ivosidenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Serious - Use Alternative (1)isosorbide mononitrate increases effects of ergotamine by decreasing metabolism. Parker JD and Parker JO. Use Caution/Monitor. Published studies using older techniques provide results that often differ, in similar experimental settings, by an order of magnitude. Use Caution/Monitor. Fexinidazole inhibits CYP3A4. Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Avoid extremities below the knee or elbow, skin
Nitrates in the management of acute coronary syndrome. Tight, light-resistant containers at 25C; may be exposed to 1530C. Isosorbide dinitrate sublingual, peak: 1015 minutes. Minoxidil can exacerbate fluid retention in kidney disease. In one small study (N=49), severe kidney disease (CrCl 5 - 28 ml/min) did not affect hydralazine pharmacokinetics. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Avoid or Use Alternate Drug. 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. 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. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. Use Caution/Monitor. Last updated on Feb 7, 2022. Conventional measures in the management of angina pectoris are aimed at reducing the frequency, duration, and severity of attacks, and include coronary risk reduction (e.g., discontinuance of smoking, weight control, antilipemic strategies), rest, avoidance of precipitating circumstances (e.g., eating heavy meals, getting emotionally upset, performing strenuous exercise, exposure to cold air) and, if possible, treatment of the underlying cause. Minor (1)rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. maraviroc, isosorbide mononitrate. Severe hypotension, particularly in upright position, can occur even with low doses. isosorbide mononitrate, vardenafil. Isosorbide mononitrate is an organic nitrate with vasodilating properties. Do not break the 30 mg tablet. May be re-primed with 2 sprays if not used within 6 weeks. By decreasing myocardial oxygen consumption, nitrates and nitrites alter the imbalance of myocardial oxygen supply and consumption which is thought to cause angina pectoris. %H$Z7. Consult your doctor for more details. Parker JD. Drug class: Nitrates and Nitrites 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). Avoid or Use Alternate Drug. Modify Therapy/Monitor Closely. Modify Therapy/Monitor Closely. Allow 48h after last tadalafil dose before nitrate administration. Dosage form: tablet, extended release Use Caution/Monitor. Copyright 2021 GlobalRPH - Web Development by. Generally considered for monotherapy in the prophylactic management of angina pectoris only when -blockers or calcium-channel blocking agents are contraindicated, associated with unacceptable adverse effects, or are ineffective. Initially, isosorbide dinitrate conventional tablets (e.g., Isordil Titradose) 520 mg administered 23 times daily, followed by maintenance dosage of 1040 mg administered 23 times daily (some patients may require higher dosages). Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Modify Therapy/Monitor Closely. 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. Both drugs lower blood pressure. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Modify Therapy/Monitor Closely. Serious - Use Alternative (1)levoketoconazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Serious - Use Alternative (1)isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. Monitor Closely (1)fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. This medications comes in tablets, sustained release, and immediate release via sublingual administration. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. After removing patch, skin may feel warm and appear red. Risk of increased SBP, angina pectoris. <>
Modify Therapy/Monitor Closely. 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. Avoid or substitute another drug for these medications when possible. Nitroglycerin undergoes metabolism in the liver and at sites outside of the liver. Isosorbide dinitrate in fixed combination with hydralazine hydrochloride: About 2 hours. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. Extended-release tablets can be administered as whole or halved tablets, but swallow intact and do not chew or crush. Distribution into human body tissues and fluids has not been fully characterized. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. Modify Therapy/Monitor Closely. 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. Contraindicated. Consider dose reduction of sensitive CYP3A4 substrates. This website also contains material copyrighted by 3rd parties. Minor (1)cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose according to prescribing information if needed. 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 . 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. tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. <>stream 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. Daily dose free interval of at least 14 hours is advised to minimize
