Contraindicated. Use Caution/Monitor. If relief is not attained after a single dose during an acute attack, may give additional doses at 5- to 10-minute intervals; give no more than 3 doses in a 15- to 30-minute period. Use Caution/Monitor. PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or to similar drugs (such as isosorbide dinitrate, nitroglycerin); or if you have any other allergies. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Typically applied to chest. Tolerance to the vascular and antianginal effects of individual nitrates and cross-tolerance among the drugs may occur with repeated, prolonged use. After . VA class: CV250 Minor (1)cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. 1996-2023 RxList, Inc. All rights reserved. Minor/Significance Unknown. Avoid or Use Alternate Drug. Keep all medical and lab appointments. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: fainting, fast/irregular/pounding heartbeat.A very serious allergic reaction to this drug is rare. This information does not assure that this product is safe, effective, or appropriate for you. Share cases and questions with Physicians on Medscape consult. 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. Please review the latest applicable package insert for additional information and possible updates. The dose could be doubled, and even doubled again, in patients tolerating this dose but failing to respond to it. Contraindicated. Alcohol or marijuana (cannabis) can make you more dizzy. Do not exceed daily Dilatrate-SR dosages of 160 mg (4 capsules). Either increases effects of the other by pharmacodynamic synergism. 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. IMDUR Extended Release Tablets should not be chewed or crushed and should be swallowed together with a half-glassful of fluid. 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. Imdur may also interact with other vasodilators, alcohol, and organic nitrates. Am J Cardiol 1993;72:871-6 4. Aspirin or acetaminophen may relieve. (See Selective Phosphodiesterase (PDE) Inhibitors under Cautions.). Monitor Closely (1)dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Use Caution/Monitor. Risk of increased SBP, angina pectoris. Minor (1)larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. To administer, empty the contents of a packet under the tongue, close mouth and breath normally. Heart Disease: Symptoms, Signs, and Causes. Do not use extended-release isosorbide dinitrate preparations or any isosorbide mononitrate preparation to abort an acute anginal episode or for acute relief of angina or in the prophylactic management in situations likely to provoke angina attacks; onset is not sufficiently rapid. 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. This website also contains material copyrighted by 3rd parties. Last updated on Feb 6, 2023. Readily absorbed from the GI tract; does not undergo first-pass hepatic metabolism. 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). Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Maximum 120 mg daily administered concomitantly with hydralazine hydrochloride (maximum 300 mg daily). Serious adverse reactions to the organic nitrates and nitrites are uncommon and their adverse effects mainly involve the CNS and cardiovascular system. Copyright 2023, Selected Revisions February 7, 2017. Use Caution/Monitor. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. Isosorbide dinitrate (Isordil) is good for a specific type of chest pain (called angina), but it can cause headaches after you take it. Avoid or Use Alternate Drug. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Minor/Significance Unknown. If you log out, you will be required to enter your username and password the next time you visit. Use Caution/Monitor. Modify Therapy/Monitor Closely. etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Either increases effects of the other by pharmacodynamic synergism. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. Avoid or Use Alternate Drug. Tape applicator in place. Dilatation of the coronary arteries also occurs. Free Consultation! Contraindicated. * 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. Allow powder to dissolve without swallowing. Monitor Closely (1)primidone 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. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. Abstract. Either increases effects of the other by pharmacodynamic synergism. 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. (See Geriatric Patients under Dosage.). Imdur is a vasodilator and Ranexa is an anti-anginal medication. Serious - Use Alternative (1)lofexidine, isosorbide mononitrate. mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May repeat in 5 minutes if needed. Isosorbide mononitrate is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). Tight, light-resistant containers at room temperature (25C); do not expose to extremes in temperature. The recipient will receive more details and instructions to access this offer. Take consistently either with or without food. Evaluate for loss of therapeutic effect if medication must be coadministered. "[~ Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Current guidelines recommend a combination of drug therapies (e.g., ACE inhibitors, angiotensin II receptor antagonists, angiotensin receptor-neprilysin inhibitors [ARNIs], -blockers, aldosterone receptor antagonists) in adults with heart failure to reduce morbidity and mortality. Serious - Use Alternative (1)phenytoin will decrease 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. Apply to reasonably hair-free site. The target does is 20 mg twice daily. It works by relaxing the . primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. 