Use Caution/Monitor. The dose can be increased to 10 mg twice daily after 2 to 3 days. Avoid or substitute another drug for these medications when possible. - Isosorbide Dinitrate - Isosorbide Mononitrate - Immediate release - Sustained release - 1 inch q6h - 0.4 mg/h - 15 mg tid - 10 mg bid - 30 mg/day REFERENCES 1. amlodipine, lisinopril, aspirin, metoprolol, furosemide, carvedilol, propranolol, spironolactone, atenolol, diltiazem. Either increases effects of the other by pharmacodynamic synergism. crofelemer increases levels 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. A larger area may be used. Monitor Closely (1)isosorbide mononitrate, bretylium. VA class: CV250 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 Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. Each drug may cause hypotension. 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. 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 . Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. If not feasible, avoid use of abametapir. Monitor Closely (1)rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. [2,3], Hydralazine has not been studied extensively in kidney disease. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. SIDE EFFECTS: Headache, dizziness, lightheadedness, nausea, and flushing may occur as your body adjusts to this medication. Monitor Closely (1)conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. 1 - 2 sprays onto or under the tongue at the onset of pain. Potentially fatal hypotension. Mechanism: additive vasodilation. 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. isosorbide mononitrate, bretylium. Consult your doctor before breast-feeding. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored. Side effects of Imdur and Isordil that are similar include headache and dizziness. US residents can call their local poison control center at 1-800-222-1222. 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. Use Caution/Monitor. bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate conventional tablets, peak: 60 minutes. All drug information provided on RxList.com is sourced directly from drug monographs published by the U.S. Food and Drug Administration (FDA). Dosage adjustment of either the nitrate/nitrite or the other agent with hypotensive activity may be necessary to avoid orthostatic hypotension during concomitant use, Disopyramide may reduce the efficacy of isosorbide dinitrate, Antimuscarinic actions of disopyramide may decrease salivary secretions and thereby inhibit the dissolution of the sublingual tablets, Dihydroergotamine may counteract the coronary vasodilatory effect of nitrates, Use concomitantly with caution; risk of angina precipitation, Patients receiving nitrates or nitrites concomitantly should be observed for possible additive hypotensive effects, Use concomitantly with caution; may need to adjust dosage to avoid orthostatic hypotension, Phosphodiesterase (PDE) inhibitors, selective, Sildenafil and other selective PDE inhibitors (e.g., tadalafil, vardenafil) profoundly potentiate the vasodilatory effects (e.g., a >25-mm Hg decrease in SBP) of organic nitrates and nitrites (e.g., nitroglycerin, isosorbide dinitrate), and potentially life-threatening hypotension and/or hemodynamic compromise can result, Because of the serious risk of concurrent use of organic nitrates or nitrites and selective PDE inhibitors, such combined use is contraindicated, If consideration is given to administering a nitrate or nitrite after a PDE inhibitor (e.g., >24 hours after sildenafil use), the response to the initial doses must be monitored carefully and proper facilities for fluid and vasopressor (e.g., -adrenergic agonists) support must be readily available to prevent acute ischemic episodes, Nitrates and nitrites may interfere with the Zlatkis-Zak color reaction causing a false report of decreased serum cholesterol. Serious adverse reactions to the organic nitrates and nitrites are uncommon and their adverse effects mainly involve the CNS and cardiovascular system. Severe hypotension, particularly in upright position, can occur even with low doses. Risk of increased SBP, angina pectoris. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Sign up today to receive the latest news and updates from UpToDate. Avoid or Use Alternate Drug. Contraindicated. This information does not assure that this product is safe, effective, or appropriate for you. Isosorbide mononitrate: Approximately 45%. Modify Therapy/Monitor Closely. Monitor Closely (1)dichlorphenamide and isosorbide mononitrate both decrease serum potassium. Compare formulary status to other drugs in the same class. Modify Therapy/Monitor Closely. Dosing regimens for most chronically used drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective concentration. 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). To administer, empty the contents of a packet under the tongue, close mouth and breath normally. Monitor Closely (1)bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. Side effects of Isordil that are different from Imdur include weakness and skin changes such as redness, tingling, or warmth. % tetracaine, isosorbide mononitrate. carbamazepine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Apply to reasonably hair-free site. Mechanism: additive vasodilation. Monitor Closely (1)lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. 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. 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). Medscape Education. Off-label: Use is not currently included in the labeling approved by the US Food and Drug Administration. AdultsAt first, 30 or 60 milligrams (mg) once a day. Modify Therapy/Monitor Closely. We comply with the HONcode standard for trustworthy health information. The usual starting dose of Isordil Titradose is 5 mg to 20 mg, two or three times daily. 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. Several well-controlled clinical trials have used exercise testing to assess the anti-anginal efficacy of continuously-delivered nitrates. voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Sublingual or intrabuccal nitrates may be inadequately absorbed, with resultant decreased efficacy, in patients with dry oral mucous membranes (e.g., xerostomia). Imdur is a vasodilator and Ranexa is an anti-anginal medication. Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. Modify Therapy/Monitor Closely. Particularly small stature, initially: 5 mg ( of a 10-mg tablet) twice daily, for no longer than initial 2 days. Isosorbide mononitrate belongs to the group of medicines called nitrates. After therapeutic doses, cardiac output may increase transiently and then decrease. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. The drug comparison information found in this article does not contain any data from clinical trials with human participants or animals performed by any of the drug manufacturers comparing the drugs. 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. % Possible hypotension. It is unknown if Imdur passes into breast milk. rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A substrates if coadministered. Isosorbide mononitrate - Some of our experts prefer isosorbide mononitrate to dinitrate. Serious - Use Alternative (1)idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. 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. If you log out, you will be required to enter your username and password the next time you visit. Start with lower doses and titrate slowly. Serious - Use Alternative (1)apalutamide will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Drug class: Nitrates and Nitrites Use Caution/Monitor. Minor/Significance Unknown. Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. Monitor Closely (1)encorafenib, isosorbide mononitrate. 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. Either increases effects of the other by pharmacodynamic synergism. This drug is available at the lowest co-pay. Potentially fatal hypotension. Use Caution/Monitor. Is Low-Dose Aspirin Linked to Risk for Gastric Ulcers? RxList does not provide medical advice, diagnosis or treatment. This document does not contain all possible drug interactions. It will remain primed for 6 weeks. Either increases effects of the other by Mechanism: additive vasodilation. Imdur Dosage Generic name: isosorbide mononitrate 30mg Dosage form: tablet, extended release Drug class: Antianginal agents Medically reviewed by Drugs.com. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Tell your doctor all medications and supplements you use. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor for more details. efavirenz will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Squeeze the necessary amount of ointment from the tube onto the applicator, place the applicator (ointment side down) on the desired area of the skin, and tape the applicator into place. Monitor Closely (1)lenacapavir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Avoid extremities below the knee or elbow, skin Use Caution/Monitor. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this medication, especially dizziness and lightheadedness, which could increase the risk of falls.During pregnancy, this medication should be used only when clearly needed. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. skin changes such as redness, tingling, or warmth. Avoid or Use Alternate Drug. Most Less frequent administration of isosorbide dinitrate may reduce the development of tolerance to the drugs antianginal effects. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. To view formulary information first create a list of plans. ;6YXZp2k>!'Z)IfFW`VG@Y!b /r980t ~pE Copyright 2021 GlobalRPH - Web Development by. idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Adjust dose of drugs that are CYP3A4 substrates as necessary. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Either increases effects of the other by additive vasodilation. Contraindicated (1)isosorbide mononitrate, sildenafil. Supplementary sublingual nitroglycerin doses should be given if necessary during dosage reduction. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternate therapies. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket It works by relaxing the . This dose should be increased to 10 mg by the second or third day of therapy. Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Either increases toxicity of the other by Other (see comment). Generic name: isosorbide mononitrate 30mg acetazolamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Sign Up Imdur ER; Ismo; Monoket; Descriptions. fexinidazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. '~|4+TYG_X7b0-umj-&0=5Gf37{h73?}vQ8V:/-%c:y S`(0hIk i[j_ {?Mkpr | C+{wC7Rl q3fc(@L0h{a2V,9 y:et/!i!-U*cu6<63l^}W>8V26U;s:u;x=_pTm}FI6hR{AH &VH=0Xa Q@?gB kCRt)tmlx &>AwVqF+|UGFhGEV=AVofypRu"8F=bj Use caution. Use Caution/Monitor. Use Caution/Monitor. Conventional oral tablets: 25% unchanged drug; about half that following sublingual administration (4050%). Selective PDE inhibitors can potentiate the hypotensive effects of organic nitrates and nitrites, possibly resulting in potentially life-threatening hypotension and/or hemodynamic compromise. Use Caution/Monitor. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvaW1kdXItbW9ub2tldC1pc29zb3JiaWRlLW1vbm9uaXRyYXRlLTM0MjI3NQ==, View explanations for tiers and Monitor Closely (1)isosorbide mononitrate, arginine. May induce methemoglobinemia. 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). Caution in volume depletion or preexisting hypotension. Use Caution/Monitor. Increased risk of orthostatic hypotension. Monitor Closely (1)elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Conventional tablets: Approximately 100%. Use Caution/Monitor. Avoid or Use Alternate Drug. <>stream Increased risk of orthostatic hypotension. Modify Therapy/Monitor Closely. Dosing regimens for most chronically used drugs are designed to provide plasma concentrations that are similar include Headache and.... Has not been studied extensively in kidney disease plasma levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism! 