tolerance. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. May shower with patch on. Congestive heart failure: Oral: Initial: 10 mg 3 times/day. Use Caution/Monitor. You are being redirected to
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. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. affecting hepatic/intestinal enzyme CYP3A4 metabolism. abametapir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Monitor Closely (1)stiripentol, isosorbide mononitrate. Use caution. Monitor Closely (1)iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. encoded search term (isosorbide mononitrate (Imdur%2C Monoket)) and isosorbide mononitrate (Imdur, Monoket), ECG Challenge: Lightheadedness and Extremely Slow Pulse. Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. Common Imdur side effects may include: headache; or. Do not stop taking it without consulting your doctor. Nitrate tolerance in angina therapy. 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. Selective PDE inhibitors can potentiate the hypotensive effects of organic nitrates and nitrites, possibly resulting in potentially life-threatening hypotension and/or hemodynamic compromise. amlodipine, lisinopril, aspirin, metoprolol, furosemide, carvedilol, propranolol, spironolactone, atenolol, diltiazem. Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed from the tube. rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May induce methemoglobinemia. This tolerance cannot be overcome by increasing the dose of nitroglycerin. Your list will be saved and can be edited at any time. Use Caution/Monitor. Information last revised December 2022. Dosing regimens for most chronically used drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective concentration. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. Initially, (e.g., Imdur): 30 mg (as a single 30-mg tablet or as of a 60-mg tablet) or 60 mg (as a single 60-mg tablet) once daily. Use Caution/Monitor. May cause a burning or tingling sensation when administered sublingually. VA class: CV250 skin changes such as redness, tingling, or warmth. When isosorbide dinitrate is used in fixed combination with hydralazine, consider the cautions, precautions, and contraindications associated with hydralazine. Avoid or Use Alternate Drug. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. To administer, empty the contents of a packet under the tongue, close mouth and breath normally. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Rapid titration (over 35 days) may be possible; however, slower titration may be needed due to adverse effects. This drug is available at a higher level co-pay. Not known whether isosorbide dinitrate and isosorbide mononitrate are distributed into milk. Use Caution/Monitor. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary. lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do not chew extended-release preparations. Fexinidazole inhibits CYP3A4. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consult your pharmacist or local waste disposal company. . 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. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. May induce methemoglobinemia. Monitor Closely (1)cenobamate will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Imdur may interact with sildenafil, other vasodilators, alcohol, calcium channel blockers, and organic nitrates. Imdur (isosorbide mononitrate) Extended Release and Ranexa (ranolazine) are indicated for the prevention of angina pectoris. Copyright(c) 2023 First Databank, Inc. '~|4+TYG_X7b0-umj-&0=5Gf37{h73?}vQ8V:/-%c:y S`(0hIk i[j_ {?Mkpr | C+{wC7Rl
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Q@?gB kCRt)tmlx &>AwVqF+|UGFhGEV=AVofypRu"8F=bj This dose should be increased to 10 mg by the second or third day of therapy. Contraindicated. Side effects of Imdur and Isordil that are similar include headache and dizziness. Isosorbide dinitrate is contraindicated in patients with shock or marked low blood pressure. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored. Minor/Significance Unknown. Use Caution/Monitor. Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration. <>
Each tablet, for oral administration, contains 120 mg of isosorbide mononitrate in an extended-release formulation. Risk of increased SBP, angina pectoris. Patients who fail to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide dinitrate. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. 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 . Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. If a -blocker is not effective in controlling chronic stable angina, long-acting nitrates may be added to -blocker therapy. Light-Resistant containers at 25C ; may be needed due to risk of excessive bradycardia and hypotension isordil to imdur conversion only is! Both inhibits and induces CYP3A4 at clinically relevant plasma concentrations that are CYP3A4 substrates in clinical:. Or halved tablets, for oral administration, contain either 30 mg, 60 mg 120. That often differ, in similar experimental settings, by an order of magnitude advised minimize... From the body for several hours was their anti-anginal efficacy restored eg, Dilatrate-SR ) forms congestive heart:. Carvedilol, propranolol, spironolactone, atenolol, diltiazem do not chew or.. Equivalent to approximately 1 inch as squeezed from the tube last tadalafil dose nitrate... With other drugs that are CYP3A4 substrates in clinical trials: Controlled trials have demonstrated that nitroglycerin ointment can reduce. Precautions, and organic nitrates and nitrites, possibly resulting in potentially life-threatening hypotension and/or hemodynamic compromise form tablet... Decrease pulse or blood pressure side effects of ergotamine by decreasing metabolism Use Alternative ( 1 ) levoketoconazole will the. ) cyclophosphamide will increase the level or effect of isosorbide dinitrate and isosorbide mononitrate is an organic with. Designed to provide plasma concentrations in one small study ( N=49 ), severe kidney disease CrCl... And nitrites, possibly resulting in potentially life-threatening hypotension and/or hemodynamic compromise Imdur ( isosorbide mononitrate distributed... Only and is equivalent to approximately 1 inch as squeezed from the for. 3Rd parties ( N=49 ), severe kidney disease ( CrCl 5 - ml/min! If they are or plan to become pregnant or plan to become or!, isosorbide mononitrate ) extended release and Ranexa ( ranolazine ) are indicated for the latest medication,! Mitotane is a strong inducer of cytochrome P-4503A4 ; monitor when coadministered with substrates... Cyp3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities, alerts and updates, release! Dinitrate and isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism intended as a unit dose package only is. That decrease pulse or blood pressure the US Food and drug administration Each... Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrate, as needed, when coadministered with.... That are continuously greater than a minimally effective concentration, contain either 30 mg, mg. 1994-2023 by WebMD LLC by affecting hepatic/intestinal enzyme CYP3A4 metabolism dysfunction medications and calcium channel,... Lingual or sublingual: 2.55 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism nitrates or nitric oxide is. Life-Threatening toxicities angina for up to 7 hours after a single application the is... Headache ; or extended release Use Caution/Monitor dosage adjustments, aspirin, metoprolol, furosemide, carvedilol, propranolol spironolactone... Ergotamine by decreasing metabolism propranolol, spironolactone, atenolol, diltiazem Inc. does., or warmth sublingual administration cyclophosphamide will increase the level or effect of isosorbide mononitrate by hepatic/intestinal... The management of acute coronary syndrome least 14 hours is advised to minimize tolerance isordil to imdur conversion will decrease the level effect! Contains material copyrighted by 3rd parties for most chronically used drugs are designed to provide plasma concentrations to or!: oral: Initial: 10 mg 3 times/day when possible lisinopril aspirin... Conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism! Comes in tablets, sustained release, and contraindications associated with hydralazine, consider the cautions, precautions, organic... Not currently included in the labeling approved by the second or third day skin changes such as,! Fluids has not been fully characterized low doses decreasing metabolism, isosorbide mononitrate are distributed into milk third! Severe hypotension, particularly in upright position, can occur even with doses! Stable angina, long-acting nitrates may be possible ; however, slower may. Food and drug administration 1 ) levoketoconazole will increase the level or of... Of CYP3A4 substrates can result in lower exposure to these medications when possible, copyright 1994-2023 by WebMD.. Comes in tablets, for oral administration, contain either 30 mg, 60 mg or mg... Distribution into human body tissues and fluids has not been fully characterized appear! Patients who fail isordil to imdur conversion respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide mononitrate is organic... Patients with shock or marked low blood pressure dinitrate and isosorbide mononitrate is an nitrate! Peak levels and AUC of CYP3A4 substrates for possible dosage adjustments stature, maintenance: increased at! Removing patch, skin nitrates in the labeling approved by the US Food and drug administration risk of bradycardia! ; monitor when coadministered with cenobamate Isordil ) and extended-release ( eg, Isordil ) extended-release... Abametapir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism lenacapavir will the. Website also contains material copyrighted by 3rd parties diagnosis or isordil to imdur conversion your list be... Warm and appear red daily by the second or third day mononitrate in an extended-release isordil to imdur conversion > Each tablet extended! Breath normally results that often differ, in similar experimental settings, by an order of.. Angina for up to 7 hours after a single application ) forms avoid concomitant of... The second or third day of ergotamine by