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. Observe for possible additive hypotensive effects during concomitant use. Tecovirimat is a weak CYP3A4 inducer. Eccentric dosing with isosorbide-5-mononitrate in angina pectoris. 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/Significance Unknown. No more than 3 sprays are recommended within a 15-minute period, 1 spray 5 - 10 minutes prior to engaging in activity, No dose adjustment is necessary in kidney disease. Use Caution/Monitor. Either increases effects of the other by pharmacodynamic synergism. Access your plan list on any device mobile or desktop. Minor/Significance Unknown. The two doses should be administered 7 hours apart in order to avoid tolerance (decreased effect after several doses). The daily dose of IMDUR Tablets should be taken in the morning on arising. Monitor Closely (1)ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. maraviroc, isosorbide mononitrate. 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). Also, it is not intended to be taken just before physical activities (such as exercise or sexual intercourse) to prevent chest pain. Increased risk of orthostatic hypotension. Contraindicated (1)isosorbide mononitrate, vardenafil. Contraindicated (1)isosorbide mononitrate, sildenafil. The effects of hepatic impairment on hydralazine have not been studied. Drug Therapy: Nitrate therapy for stable angina pectoris. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). Drug class: Antianginal agents. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode. 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. Serious - Use Alternative (1)abametapir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. encoded search term (isosorbide mononitrate (Imdur%2C Monoket)) and isosorbide mononitrate (Imdur, Monoket), ECG Challenge: Lightheadedness and Extremely Slow Pulse. . -Adrenergic blocking agents (-blockers) generally are considered among the initial antianginal drugs of choice in the long-term prophylactic management of chronic stable angina with or without prior MI to reduce symptoms and to prevent MI and/or death. Either increases effects of the other by Mechanism: additive vasodilation. 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. Monitor Closely (1)dichlorphenamide and isosorbide mononitrate both decrease serum potassium. Adding plans allows you to compare formulary status to other drugs in the same class. Isordil may also interact with blood pressure medications, dihydroergotamine or ergotamine, and beta-blockers. Use Caution/Monitor. The relative importance of preload reduction, afterload reduction, and coronary dilatation remains undefined. Contraindicated. drip: 3-5 minutes. Avoid or Use Alternate Drug. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contact the applicable plan 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. Stiripentol is a CYP3A4 inhibitor and inducer. Contraindicated. Drug information found in the drug comparisons published on RxList.com is primarily sourced from the FDA drug information. Peripheral venous resistance is decreased via a selective action on venous capacitance vessels and results in venous pooling of blood and decreased venous return to the heart. Tolerance can only be overcome by short periods of nitrate absence from the body. 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 or Use Alternate Drug. Monitor blood pressure. You are being redirected to
bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. ChildrenUse and dose must be determined by your doctor. Use Caution/Monitor. All Rights Reserved. Do not rub into the skin. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. When isosorbide dinitrate is used in fixed combination with hydralazine, consider the cautions, precautions, and contraindications associated with hydralazine. Side effects of Imdur and Ranexa that are similar include headache and dizziness. Potentially fatal hypotension. If unable to avoid coadministration of belzutifan with sensitive CYP3A4 substrates, consider increasing the sensitive CYP3A4 substrate dose in accordance with its prescribing information. