The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. 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. istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. % If you log out, you will be required to enter your username and password the next time you visit. Avoid or Use Alternate Drug. Importance of informing patients of other important precautionary information. Adjust dose according to prescribing information if needed. Monitor Closely (1)isosorbide mononitrate increases toxicity of dapsone topical by altering metabolism. Isosorbide mononitrate: Generally, food delays the rate but not the extent of absorption (less than 10%) of conventional or extended-release tablets. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode. Monitor Closely (1)encorafenib, isosorbide mononitrate. 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. Most Extended-release oral nitrate preparations should not be used in patients with functional or organic GI hypermotility or malabsorption syndrome. Drug Therapy: Nitrate therapy for stable angina pectoris. Chewable tablet: 5-10 mg every 2-3 hours. Make sure laboratory personnel and all your doctors know you use this drug. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. Contraindicated. acetazolamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Known hypersensitivity to isosorbide or any ingredient in the respective formulation. Dosage form: tablet, extended release phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Primarily reduces cardiac oxygen demand by decreasing preload (left ventricular end-diastolic pressure); may modestly reduce afterload; dilates coronary arteries and improves collateral flow to ischemic regions. It is not known if Isordil affects the fetus in pregnant women or if it occurs in breast milk. Minor (1)anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Imdur (isosorbide mononitrate) Extended Release Tablets are a vasodilator indicated for the prevention of angina pectoris due to coronary artery disease. View the formulary and any restrictions for each plan. The manufacturer of the fixed combination of isosorbide dinitrate and hydralazine hydrochloride states that dosage should be selected with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy. Imdur may also interact with other vasodilators, alcohol, and organic nitrates. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Available for Android and iOS devices. -Adrenergic blocking agents (-blockers) generally are considered among the initial antianginal drugs of choice in the long-term prophylactic management of chronic stable angina with or without prior MI to reduce symptoms and to prevent MI and/or death. Comes in 4.1g (90 sprays) and 8.5g (230 sprays) bottle. Use Caution/Monitor. Nitrate tolerance in angina therapy. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. MISSED DOSE: If you miss a dose, take it as soon as you remember. It works by relaxing and widening blood vessels so blood can flow more easily to the heart.This medication will not relieve chest pain once it occurs. Mechanism: additive vasodilation. Monitor blood pressure. Symptoms of overdose may include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Coadministration may increase risk for adverse effects of CYP3A4 substrates. May repeat in 5 minutes if needed. Safety and effectiveness of Isordil in pediatric patients have not been established. 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. folds, scar tissue, burned or irritated areas. Contraindicated. Mechanism: additive vasodilation. 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. 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. It is important to take the drug at the same times each day. Modify Therapy/Monitor Closely. Subsequent studies discovered that a chemical reaction between . Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. A local search option of this data can be found here. This tolerance cannot be overcome by increasing the dose of nitroglycerin. Mechanism: additive vasodilation. % imdur dose imdur vs nitroglycerinNov 1, 2011 . This effect was not observed with istradefylline 20 mg/day. Administer extended-release tablets with adequate amounts of fluid (e.g., 120 mL) on arising in the morning. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate, captopril. 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. If a -blocker is not effective in controlling chronic stable angina, long-acting nitrates may be added to -blocker therapy. Use Caution/Monitor. This drug is available at a higher level co-pay. Use Caution/Monitor. Isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate. 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. Isosorbide dinitrate is contraindicated in patients with shock or marked low blood pressure. Imdur ER; Ismo; Monoket; Descriptions. Use Caution/Monitor. Use Caution/Monitor. Use Caution/Monitor. Importance of instructing patients receiving isosorbide dinitrate for relief of acute attacks of angina pectoris to consult a clinician or go to a hospital emergency room immediately if chest pain is not relieved after 3 doses approximately every 5 minutes, because inability to relieve chest pain may indicate acute MI. Coadministration may increase risk for adverse effects of CYP3A4 substrates. endobj Use Caution/Monitor. lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate: Food may decrease substantially mean peak plasma concentrations, yet total bioavailability does not seem to be affected. The two doses should be administered 7 hours apart in order to avoid tolerance (decreased effect after several doses). 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. <>stream Potentially fatal hypotension. 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. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. 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. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Minor/Significance Unknown. Stiripentol is a CYP3A4 inhibitor and inducer. 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. Take the first dose in the morning right after you . Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Serious - Use Alternative (1)levoketoconazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses. Z L0y+"Z=A]*=_/Kw&FEa"O,KqKl]s-:G{. Allow 48h after last tadalafil dose before nitrate administration. anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consult your doctor for more details. Isosorbide dinitrate conventional tablets, peak: 60 minutes. In some controlled trials of other organic nitrate formulations, efficacy has declined with time. Nitrates in the management of acute coronary syndrome. Sublingual or intrabuccal nitrates may be inadequately absorbed, with resultant decreased efficacy, in patients with dry oral mucous membranes (e.g., xerostomia). Use Caution/Monitor. Do not break the 30 mg tablet. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Use Caution/Monitor. Avoid or Use Alternate Drug. 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. Minor/Significance Unknown. This website also contains material copyrighted by 3rd parties. Drug information found in the drug comparisons published on RxList.com is primarily sourced from the FDA drug information. 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. Mechanism: additive vasodilation. What Are Possible Side Effects of Isordil? 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. 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. Caution in volume depletion or preexisting hypotension. Use Caution/Monitor. May induce methemoglobinemia. May need to adjust schedule for those arising earlier than 7 a.m. since early morning angina is common. Am J Cardiol 1993;72:871-6 4. Why Use Isosorbide Dinitrate vs Isosorbide Mononitrate? rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Available for Android and iOS devices. This dose should be increased to 10 mg by the second or third day of therapy. Monitor Closely (1)istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Always ask your health care professional for complete information about this product and your specific health needs. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Potentially fatal hypotension. Possibility of an increased frequency or severity of angina during the nitrate-free interval should be considered. AdultsAt first, 30 or 60 milligrams (mg) once a day. 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. Serious - Use Alternative (1)isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. 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. Side effects of Imdur and Isordil that are similar include headache and dizziness. isosorbide mononitrate, bupivacaine implant. Modify Therapy/Monitor Closely. A larger area may be used. (See Cautions.). This is normal. Pharmacokinetics: The volume of distribution of nitroglycerin is about 3 L/kg, and nitroglycerin is cleared from this volume at extremely rapid rates, with a resulting serum half-life of about three minutes. Contraindicated (1)isosorbide mononitrate, sildenafil. If unavoidable, reduce CYP3A substrate dose according to product labeling. Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. Avoid or Use Alternate Drug. tecovirimat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide mononitrate is an organic nitrate with vasodilating properties. Isosorbide dinitrate (Isordil) is good for a specific type of chest pain (called angina), but it can cause headaches after you take it. Isosorbide dinitrate: Also probably metabolized at extrahepatic sites. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Avoid or Use Alternate Drug. Use Caution/Monitor. Limit alcoholic beverages. Use Caution/Monitor. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Supplementary sublingual nitroglycerin doses should be given if necessary during dosage reduction. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. 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. Drug class: Antianginal agents. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Prices imdur to isordil dose conversion from levemir. Either increases effects of the other by Mechanism: additive vasodilation. Call your doctor for medical advice about side effects. 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). This effect was not observed with istradefylline 20 mg/day. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Each day of nitroglycerin mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate in pregnant or... 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