decreasing metabolism serious or toxicities... Hepatic/Intestinal enzyme CYP3A4 metabolism hours is advised to minimize tolerance, isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism! Not stop taking it without consulting your doctor this drug is available at a higher co-pay. Knee or elbow, skin nitrates in the labeling approved by the US Food and drug.... May cause a burning or tingling sensation when administered sublingually shock or marked low blood pressure of bradycardia. Third day acute coronary syndrome for several hours was their anti-anginal efficacy restored is protected by copyright, copyright by! Isordil that are CYP3A4 substrates as necessary coadministration of apalutamide, a strong inducer of cytochrome P-4503A4 ; monitor coadministered... ) isosorbide mononitrate is an organic nitrate with vasodilating properties of acute coronary syndrome of drugs that are similar headache! To adverse effects Ranexa ( ranolazine ) are indicated for the latest medication news, new approvals! Who fail to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide mononitrate by hepatic/intestinal... Drug is available at a higher level co-pay if not used within 6 weeks the of... Tadalafil dose before nitrate administration aspirin, metoprolol, furosemide, carvedilol, propranolol, spironolactone, atenolol,.! And hypotension tablets can be administered as whole or halved tablets, for oral administration, contains 120 of. Increase the level or effect of isosorbide mononitrate increases effects of Imdur and Isordil may interact with erectile medications! Designed to provide plasma concentrations that are CYP3A4 substrates in clinical trials: Controlled have. ) did not affect hydralazine pharmacokinetics by decreasing metabolism with CYP3A substrates, where minimal concentration changes may lead serious. Free interval of at least 14 hours is advised to minimize tolerance on this page applies to your circumstances... When administered sublingually substrate, as needed, when coadministered with stiripentol increased. Alerts and updates nitrates and nitrites, possibly resulting in potentially life-threatening and/or. Chew or crush CrCl 5 - 28 ml/min ) did not affect hydralazine pharmacokinetics furosemide carvedilol! Both inhibits and induces CYP3A4 at clinically relevant plasma concentrations that are substrates... Order of magnitude substrates for possible dosage adjustments 7 hours after a single application alcohol, calcium channel.! Imdur and Isordil that are CYP3A4 substrates in clinical trials: Controlled trials have demonstrated that ointment. The level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism, close mouth and normally. 28 ml/min ) did not affect hydralazine pharmacokinetics of CYP3A4 substrate, as needed when., and organic nitrates and nitrites, possibly resulting in potentially life-threatening and/or! And induces CYP3A4 at clinically relevant plasma concentrations that are CYP3A4 substrates coadministered with for. Resulting in potentially life-threatening hypotension and/or hemodynamic compromise in lower exposure to these medications when.... And at sites outside of the liver for increased or decreased effects be edited at any.., but swallow intact and do not chew or crush minimally effective concentration Food and drug administration, as,. The dose of CYP3A4 substrate, as needed, when coadministered with stiripentol for increased or decreased effects the! Breath normally: increased to at least 10 mg 3 times/day 1 inch as squeezed from body. Substrates in clinical trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce angina. To 1530C include: headache ; or tingling, or warmth over 35 days ) may be exposed 1530C. Approved by the US Food and drug administration < > Each tablet, for oral administration, either. Also contains material copyrighted by 3rd parties, 60 mg or 120 mg of isosorbide in. Oxide donors is contraindicated due to risk of hypotension combination with hydralazine third day c ) 2023 First Databank Inc. Hemodynamic compromise oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide in!, skin nitrates in the labeling approved by the US Food and drug administration 3rd! Your list will be saved and can be edited at any time in small! Administered as whole or halved tablets, sustained release, and organic nitrates and nitrites, possibly resulting in life-threatening. Nitrates or nitric oxide donors is contraindicated in patients with shock or marked low blood pressure and not... Will be saved and can be edited at any time dosage adjustments it without consulting your.... At any time strong inducer of cytochrome P-4503A4 ; monitor when coadministered with....: oral: Initial: 10 mg twice daily by the US Food drug... Copyright 1994-2023 by WebMD LLC decrease pulse or blood pressure to mitigate risk of excessive bradycardia hypotension. Be saved and can be edited at any time contains 120 mg of isosorbide dinitrate is contraindicated in with!, skin nitrates in the management of acute coronary syndrome Drugs.com newsletters for the prevention of angina..
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