IMDUR Extended Release Tablets should not be chewed or crushed and should be swallowed together with a half-glassful of fluid. 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. 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. cenobamate will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases effects of the other by pharmacodynamic synergism. Due to the time-sensitive nature of drug information, RxList.com makes no guarantees that the information provided is the most current. Contraindicated. 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. Isosorbide mononitrate: Approximately 45%. 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. and formulary information changes. Dose escalation does not overcome this effect. Side effects of Imdur and Isordil that are similar include headache and dizziness. This site complies with the HONcode standard for trust- worthy health information: verify here. Risk of increased SBP, angina pectoris. In chronic dosing, duration of effect is much shorter due to tolerance, Patients with chest pain should take 1 dose of quick-acting nitroglycerin, If pain is not improved or worsening after 5 minutes, it is recommended that 9-1-1 be called, and further instructions should be taken from them, If pain is significantly improved after 1 dose, then 2 more doses should be given five minutes apart (total of 3 doses), and 9-1-1 should be called if pain does not resolve completely [4], Nitrates should not be taken within 24 hours of sildenafil (Viagra), Nitrates should not be taken within 48 hours of tadalafil (Cialis), The suitable time for the administration of nitrates after vardenafil (Levitra) has not been determined [11], Nitroglycerin is metabolized by a reductase enzyme in the liver, Nitroglycerin also undergoes extrahepatic metabolism in red blood cells and vascular walls, Pricing based on one month of therapy at standard dosing in an adult, Pricing based on information from GoodRX.com, Pricing may vary by region and availability, 1 - Manufacturer's Package Insert for each drug listed. In some controlled trials of other organic nitrate formulations, efficacy has declined with time. Use Caution/Monitor. Use Caution/Monitor. 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. Manufacturers state that selective phosphodiesterase (PDE) inhibitors (e.g., sildenafil, tadalafil, vardenafil) are contraindicated in patients receiving nitrates. Observe for possible additive hypotensive effects during concomitant use. Risk of increased SBP, angina pectoris. Monitor Closely (1)rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Vasodilatory effect on arteriolar resistance is not as great as the action on the venous side; as a result of this combined action, both venous filling pressure (preload) and, to a lesser extent, arterial impedance (afterload) are reduced. Side effects of Imdur and Isordil that are similar include headache and dizziness. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. This drug is available at a higher level co-pay. Transient flushing may occur with the nitrates, and inhalation of amyl nitrite commonly causes cutaneous flushing of the head, neck, and clavicular area. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. !W#Lgy It has not been studied in liver disease. maraviroc, isosorbide mononitrate. David McAuley, Pharm.D. levoketoconazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. Other (see comment). 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. Minor/Significance Unknown. Otherwise, call a poison control center right away. cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Particularly small stature, initially: 5 mg ( of a 10-mg tablet) twice daily, for no longer than initial 2 days. Use Caution/Monitor. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. We comply with the HONcode standard for trustworthy health information. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Isosorbide dinitrate has been used effectively for diffuse esophageal spasm [off-label] without gastroesophageal reflux to relieve pain, dysphagia, and spasm. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. 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 Either increases effects of the other by Mechanism: additive vasodilation. prescription products. It is recommended that minoxidil be taken with a diuretic and beta blocker (see minoxidil side effects) May take without regard to food Hair loss (off-label) Dosing: 0.25 - 5 mg once daily See low-dose oral minoxidil for hair loss May take without regard to food Kidney disease Minoxidil can exacerbate fluid retention in kidney disease. Do not stop taking it without consulting your doctor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. The Vasodilator-Heart Failure Trials I and II. Most 1 - 2 sprays onto or under the tongue at the onset of pain. Use caution. 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. National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. After 2 weeks of treatment, during a symptom-limited bicycle ergometer exercise test performed 3 h after . Use Caution/Monitor. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Imdur (isosorbide mononitrate) Extended Release and Nitrolingual Pumpspray (nitroglycerin lingual spray) are vasodilators indicated for the prevention of angina pectoris. After . Avoid or Use Alternate Drug. Make sure laboratory personnel and all your doctors know you use this drug. The observed clearance rates (close to 1 L/kg/min) greatly exceed hepatic blood flow; known sites of extrahepatic metabolism include red blood cells and vascular walls. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Paradoxical bradycardia and angina exacerbation may accompany hypotension. Use Caution/Monitor. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored. mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. RxList does not provide medical advice, diagnosis or treatment. nitroglycerin rectal, isosorbide mononitrate. Mechanism: additive vasodilation. isosorbide mononitrate, arginine. Avoid or Use Alternate Drug. May repeat in 5 minutes if needed. anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Monitor Closely (1)encorafenib, isosorbide mononitrate. 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. Use Caution/Monitor. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. 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). Modify Therapy/Monitor Closely. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Maximum 120 mg daily administered concomitantly with hydralazine hydrochloride (maximum 300 mg daily). Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Chewable tablet: 5-10 mg every 2-3 hours. The minimum necessary length of such an interval has not been defined, but studies with other nitroglycerin formulations have shown that 10 to 12 hours is sufficient. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Possible hypotension. 1 0 obj 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. NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood pressure) should be done while you are taking this medication. elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Potentially fatal hypotension. Serious - Use Alternative (1)isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. Minoxidil can exacerbate fluid retention in kidney disease. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Always ask your health care professional for complete information about this product and your specific health needs. Use caution. DOSAGE AND ADMINISTRATION As noted above (CLINICAL PHARMACOLOGY), controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Use Caution/Monitor. Increased risk of orthostatic hypotension. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. Importance of consulting clinician if headache continues with repeated dosing. May need to adjust schedule for those arising earlier than 7 a.m. since early morning angina is common. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Advise patients of the likelihood of headache, particularly with initial nitrate therapy. Contraindicated (1)isosorbide mononitrate, vardenafil. Use Caution/Monitor. Monitor Closely (1)fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minoxidil can exacerbate fluid retention in liver disease. This is not a complete list of side effects and others may occur. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. rifabutin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Distribution into human body tissues and fluids has not been fully characterized. Modify Therapy/Monitor Closely. Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). Modify Therapy/Monitor Closely. Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. Isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Adjust dosage of isosorbide dinitrate and isosorbide mononitrate carefully according to the patients requirements and response; use the smallest effective dosage. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Drug class: Nitrates and Nitrites VA class: CV250 Chemical name: d-Glucitol-1,4:3,6-dianhydrodinitrate Molecular formula: C 6 H 8 N 2 O 8 C 6 H 9 NO 6 . Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Warn all patients taking either selective PDE inhibitors or organic nitrates or nitrites of the potential 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. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. 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. Minor/Significance Unknown. endobj Consult your pharmacist or local waste disposal company. lofexidine, isosorbide mononitrate. Potentially fatal hypotension. View the formulary and any restrictions for each plan. imdur dose imdur vs nitroglycerinNov 1, 2011 . flushing (warmth, redness, or tingly feeling). Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Symptoms of overdose may include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips. Minor/Significance Unknown. By clicking send, you acknowledge that you have permission to email the recipient with this information. Access your plan list on any device mobile or desktop. Consider increasing CYP3A substrate dose if needed. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. 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. The recipient will receive more details and instructions to access this offer. Z L0y+"Z=A]*=_/Kw&FEa"O,KqKl]s-:G{. 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. The usual starting dose of Isordil Titradose is 5 mg to 20 mg, two or three times daily. Either increases effects of the other by additive vasodilation. Either increases effects of the other by pharmacodynamic synergism.