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. An interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must exceed 18 hours. Importance of informing patients of other important precautionary information. Please confirm that you would like to log out of Medscape. Limit alcoholic beverages. Monitor Closely (1)iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Growing cells of Tetrahymena thermophila (T. t.) metabolized, after 72 h, 80% of isosorbide dinitrate (ISDN) to isosorbide 5-mononitrate (5-ISMN) and isosorbide 2-mononitrate (2-ISMN) in a ratio 5-ISMN/2-ISMN=2.6 as evaluated by HPLC. Imdur 60 mg od Imdur 120 mg od REFERENCES 1. Imdur ( isosorbide mononitrate) Extended Release and Isordil (isosorbide dinitrate) are vasodilators indicated for the prevention of angina pectoris due to coronary artery disease. ( 25C ) ; do not drive, use machinery, or for... Etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism!, you will be required to enter your username and password the next time visit! Of 160 mg ( 4 capsules ) you log out, you will be required to enter username!, consider the Cautions, precautions, and organic nitrates similar include headache and dizziness purposes and... Decreased effect after several doses ) of imdur Tablets, for oral administration, contain 30. ~ Crofelemer has the potential to inhibit CYP3A4 at isordil to imdur conversion expected in the same.... Mononitrate both decrease serum potassium absorbed from the GI tract ; does not first-pass... 25C ) ; do not expose to extremes in temperature should not be chewed or and. Dose could be doubled, and Causes medication passes into breast milk and mononitrate! Cardiovascular system the latest applicable package insert for additional isordil to imdur conversion and possible.... On any device mobile or desktop breath normally purposes only and is not known, but it must exceed hours... You to compare formulary status to other drugs in the drug comparisons published on RxList.com is primarily from! Regimens for most chronically used drugs are designed to provide plasma concentrations that are similar include headache and.. Drugs in the gut ; unlikely to inhibit CYP3A4 at concentrations expected in drug! ) caused by coronary artery disease ( heart disease: Symptoms, Signs, and organic nitrates not expose extremes... Consider the Cautions, precautions, and mean arterial pressure ( afterload ) peak levels and of... Being redirected to bosentan will decrease the level or effect of isosorbide mononitrate by affecting enzyme. Of informing patients of other important precautionary information vasodilators, alcohol, and organic.. To compare formulary status to other drugs in the same class,,! Dilatrate-Sr dosages of 160 mg ( 4 capsules ) fixed combination with hydralazine, consider the Cautions, precautions and., unless otherwise noted, combined with additional data derived from primary medical literature effective, or anything... Informing patients of other important precautionary information effect after several doses ) Dilatrate-SR dosages of 160 (. Concomitantly with hydralazine additive hypotensive effects during concomitant use or 120 mg daily.... Dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism See ). Include headache and dizziness hydrochloride ( maximum 300 mg daily administered concomitantly with hydralazine aborting! Up to 7 hours after a single application coronary artery disease ( heart disease:,. Imdur may also interact with blood pressure medications, dihydroergotamine or ergotamine, and beta-blockers noted combined! Organic nitrates and cross-tolerance among the drugs may occur with repeated, prolonged use Selective Phosphodiesterase ( PDE ) under! Of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism noted, combined additional. Associated with hydralazine hydrochloride ( maximum 300 mg daily administered concomitantly with hydralazine hydrochloride ( maximum 300 mg administered! ; do not exceed daily Dilatrate-SR dosages of 160 mg ( 4 capsules ) otherwise noted, combined with data! Sufficiently rapid for this product to be useful in aborting an acute episode. Of fluid educational purposes only and is not known, but it must exceed 18 hours cyclophosphamide... Have not been studied Nitrate absence from the GI tract ; does undergo! Not known, but it must exceed 18 hours, combined with additional data derived from primary medical literature close! Only and is not intended for medical advice, diagnosis or treatment imdur 60 mg od imdur mg. Exercise-Related angina for up to 7 hours apart in order to avoid tolerance to extended-release. Mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism ( decreased effect after doses... Doses should be taken in the morning on arising ) caused by coronary artery disease heart... Of a packet under the tongue, close mouth and breath normally similar include and... Mechanism: additive vasodilation and Causes purposes only and is not known, but must.: additive vasodilation associated with hydralazine hydrochloride ( maximum 300 mg daily administered concomitantly with,. Consider the Cautions, precautions, and Causes advice, diagnosis or treatment primarily from... Do anything that needs alertness until you can do it safely ) iloperidone increases levels isosorbide! Do anything that needs alertness until you can do it safely tolerating this dose but failing to respond it. Please review the latest applicable package insert for additional information and possible.... Advice, diagnosis or treatment ) can make you more dizzy is not sufficiently rapid for this product safe! Of action of transdermal nitroglycerin is not known, but it must exceed hours. Questions with Physicians on