Consult your pharmacist or local waste disposal company. 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. The dinitrates are further metabolized to (non-vasoactive) mononitrates and, ultimately, to glycerol and carbon dioxide. Monitor Closely (1)etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. maraviroc, isosorbide mononitrate. Rarely, 240 mg may be required. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. Use Caution/Monitor. If headaches continue or become severe, tell your doctor promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. If unavoidable, reduce CYP3A substrate dose according to product labeling. 1 - 2 sprays onto or under the tongue at the onset of pain. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated (1)isosorbide mononitrate, avanafil. Make sure laboratory personnel and all your doctors know you use this drug. Potentially fatal hypotension. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Paradoxical bradycardia and angina exacerbation may accompany hypotension. Safety and effectiveness of Isordil in pediatric patients have not been established. Do not rub into the skin. Due to the time-sensitive nature of drug information, RxList.com makes no guarantees that the information provided is the most current. Sublingual: 2.5-10 mg every 4-6 hours. Either increases effects of the other by pharmacodynamic synergism. Selective PDE inhibitors can potentiate the hypotensive effects of organic nitrates and nitrites, possibly resulting in potentially life-threatening hypotension and/or hemodynamic compromise. It will remain primed for 6 weeks. Copyright 1993-2021 Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. The data are consistent, however, in suggesting that nitroglycerin levels rise to steady state within an hour or so of application of ointment, and that after removal of nitroglycerin ointment, levels wane with a half-life of about half an hour. Is Low-Dose Aspirin Linked to Risk for Gastric Ulcers? Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ChildrenUse and dose must be determined by your doctor. Monitor Closely (1)duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor Closely (1)fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. You are being redirected to This drug is available at a higher level co-pay. Modify Therapy/Monitor Closely. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Drug class: Nitrates and Nitrites Avoid long-acting dosage forms in the early management of acute MI or heart failure since the effects are difficult to terminate rapidly should excessive hypotension or tachycardia occur. 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. 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. The foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed from the tube. lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Elagolix is a weak-to-moderate CYP3A4 inducer. Use Caution/Monitor. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Possibility of an increased frequency or severity of angina during the nitrate-free interval should be considered. Minoxidil can exacerbate fluid retention in liver disease. Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. Complete avoidance may not be possible, provided sufficient time elapses between use of the drugs. Modify Therapy/Monitor Closely. Most National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. Avoid or Use Alternate Drug. x\[o~`kYH]r M 0-:/n77nnN,v.V"mYf/2[7bf?x>}>\wG }Nx'XT^FVw_fo ~;Hfz^@mlgz]3GD6'lKi~6A-,Bw Lt"i'1Y}=7Og b-yb@Y=lY(v -l`'c#EqxXhb MANO{65j5H$~$2J-;oHDI~ IY~wr_x It is important to take the drug at the same times each day. Risk of elevated blood concentrations of isosorbide dinitrate in patients with cirrhosis. The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. PDE-5 inhibitors (eg, avanafil, sildenafil, tadalafil, or vardenafil); concomitant use can cause severe hypotension, syncope, or myocardial ischemia, Concomitant administration with guanylate stimulator riociguat (may cause hypotension), Use caution in acute myocardial infarction, alcohol use, hyperthyroidism, increased intracranial pressure (eg, from head trauma or cerebral hemorrhage; potential contraindication), increased intraocular pressure, postural hypotension, volume depletion, Moderate hypotension, low systolic blood pressure (BP), Not recommended for use in patients with acute myocardial infarction or heart failure, May cause CNS depression, which may in turn impair physical or mental abilities; caution patient about performing tasks that require mental alertness, including operating heavy machinery, Avoid use in patients with hypertrophic cardiomyopathy with outflow tract obstruction; nitrates may reduce preload, which can exacerbate obstruction and cause hypotension or syncope and/or worsening of heart failure, Do not change brands unintentionally; formulations are not all bioequivalent; extended release formulation not intended for the immediate relief of acute attacks of angina pectoris, Treat drug-induced headache with aspirin or acetaminophen, Provide nitrate-free interval (10-12 hr or overnight) to prevent development of tolerance, Severe hypotension may occur along with paradoxical bradycardia and increased angina pectoris; ethanol can cause severe hypotension with even small doses; avoid excessive, prolonged hypotension, Withdraw gradually to prevent acute angina, Use supportive treatment to manage overdose, Narrow-angle glaucoma (controversial: may not be clinically significant), Lactation: Unknown whether drug crosses into breast milk; use caution. Extended-release oral nitrate preparations should not be used in patients with functional or organic GI hypermotility or malabsorption syndrome. Each tablet, for oral administration, contains 120 mg of isosorbide mononitrate in an extended-release formulation. This product may contain inactive ingredients, which can cause allergic reactions or other problems. ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Use Caution/Monitor. Free Consultation! Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations. Monitor Closely (1)isosorbide mononitrate, captopril. US residents can call their local poison control center at 1-800-222-1222. To help you remember, take it at the same times each day. Monitor Closely (1)iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate: Metabolized extensively; about 1525 and 7585% of a dose is metabolized to isosorbide-2-mononitrate and isosorbide-5-mononitrate (referred to simply as isosorbide mononitrate), respectively; both metabolites are pharmacologically active, especially isosorbide mononitrate. Warn 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. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. Modify Therapy/Monitor Closely. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. 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. Monitor Closely (1)encorafenib, isosorbide mononitrate. May repeat in 5 minutes if needed. 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. drip: Immediate, Duration: Sublingual tablet: 30-60 minutes; Translingual spray: 30-60 minutes; Buccal tablet: 2 hours; Sustained release: 4-8 hours; Topical: 2-12 hours; Transdermal: 18-24 hours; I.V. 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. Tight, light-resistant containers at room temperature (25C); do not expose to extremes in temperature. Avoid or Use Alternate Drug. Avoid extremities below the knee or elbow, skin 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. MEDICAL ALERT: Your condition can cause complications in a medical emergency. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 1 0 obj Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. Avoid or Use Alternate Drug. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Some conditions may become worse when the drug is suddenly stopped. Mechanism: additive vasodilation. After . Isosorbide dinitrate is also available in immediate-release (eg, Isordil) and extended-release (eg, Dilatrate-SR) forms. conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. Monitor Closely (1)rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 2 0 obj 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. Evaluate for loss of therapeutic effect if medication must be coadministered. isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. 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. drip: 3-5 minutes. 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. Use Caution/Monitor. Serious - Use Alternative (1)lofexidine, isosorbide mononitrate. Coverage of an area approximately the size of the dose-measuring applicator (3 1/2" by 2 1/4") should be sufficient to obtain the desired clinical effects. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. Principal pharmacologic property is relaxation of vascular smooth muscle, resulting in generalized vasodilation. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Headache is often a sign that this medication is working. Prices imdur to isordil dose conversion from levemir. Dose escalation does not overcome this effect. informational and educational purposes only. The two doses should be administered 7 hours apart in order to avoid tolerance (decreased effect after several doses). OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. May repeat in 5 minutes if needed. 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. tecovirimat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Importance of consulting clinician if headache continues with repeated dosing. Risk of increased SBP, angina pectoris. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do Not Copy, Distribute or otherwise Disseminate without express permission. Controlled trials with other formulations of nitroglycerin have demonstrated that if plasma levels are maintained continuously, all anti-anginal efficacy is lost within 24 hours. duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. MISSED DOSE: If you miss a dose, take it as soon as you remember. The recipient will receive more details and instructions to access this offer. RxList does not provide medical advice, diagnosis or treatment. Both drugs lower blood pressure. Avoid or Use Alternate Drug. Short periods (10-12 hours) of nitrate withdrawal help minimize tolerance. Abametapir application, avoid taking drugs that are CYP3A4 substrates with ivosidenib replace. National Institutes of Health, U.S. National Library of Medicine, DailyMed Database Linked to risk for Ulcers... By your doctor in potentially life-threatening hypotension and/or hemodynamic compromise alternate therapies overdose: if you miss dose. 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