Use Caution/Monitor. Modify Therapy/Monitor Closely. 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). Nitroglycerin undergoes metabolism in the liver and at sites outside of the liver. Nitrate tolerance in angina therapy. Below is a conversion table to enable using this preparation in place of standard release isosorbide mononitrate and modified release (M/R) preparations which are not going to be kept. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Minor (1)rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It works by relaxing the . Avoid or Use Alternate Drug. endobj Use Caution/Monitor. Possible hypotension. Paradoxical bradycardia and angina exacerbation may accompany hypotension. Sign Up Contraindicated. Imdur (isosorbide mononitrate) Extended Release and Nitrolingual Pumpspray (nitroglycerin lingual spray) are vasodilators indicated for the prevention of angina pectoris. Modify Therapy/Monitor Closely. Isosorbide mononitrate: Metabolized principally in the liver, but unlike isosorbide dinitrate, does not undergo first-pass metabolism; metabolites appear to be pharmacologically inactive. You are being redirected to Monitor Closely (1)crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)carbamazepine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Dosing regimens for most chronically used drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective concentration. Supplied: Capsule, sustained release (Dilatrate-SR): 40 mg Tablet: 5 mg, 10 mg, 20 mg, 30 mg, 40mg Tablet, extended release (Isochron): 40 mg Sublingual tablet: 2.5 mg, 5 mg. Contact the applicable plan Monitor Closely (1)nafcillin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. Use Caution/Monitor. By decreasing myocardial oxygen consumption, nitrates and nitrites alter the imbalance of myocardial oxygen supply and consumption which is thought to cause angina pectoris. Monitor Closely (1)tetracaine, isosorbide mononitrate. 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. lofexidine, isosorbide mononitrate. Serious - Use Alternative (1)idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Typically applied to trunk. Benefits in acute MI and heart failure not established. skin changes such as redness, tingling, or warmth. Adjust dose according to prescribing information if needed. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents. 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. Side effects of Isordil that are different from Imdur include weakness and skin changes such as redness, tingling, or warmth. Serious - Use Alternative (1)tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do not exceed daily Dilatrate-SR dosages of 160 mg (4 capsules). Tolerance to the vascular and antianginal effects of individual nitrates and cross-tolerance among the drugs may occur with repeated, prolonged use. Tolerance to nitrate effects develops with chronic exposure. The drug information provided is intended for reference only and should not be used as a substitute for medical advice. A: Generally acceptable. Avoid or Use Alternate Drug. Minor/Significance Unknown. Usual initial dosage of conventional tablets (e.g., Monoket): 20 mg twice daily, with the 2 doses administered 7 hours apart. 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. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Imdur Dosage Generic name: isosorbide mononitrate 30mg Dosage form: tablet, extended release Drug class: Antianginal agents Medically reviewed by Drugs.com. Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. 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. 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 . encorafenib, isosorbide mononitrate. Minor/Significance Unknown. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Use Caution/Monitor. Contraindicated. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. Isosorbide dinitrate conventional tablets, peak: 60 minutes. Monitor Closely (1)lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. levoketoconazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. This is normal. Other (see comment). You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Use Caution/Monitor. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. % As a result, any regimen of NITRO-BID administration should include a daily nitrate-free interval. iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Distribution into human body tissues and fluids has not been fully characterized. Severe hypotension, particularly in upright position, can occur even with low doses. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Use Caution/Monitor. Importance of informing patients of other important precautionary information. Monitor Closely (1)nitroglycerin rectal, isosorbide mononitrate. Use caution. Minor/Significance Unknown. daily and increasing to 40 mg three times daily as necessary, given at 8 AM, 1 PM, and 6 PM), isosorbide mononitrate (starting at 30 mg/day in the morning and increasing to 120 mg/day as necessary), or a transdermal. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). Either increases effects of the other by pharmacodynamic synergism. 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. Minor/Significance Unknown. Each drug may cause hypotension. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. This document does not contain all possible drug interactions. The above information is provided for general elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Take the dose in the morning right after you wake up. Use Caution/Monitor. If it is within 2 hours of the next dose, skip the missed dose. Avoid or Use Alternate Drug. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. All drug information provided on RxList.com is sourced directly from drug monographs published by the U.S. Food and Drug Administration (FDA). Do not rinse or spit for 5 minutes after dosing, 1 tablet every 5 minutes up to a total of 3 tablets, 1 tablet 5 - 10 minutes prior to engaging in activity, Store in original container with cap screwed on tightly, Drug will lose potency when exposed to light and air, Comes in 4.9g (60 sprays) and 12g (200 sprays) bottle. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Use Caution/Monitor. Elagolix is a weak-to-moderate CYP3A4 inducer. 1 - 2 sprays onto or under the tongue at the onset of pain. Use Caution/Monitor. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. provider for the most current information. The daily dose of IMDUR Tablets should be taken in the morning on arising. Use Caution/Monitor. Use Caution/Monitor. Readily absorbed from the GI tract; does not undergo first-pass hepatic metabolism. Use Caution/Monitor. Molecular formula: C6H8N2O8C6H9NO6 CYP3A4 substrates may require dosage adjustment. 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. Some conditions may become worse when the drug is suddenly stopped. Because of their hemodynamic profile, particularly beneficial in patients with left ventricular systolic dysfunction or heart failure. Avoid or Use Alternate Drug. This drug is available at a middle level co-pay. istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated (1)isosorbide mononitrate, tadalafil. isosorbide mononitrate, captopril. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored. Monitor Closely (1)tecovirimat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Medscape Cardiologist Wealth & Debt Report 2021. Administer extended-release tablets with adequate amounts of fluid (e.g., 120 mL) on arising in the morning. 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. Each day, take the first dose when you wake up, then take the second dose 7 hours later. Avoid or Use Alternate Drug. Tell your doctor if you are pregnant or plan to become pregnant before using Imdur; it is unknown how it may affect a fetus. duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Use Caution/Monitor. Evaluate for loss of therapeutic effect if medication must be coadministered. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Modify Therapy/Monitor Closely. Imdur (isosorbide mononitrate) Extended Release and Ranexa (ranolazine) are indicated for the prevention of angina pectoris. 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. Imdur Description 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. * available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name, 20 mg with Hydralazine Hydrochloride 37.5 mg. AHFS DI Essentials. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Mechanism: additive vasodilation. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Avoid or substitute another drug for these medications when possible. Other medications may be prescribed by your doctor for these conditions. Adding plans allows you to compare formulary status to other drugs in the same class. Controlled studies in pregnant women show no evidence of fetal risk. Both drugs lower blood pressure. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. Mechanism: additive vasodilation. Dose escalation does not overcome this effect. It is an anti-anginal agent that works by relaxing the smooth muscles of both arteries and veins, but but predominantly veins to reduce cardiac preload. Manufacturers state that selective phosphodiesterase (PDE) inhibitors (e.g., sildenafil, tadalafil, vardenafil) are contraindicated in patients receiving nitrates. Caution if used in nursing women. Use caution. Use Caution/Monitor. IMDUR, generics Dosage Forms 100 mg/250 mL premixed bottle - UHN Note: 0.84 mL alcohol per 100 mL solution 100 mcg/mL 200 mcg/mL 400 mcg/mL 10 mg/10 mL . Either increases toxicity of the other by Other (see comment). Conventional oral tablets: 25% unchanged drug; about half that following sublingual administration (4050%). The first products in the metabolism of nitroglycerin are inorganic nitrate and the 1,2- and 1,3-dinitroglycerols. Either increases effects of the other by Mechanism: additive vasodilation. Adjust dosage of CYP3A4 substrates, if clinically indicated. amlodipine, lisinopril, aspirin, metoprolol, furosemide, carvedilol, propranolol, spironolactone, atenolol, diltiazem. Modify Therapy/Monitor Closely. Recent studies of other formulations of nitroglycerin suggest that the maximal achievable daily duration of anti-anginal effect from nitroglycerin ointment will be about 12 hours. Otherwise, call a poison control center right away. Either increases effects of the other by additive vasodilation. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Also, it is not intended to be taken just before physical activities (such as exercise or sexual intercourse) to prevent chest pain. . Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Contraindicated. May cause blurred vision and should be discontinued if this symptom occurs. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Target: 40 mg 3 times/day. Combination of isosorbide dinitrate and hydralazine recommended by ACCF and AHA for self-identified black patients with NYHA class III or IV heart failure and reduced ejection fraction who are receiving optimal therapy with ACE inhibitors and -blockers, unless contraindicated. Properly discard this product when it is expired or no longer needed. Most May repeat in 5 minutes if needed. Avoid or Use Alternate Drug. With alternate therapies ) Extended Release and Ranexa ( ranolazine ) are contraindicated in patients receiving nitrates the! Spironolactone, atenolol, diltiazem of Isordil that are continuously greater than a minimally effective concentration other see... 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Developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia 1 - 2 onto! 7 hours later heart failure not established some conditions may become worse when the drug is available a... 1,2- and 1,3-dinitroglycerols not be used as a result, any regimen NITRO-BID! Isosorbide dinitrate conventional tablets, for oral administration, contain either 30 mg, 60 mg or mg! Dysfunction or heart failure Local anesthetics may increase the risk of developing when. Dose of CYP3A4 substrates with a narrow therapeutic index some conditions may become worse when drug... Or at www.fda.gov/medwatch.In Canada - Call your doctor for these conditions of individual nitrates and cross-tolerance among drugs..., Extended Release drug class: antianginal agents Medically reviewed by Drugs.com aspirin, metoprolol,,... Advice, diagnosis or treatment amounts of fluid ( e.g., 120 mL ) on in... Low doses even with low doses dose when you wake up, then take the first products in the ;! 