Potentially fatal hypotension. endobj Consider increasing CYP3A substrate dose if needed. Dose escalation does not overcome this effect. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. 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. Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Contraindicated (1)isosorbide mononitrate, avanafil. Last updated on Feb 6, 2023. Contraindicated (1)isosorbide mononitrate, tadalafil. By clicking send, you acknowledge that you have permission to email the recipient with this information. Tell your doctor if this medication stops working well (for example, you have more frequent or worsening chest pain). Avoid or Use Alternate Drug. Serious adverse reactions to the organic nitrates and nitrites are uncommon and their adverse effects mainly involve the CNS and cardiovascular system. It is important to take the drug at the same times each day. skin changes such as redness, tingling, or warmth. belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Controlled studies in pregnant women show no evidence of fetal risk. Not known whether isosorbide dinitrate and isosorbide mononitrate are distributed into milk. iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Possible hypotension. Use Caution/Monitor. Imdur (isosorbide mononitrate) Extended Release and Nitrolingual Pumpspray (nitroglycerin lingual spray) are vasodilators indicated for the prevention of angina pectoris. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). USES: Isosorbide mononitrate is used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery disease). Possible 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. Contraindicated. Published studies using older techniques provide results that often differ, in similar experimental settings, by an order of magnitude. 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. Consult your doctor for more details.Lifestyle changes such as dietary changes, exercise, and not smoking may help this drug work better. Any missing drug warnings or information does not in any way guarantee the safety, effectiveness, or the lack of adverse effects of any drug. Minor/Significance Unknown. 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. Less frequent administration of isosorbide dinitrate may reduce the development of tolerance to the drugs antianginal effects. Compare formulary status to other drugs in the same class. Use Caution/Monitor. Use Caution/Monitor. Avoid or Use Alternate Drug. mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide mononitrate conventional tablets, peak: 0.51 hour. The approximate onset and duration of action of various dosage forms of isosorbide dinitrate (ISDN) and isosorbide mononitrate (ISMN) are as follows: Onset and duration of action following intrabuccal administration are probably similar to those after sublingual administration of isosorbide dinitrate. Side effects of Imdur and Ranexa that are similar include headache and dizziness. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Monitor Closely (1)mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. 2 0 obj This information does not assure that this product is safe, effective, or appropriate for you. 4 0 obj Avoid or Use Alternate Drug. Principal pharmacologic property is relaxation of vascular smooth muscle, resulting in generalized vasodilation. Avoid or Use Alternate Drug. isosorbide mononitrate, avanafil. Avoid extremities below the knee or elbow, skin Minor (1)acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). <> Complete avoidance may not be possible, provided sufficient time elapses between use of the drugs. Minor (1)rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Allow powder to dissolve without swallowing. The above information is provided for general 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 <>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 595.32 841.92] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> IMDUR Extended Release Tablets should not be chewed or crushed and should be swallowed together with a half-glassful of fluid. 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. It works by relaxing the . Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. 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. To avoid development of tolerance to nitroglycerin, drug-free intervals of 10 - 12 hours are known to be sufficient; shorter intervals have not been well studied. Heart Disease: Symptoms, Signs, and Causes. May induce methemoglobinemia. The drug information provided is intended for reference only and should not be used as a substitute for medical advice. x][7~_cNv2}LN ` 8ql'O_}U%zwZ]U{_U]V?/*S~[~|^bn[zHsxuy][^,;}.oO^mweU^.Wn>{l .6=(r#n*xW7| J{{or`}|4^r Minor/Significance Unknown. Chewable tablet: 5-10 mg every 2-3 hours. Maximum: 80 mg 3 times/day. isosorbide mononitrate increases toxicity of dapsone topical by altering metabolism. Avoid or Use Alternate Drug. tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Isosorbide dinitrate has been used effectively for diffuse esophageal spasm [off-label] without gastroesophageal reflux to relieve pain, dysphagia, and spasm. Observe for possible additive hypotensive effects during concomitant use. Take your next dose at the regular time. 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. Available for Android and iOS devices. Dose adjustments do not appear to be necessary in kidney disease. Both direct vasodilatory effects on the coronary bed and drug-induced prevention of episodic coronary artery vasoconstriction increase total coronary blood flow. Use Caution/Monitor. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Side effects of Isordil that are different from Imdur include weakness and skin changes such as redness, tingling, or warmth. commonly, these are "non-preferred" brand drugs or specialty Monitor Closely (1)lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If unavoidable, reduce CYP3A substrate dose according to product labeling. A starting dose of 5 mg twice a day may be appropriate in smaller patients. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. Modify Therapy/Monitor Closely. Adjust dosage of isosorbide dinitrate and isosorbide mononitrate carefully according to the patients requirements and response; use the smallest effective dosage. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. Contraindicated (1)isosorbide mononitrate, sildenafil. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Importance of clinicians unfamiliar with their patients drug history, especially those involved in emergency care (e.g., for presumed myocardial infarction or ischemia), to take a careful history so that concomitant use with selective PDE inhibitors can be avoided. Sign up today to receive the latest news and updates from UpToDate. Dosage form: tablet, extended release isosorbide mononitrate, riociguat. The patient should be sitting immediately after sublingual or intrabuccal administration. Aspirin or acetaminophen may relieve. 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], Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration. Mechanism: additive vasodilation. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. 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. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. imdur dose imdur vs nitroglycerinNov 1, 2011 . The recipient will receive more details and instructions to access this offer. Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. maraviroc, isosorbide mononitrate. cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Typically applied to chest. Consult your doctor before breast-feeding. crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Use Caution/Monitor. This is not a complete list of side effects and others may occur. Tell your doctor if you are pregnant or plan to become pregnant before using Imdur; it is unknown how it may affect a fetus. 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