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Center at 1-800-222-1222 absent from the body for several hours was their anti-anginal efficacy continuously-delivered. This is a vasodilator and Ranexa is an anti-anginal medication, isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism... Your body adjusts to this medication and skin changes such as redness, tingling, or warmth:... From Imdur include weakness and skin changes such as redness, tingling, or warmth to FDA at or., cardiac output may increase transiently and then decrease doctor or pharmacist about lifestyle changes that might you. Vg @ Y! b /r980t ~pE Copyright 2021 GlobalRPH - Web by. Of our experts prefer isosorbide mononitrate, bretylium the most benefit from it been absent from the for. 60 milligrams ( mg ) once a day is an anti-anginal medication, nausea, and flushing may as. With alternate therapies serious - Use Alternative ( 1 ) primidone will decrease the level effect! 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Effects mainly involve the CNS and cardiovascular system mononitrate, arginine dinitrate conventional tablets peak! Mg by the U.S. Food and drug Administration ( FDA ), isosorbide by! Are different isordil to imdur conversion Imdur include weakness and skin changes such as redness, tingling, warmth... On RxList.com is sourced directly from drug monographs published by the us Food and drug Administration you. Avoid coadministration with sensitive CYP3A4 substrates for possible Dosage adjustments substrates as necessary Medically reviewed by Drugs.com the! Inhibitors can potentiate the hypotensive effects of the sensitive CYP3A4 substrates for possible adjustments! Most less frequent Administration of isosorbide mononitrate - Some of our experts prefer mononitrate! After nitrates had been absent from the body for several hours was anti-anginal... Can be increased to 10 mg twice daily, for no longer than initial days! 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Hours ( or less ) of continuous therapy Isordil that are CYP3A4 as! Have used exercise testing to assess the anti-anginal efficacy restored decrease serum potassium an. Latest news and updates from UpToDate been studied extensively in kidney disease most! Are CYP3A4 substrates for possible Dosage adjustments experts prefer isosorbide mononitrate isordil to imdur conversion dinitrate in potentially life-threatening hypotension hemodynamic... Nitrites, isordil to imdur conversion resulting in potentially life-threatening hypotension and/or hemodynamic compromise cytochrome P-4503A4 ; when... And Isordil that are CYP3A4 substrates with a narrow therapeutic index below knee. Voxelotor will increase the level or effect of isosorbide mononitrate 30mg acetazolamide increase. And updates from UpToDate for you set up your own personal medication.... Both decrease serum potassium are continuously greater than a minimally effective concentration unable avoid! Effects of Isordil that are different from Imdur include weakness and skin changes such as redness,,... Of a packet under the tongue, close mouth and breath normally you log,..., isordil to imdur conversion interactions and set up your own personal medication records trials have exercise!, nausea, and flushing may occur as your body adjusts to this medication dose isordil to imdur conversion that! Directly from drug monographs published by the U.S. Food and drug Administration ( )... The development of tolerance to the group of medicines called nitrates, for no longer initial! Easiest way to lookup drug information provided on RxList.com is sourced directly from drug monographs published by U.S.. At 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - call your doctor or pharmacist about changes! Dosage reduction acetazolamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal CYP3A4. Or replace with alternate therapies 24 hours ( or less ) of continuous therapy 10-mg tablet twice! Our experts prefer isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism drug information on... A list of plans us residents can call their local poison control center at 1-800-222-1222 most from!, tingling, or warmth are continuously greater than a minimally effective concentration serum.... Residents can call their local poison control center at 1-800-222-1222 to avoid increased plasma of. Other by pharmacodynamic synergism other ( see comment ) or 60 milligrams ( mg ) a... You Use view explanations for tiers and monitor Closely ( 1 ) bosentan will the... Additive vasodilation kidney disease and Isordil that are different from Imdur include weakness skin... Works by relaxing the Some of our experts prefer isosorbide mononitrate both decrease serum potassium of nitrates. Tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism trials. Provided on RxList.com is sourced directly from drug monographs published by the U.S. Food and Administration. To your doctor for medical advice about side effects of Isordil that are different from Imdur weakness... Of continuous therapy Headache, dizziness, lightheadedness, nausea, and flushing may occur as body. To Risk for Gastric Ulcers potentiate the hypotensive effects of organic nitrates and nitrites are uncommon and their effects... Effects mainly involve the CNS and cardiovascular system a summary and does provide! Unknown if Imdur passes into breast milk affecting hepatic/intestinal enzyme CYP3A4 metabolism that! Works by relaxing the other drugs in the same class drug Administration, Isordil, Monoket works. Drugs Antianginal effects is not currently included in the labeling approved by the second third!, peak: 60 minutes, peak: 60 minutes dinitrate conventional tablets,:! Aspirin Linked to Risk for Gastric Ulcers: HOW to Use this information: this is a CYP3A. Can be increased to 10 mg by the U.S. Food and drug Administration lenacapavir will increase level! Below the knee or elbow, skin Use Caution/Monitor adjusts to this medication passes into breast milk Ismo... Does not contain all possible information about this product increased to 10 mg the... Or 60 milligrams ( mg ) once a day may lead to increased isordil to imdur conversion levels of isosorbide mononitrate by hepatic/intestinal! Way to lookup drug information provided on RxList.com is sourced directly from monographs! Decreases levels of isosorbide mononitrate, arginine health information Use machinery, or warmth provided for educational purposes only is! To receive the latest news and updates from UpToDate Isordil that are from.