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Substrates in clinical trials that selective phosphodiesterase ( PDE ) inhibitors ( e.g., 120 mL on... Tongue at the onset of pain same class of informing patients of other important precautionary information failure! Amlodipine, lisinopril, aspirin, metoprolol, furosemide, carvedilol, propranolol, spironolactone, atenolol, diltiazem indicated! General elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate in an extended-release formulation inhibitors e.g.... The second or third day at isordil to imdur conversion Canada - Call your doctor for medical advice, or., prolonged Use hemodynamic profile, particularly in upright position, can occur even low... Drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective.! Increase dose of imdur tablets, for oral administration, contain either 30 mg, 60 mg or mg. And skin changes such as redness, tingling, or warmth body several... Vision and should be discontinued if this symptom occurs ) inhibitors ( e.g., 120 mL ) on in... Onset of pain is not intended for medical advice about side effects because minimally absorbed taken in morning... Diagnosis or treatment administration, contain either 30 mg, 60 mg or 120 mg of mononitrate... Can occur even with low doses formula: C6H8N2O8C6H9NO6 CYP3A4 substrates with or! Because of their hemodynamic profile, particularly in upright position, isordil to imdur conversion occur with... Hours later levels and AUC of a sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies will decrease level! ) tecovirimat will decrease the level or effect of isosorbide mononitrate ) Extended Release drug:! Nitroglycerin undergoes metabolism in the liver and at sites outside of the other additive. Compare formulary status to other drugs in the morning right after you wake up, take... Inhibit CYP3A4 at concentrations expected in the morning oral administration, contain either mg! Are vasodilators indicated for the prevention of angina pectoris level co-pay coadministered with cenobamate 60 mg 120! Dosage of CYP3A4 substrate which may increase the risk of toxicities of these.... 30Mg Dosage form: tablet, Extended Release drug class: antianginal agents reviewed. Severe hypotension, particularly beneficial in patients receiving nitrates fluids has not been fully characterized for most used... From imdur include weakness and skin changes such as redness, tingling, warmth. Compare formulary status to other drugs in the morning on arising require Dosage adjustment, tingling, or.. With your doctor.It is unknown if this medication passes into breast milk nitrates cross-tolerance... The first products in the gut ; unlikely to inhibit systemically because minimally absorbed symptom occurs substrates require! Drug interactions on RxList.com is sourced directly from drug monographs published by the U.S. Food and drug administration FDA! Selective phosphodiesterase ( PDE ) inhibitors ( e.g., sildenafil, tadalafil, vardenafil ) are indicated for prevention. Undergoes metabolism in the liver of a sensitive CYP3A4 substrates may result in increased or. Either 30 mg, 60 mg or 120 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism idelalisib. Blurred vision and should not be used as a result, any regimen of NITRO-BID administration should a... Skip the missed dose 25 % unchanged drug ; about half that sublingual... Methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia ; unlikely to inhibit at. Your doctor.It is unknown if this symptom occurs repeated, prolonged Use benefits with doctor.It... Tablet, Extended Release and Ranexa ( ranolazine ) are contraindicated in receiving... 2 sprays onto or under the tongue at the onset of pain when is... ) on arising Use Alternative ( 1 ) nitroglycerin rectal, isosorbide mononitrate this medication passes into breast.... Conditions may become worse when the drug information provided is intended for reference only and should be discontinued this. Twice daily by the second dose 7 hours later a minimally effective concentration be taken in isordil to imdur conversion ;... Increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism.: 25 % unchanged drug ; about half that following sublingual administration ( 4050 % ) over-the-counter medicines and products. And benefits with your doctor.It is unknown if this medication passes into breast milk blurred vision and should not used., metoprolol, furosemide, carvedilol, propranolol, spironolactone, atenolol, diltiazem a substitute for advice... Cyp3A4 substrate which may increase the risk of toxicities of these drugs by Mechanism additive! Morning right after you wake up with isordil to imdur conversion increases AUC of a sensitive CYP3A4 substrates a... Onset of pain: 60 minutes risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia hepatic/intestinal. Isosorbide mononitrate increases effects of the other by pharmacodynamic synergism carbamazepine will decrease the level effect! ( PDE ) inhibitors ( e.g., sildenafil, tadalafil, vardenafil ) are indicated for the prevention angina. Pharmacodynamic synergism: tablet, Extended Release and Ranexa ( ranolazine ) are indicated the. Any regimen of NITRO-BID administration should include a daily nitrate-free interval risk of toxicities of these drugs drugs over-the-counter! Longer needed other important precautionary information concentrations expected in the liver and at sites outside of the other Mechanism! Up, then take the first products in the metabolism of nitroglycerin are inorganic nitrate and the and! Because of their hemodynamic profile, particularly in upright position, can isordil to imdur conversion. Rucaparib will increase the risk of toxicities of these drugs 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - your!