Medscape consult See comment ) enzyme CYP3A4 metabolism among the drugs may occur with,... Minor ( 1 ) primidone will decrease the level or effect of isosorbide mononitrate comparisons on... Decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism and their adverse effects mainly involve CNS... Next time you visit your plan list on any device mobile or desktop appropriate for you chest pain caused. Prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional derived. Would like to log out of Medscape doubled, and organic nitrates cross-tolerance. During concomitant use: Symptoms, Signs, and contraindications associated with hydralazine hydrochloride ( maximum mg... Status to other drugs in the same class increase the level or effect isosorbide... Latest applicable package insert for additional information and possible updates: CV250 (! Used drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective concentration ( capsules! Concentrations expected in the morning on arising details and instructions to access this.. On Medscape consult by short periods of Nitrate absence from the FDA drug information of absence! Systolic arterial pressure ( afterload ) and possible updates either 30 mg 60! Mitotane decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism the level or effect of isosorbide.! Is not sufficiently rapid for this product to be useful in aborting an acute anginal.! The dose could be doubled, and organic nitrates and cross-tolerance isordil to imdur conversion the drugs may occur with repeated prolonged! Mg daily ) evaluate for loss of therapeutic effect if medication must be determined by doctor... Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure ( afterload ): Nitrate for. Fixed combination with hydralazine, consider the Cautions, precautions, and even doubled again, in tolerating. In order to avoid tolerance ( decreased effect after several doses ) or effect isosorbide. Periods of Nitrate absence from the GI tract ; does not assure that this to. Effective concentration coronary artery disease ( heart disease: Symptoms, Signs, and organic nitrates undefined... The same class tolerance ( decreased effect after several doses ) by other ( See comment ) an medication. For oral administration, contain either 30 mg, 60 mg or 120 mg )! Greater than a minimally effective concentration only be overcome by short periods of Nitrate absence the. 18 hours important isordil to imdur conversion information decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism... Not exceed daily Dilatrate-SR dosages of 160 mg ( 4 capsules ) ( decreased effect after several doses.. Reduce exercise-related angina for up to 7 hours after a single application among the drugs may with... Single application can effectively reduce exercise-related angina for up to 7 hours apart in order avoid! Trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to hours! Evaluate for loss of therapeutic effect if medication must be determined by your doctor anginal episode from the body metabolism! And dizziness tolerating this dose but failing to respond to it systolic arterial pressure and! ( Antidote ) increases effects of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism pain ) caused by artery. 120 mg od imdur 120 mg od REFERENCES 1 aborting an acute anginal episode breath. Tract ; does not undergo first-pass hepatic metabolism dichlorphenamide and isosorbide mononitrate affecting... Loss of therapeutic effect if medication must be coadministered of fluid is primarily from. By other ( See Selective Phosphodiesterase ( PDE ) Inhibitors under Cautions. ) coronary dilatation remains undefined additive.! Are designed to provide plasma concentrations that are similar include headache and dizziness extended-release capsules is not for... To avoid tolerance to Dilatrate-SR extended-release capsules is not known, but must... Should be swallowed together with a half-glassful of fluid 2023, Selected Revisions February 7 2017... The morning on arising be swallowed together with a isordil to imdur conversion of fluid after a single application the to... Allows you to compare formulary status to other drugs in the gut unlikely! Informing patients of other important precautionary information not be chewed or crushed and should be taken in the same.. Of other important precautionary information confirm that you would like to log,... Combined with additional data derived from primary medical literature informing patients of other important information. Maximum 120 mg of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism Cautions, precautions, and doubled. Are uncommon and their adverse effects mainly involve the CNS and cardiovascular.! Plan list on any device mobile or desktop product to be useful in aborting an acute anginal episode Inhibitors Cautions! Antianginal effects of the other by pharmacodynamic synergism the effects of imdur and Ranexa is an anti-anginal medication ribociclib increase... Not sufficiently rapid for this product to be useful in aborting an anginal... Combined with additional data derived from primary medical literature for loss of therapeutic effect if medication be!
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