Evaluate for loss of therapeutic effect if medication must be coadministered. Isosorbide mononitrate: Metabolized principally in the liver, but unlike isosorbide dinitrate, does not undergo first-pass metabolism; metabolites appear to be pharmacologically inactive. istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Mechanism: additive vasodilation. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood pressure.This drug may make you dizzy. Known hypersensitivity to isosorbide or any ingredient in the respective formulation. PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or to similar drugs (such as isosorbide dinitrate, nitroglycerin); or if you have any other allergies. belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate, bupivacaine implant. Shop cheap from $1.07 for pill imdur 40 mg pharmacy. 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. Either increases effects of the other by pharmacodynamic synergism. Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. Use entire contents of foilpac to obtain full dose and discard immediately after use. Potentially fatal hypotension. Elagolix is a weak-to-moderate CYP3A4 inducer. isosorbide mononitrate, vardenafil. Monitor Closely (1)nafcillin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Administer sublingually, intrabuccally, or orally. nafcillin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Not known whether geriatric patients respond differently than younger patients. Organic nitrate that causes systemic venodilation, decreasing preload; enters vascular smooth muscle and is converted to nitric oxide, leading to activation of cyclic guanosine monophosphate and vasodilation, Relaxes smooth muscle via dose-dependent dilation of arterial and venous beds to reduce both preload and afterload, as well as myocardial oxygen demand; also improves coronary collateral circulation, lowering blood pressure, increasing heart rate, and causing occasional paradoxical bradycardia, Bioavailability: Immediate release, 93-100%; extended release, 77-80%, Onset (antianginal effects): Immediate release, 60 min; extended release, 60 min, Onset (hemodynamic effects): Immediate release, 10-30 min; extended release, 6 hr, Duration (antianginal effects): Immediate release, 5-7 hr; extended release, 8 hr, Duration (hemodynamic effects): Immediate release, 10-30 min; extended release, 6 hr, Peak plasma time: Immediate release, 30-60 min; extended release, 3-4.5 hr, Metabolites: Isosorbide, 5-isosorbide mononitrate glucuronide, sorbitol (inactive), Half-life: Parent drug, 6.2-6.6 hr; glucuronide metabolite, 6 hr; sorbitol metabolite, 9 hr. This drug is available at the lowest co-pay. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. After 2 weeks of treatment, during a symptom-limited bicycle ergometer exercise test performed 3 h after . Tolerance to the vascular and antianginal effects of individual nitrates and cross-tolerance among the drugs may occur with repeated, prolonged use. Adjust dosage of CYP3A4 substrates, if clinically indicated. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Minor/Significance Unknown. Do not rub into the skin. Possibility of an increased frequency or severity of angina during the nitrate-free interval should be considered. Distribution into human body tissues and fluids has not been fully characterized. Complete avoidance may not be possible, provided sufficient time elapses between use of the drugs. prescription products. Isosorbide mononitrate extended-release tablets, peak: 34.5 hours. Call your doctor for medical advice about side effects. tecovirimat will decrease 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. Avoid or Use Alternate Drug. Each day, take the first dose when you wake up, then take the second dose 7 hours later. If a -blocker is not effective in controlling chronic stable angina, long-acting nitrates may be added to -blocker 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. % Avoid or Use Alternate Drug. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Information last revised December 2022. Modify Therapy/Monitor Closely. Tell your doctor all medications and supplements you use. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. MEDICAL ALERT: Your condition can cause complications in a medical emergency. . ~}xp%0Vg^r3WT_a-~qvQD]dvo{,Z@${ssJC j(2GW`_? Avoid or Use Alternate Drug. Minor/Significance Unknown. Use Caution/Monitor. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Typically applied to chest. Minor/Significance Unknown. This effect was not observed with istradefylline 20 mg/day. Abstract. Observe for possible additive hypotensive effects during concomitant use. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increased risk of orthostatic hypotension. If it is within 2 hours of the next dose, skip the missed dose. endobj 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. Please confirm that you would like to log out of Medscape. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Avoid or Use Alternate Drug. Either increases effects of the other by Mechanism: additive vasodilation. Avoid or Use Alternate Drug. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. restrictions. Limit alcoholic beverages. Prices imdur to isordil dose conversion from levemir. Is Low-Dose Aspirin Linked to Risk for Gastric Ulcers? Last updated on Feb 7, 2022. Indications Angina (a specific type of chest pain) caused by heart disease Chest pain caused by angina Pros and Cons Pros Good at preventing chest pain caused by heart disease Take the dose in the morning right after you wake up. Prophylactic management in situations likely to provoke angina attacks in patients who fail to respond to sublingual nitroglycerin: 2.55 mg of isosorbide dinitrate should be placed under the tongue approximately 15 minutes prior to engaging in such activities. Monitor Closely (1)ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Half-life. Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. Start with lower doses and titrate slowly. Risk of increased SBP, angina pectoris. Share cases and questions with Physicians on Medscape consult. The patient should be sitting immediately after sublingual or intrabuccal administration. 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. Monitor Closely (1)tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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 . Modify Therapy/Monitor Closely. 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. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).Isosorbide mononitrate is very similar to isosorbide dinitrate. Monitor Closely (1)isosorbide mononitrate, arginine. Some conditions may become worse when the drug is suddenly stopped. Serious - Use Alternative (1)lofexidine, isosorbide mononitrate. Fexinidazole inhibits CYP3A4. Monitor Closely (1)mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In one well-controlled clinical trial, subjects receiving nitroglycerin appeared to exhibit a rebound or withdrawal effect, so that their exercise tolerance at the end of the daily drug-free interval was less than that exhibited by the parallel group receiving placebo. Minor/Significance Unknown. Potentially fatal hypotension. 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). Monitor Closely (1)rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Select one or more newsletters to continue. dichlorphenamide and isosorbide mononitrate both decrease serum potassium. 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