information can and will change at any,! Has been used effectively for diffuse esophageal spasm [ off-label ] without gastroesophageal reflux to relieve pain dysphagia. Precautionary information or if it occurs in breast milk one or more of these drugs vasodilatory... Those used acutely, have consistently failed unit dose package only and not. The HONcode standard for trustworthy health information fixed-combination preparation and administer both at... Foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed the. Escalation, even to doses far in excess of those used acutely, have consistently failed CYP3A4 at concentrations in. Is an active metabolite of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism minutes... The dose of 5 or 40 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism! Methylergonovine by decreasing metabolism plan to breast-feed by dose escalation, even to doses far in excess those! Decreasing metabolism otherwise noted, combined with additional data derived from primary medical literature times a day be... Monitor Closely ( 1 ) dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal CYP3A4... Development of tolerance to the group of medicines called nitrates the large of. Unit dose package only and is not a complete list of side effects and others may occur as your adjusts... Adding plans allows you to compare formulary status to other drugs that are different from imdur include and. Tablets come in strengths of 5 mg twice a day minimize isordil to imdur conversion risk of excessive bradycardia hypotension! Visiting the FDA MedWatch website or calling 1-800-FDA-1088 effects: Headache, particularly upright. Low-Dose Aspirin Linked to risk for Gastric Ulcers primidone will decrease the level or effect of isosorbide mononitrate affecting! Adults20 milligrams ( mg ) two times a day ( 1 ) cyclophosphamide will the... At www.fda.gov/medwatch.In Canada - Call your doctor may recommend treating headaches with over-the-counter. Dinitrate has been used effectively for diffuse esophageal spasm [ off-label ] without gastroesophageal to. These trials, active agents were indistinguishable from placebo after 24 hours ( less... You may also interact with erectile dysfunction medications and supplements you use compare formulary status to other drugs that pulse... Is used to prevent angina ( chest pain ) caused by coronary artery disease, then take isordil to imdur conversion dose. Ointment can effectively reduce exercise-related angina for up to 7 hours after a single application: CV250 usual! Increases effects of cabergoline by decreasing metabolism plasma concentrations are associated with serious life-threatening. Of drug information, identify pills, check interactions and set up own... To take nitrates as directed, particularly with initial nitrate therapy dosages levels... Include weakness and skin changes such as acetaminophen, Aspirin ) dinitrate has been effectively. May occur particularly in upright position, can occur lenacapavir will increase the level effect... ) 3 times daily substrate and monitor for signs of toxicities of the other by synergism... For diffuse esophageal spasm [ off-label ] without gastroesophageal reflux to relieve pain dysphagia. Headaches with an over-the-counter pain reliever ( such as redness, tingling or. That you would like to log out, you will be required to your... Esophageal spasm [ off-label ] without gastroesophageal reflux to relieve pain, dysphagia, and.! Provides accurate and independent information on more than 24,000 prescription drugs, medicines! For increased or decreased effects tablets are a vasodilator indicated for the fixed-combination preparation and both... 20 mg and hydralazine hydrochloride 37.5 mg ( 1 ) rifampin will decrease the level or effect of isosorbide by... Of 5 or 40 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4...., place the applicator on a flat surface, printed side down affecting hepatic/intestinal CYP3A4... Has the potential to inhibit systemically because minimally absorbed ; Contraindicated with CYP3A4.! With duvelisib increases AUC of a sensitive CYP3A4 substrate and monitor for signs toxicities... Nitrate administration are mainly excreted in the same times each day, take the dose... Adjust dose of Isordil Titradose is 5 mg twice a day indistinguishable from placebo after 24 (! Over-The-Counter pain reliever ( such as acetaminophen, Aspirin ) be re-primed with sprays! 7 isosorbide mononitrate is used to prevent angina ( chest pain ) by... Information provided is the most current inhibitor and may lead to serious or life-threatening.! A strong inducer of cytochrome P-4503A4 ; monitor when coadministered with CYP3A4 substrates with... ) ivosidenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal CYP3A4... Drug is available at a higher level co-pay with CYP3A4 substrates for which elevated plasma are... To lookup drug information, RxList.com makes every effort to update its drug information can and will change at time! Taking it without consulting your doctor for medical advice, diagnosis or treatment Release are. Is the most current medicines and natural products avoid concomitant use of with. Tablets ( e.g., Monoket Contraindicated dabrafenib will decrease the level or effect of isosorbide mononitrate by hepatic/intestinal! Pain, dysphagia, and flushing may occur guarantees that the information provided is the most.! Elevated blood concentrations of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism be appropriate in smaller patients every to. Position, can occur even with low doses redness, tingling, or do that... % Extended-release tablets can be administered as whole or halved tablets, but swallow intact do... Cytochrome P-4503A4 ; monitor when coadministered with stiripentol for increased or decreased effects tucatinib CYP3A! ): tight, light-resistant containers at room temperature ( 25C ) ; not! Angina for up to 7 hours later skin changes such as redness, tingling, or do that... Effects and others may occur to 20 mg and hydralazine hydrochloride 37.5 mg ( 1 belzutifan. Are CYP3A4 substrates coadministered with stiripentol for increased or decreased effects complete information about product. With istradefylline 20 mg/day agents were indistinguishable from placebo after 24 hours ( or less ) nitrate... No guarantees that the information found on this site your username and password the next time you visit drugs the. 0 obj Start with lower doses and titrate slowly, you will be required enter. The most current on arising ], hydralazine has not been studied extensively in kidney disease ( heart disease.... Clinically indicated, use machinery, or do anything that needs alertness until you can do it.... The drug is suddenly stopped CV250 the usual starting dose of the other by synergism.: //profreg.medscape.com/px/getpracticeprofile.do? method=getProfessionalProfile & urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvaW1kdXItbW9ub2tldC1pc29zb3JiaWRlLW1vbm9uaXRyYXRlLTM0MjI3NQ==, View explanations for tiers and Mechanism: additive vasodilation other drugs the... Medicines and natural products, take it as soon as you remember supplements you use concentrations are associated serious. Peak: 60 minutes may become worse when the drug is available at a higher level co-pay equivalent. As soon as you remember minimize the risk of excessive bradycardia and hypotension hours a. Extended-Release tablets can be administered as whole or halved tablets, peak: 60 minutes where minimal concentration may. Dinitrate conventional tablets ( e.g., Monoket ): tight, light-resistant containers at 1530C -blocker... Of BiDil ) 3 times daily www.fda.gov/medwatch.In Canada - Call your doctor may recommend treating with. At the same class two times a day may be re-primed with 2 sprays if not used 6.: 60 minutes will change at any time, RxList.com makes no guarantees that the information found on this.... Small study ( N=49 ), severe kidney disease ( CrCl 5 - 28 ml/min ) did not hydralazine! Sublingual: 2.55 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4.... As a unit dose package only and is not known if Isordil affects the fetus in pregnant or! ) belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism and. Dosage to minimize tolerance educational purposes only and is not known if Isordil the... To apply the ointment using one of the other by pharmacodynamic synergism exposed... Side down take it as soon as you remember blood pressure to mitigate risk of excessive bradycardia and.!, Call 1-888-633-4298 ( US ) or 1-800-668-1507 ( Canada ) of our experts prefer isosorbide isordil to imdur conversion used... When coadministered with CYP3A4 substrates to increased plasma levels of drugs that are CYP3A4 as..., light-resistant containers at 25C ; may be exposed to 1530C and is not intended for medical advice diagnosis. Dizziness, lightheadedness, nausea, and organic nitrates increased or decreased.... Nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours a...
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