isordil to imdur conversion

prescription products. Contraindicated. Daily dose free interval of at least 14 hours is advised to minimize tolerance. Free Consultation! Monitor Closely (1)isosorbide mononitrate, arginine. Prolonged use of oral nitrates has been associated with the development of tolerance to the hemodynamic and antianginal effects and possibly with cross-tolerance to sublingual nitrates. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. imdur to isordil imdur vs nitro patch. - 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. efavirenz will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate increases effects of cabergoline by decreasing metabolism. To help you remember, take it at the same times each day. The manufacturer of the fixed combination of isosorbide dinitrate and hydralazine hydrochloride states that dosage should be selected with caution because of age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy. Use Caution/Monitor. 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. The daily dose of IMDUR Tablets should be taken in the morning on arising. Most Mechanism: additive vasodilation. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Potentially fatal hypotension. Maximum daily dosage of Dilatrate-SR: 160 mg (4 capsules). 4 0 obj conivaptan will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do not chew extended-release preparations. Minor/Significance Unknown. Individual plans may vary Other medications may be prescribed by your doctor for these conditions. Avoid or Use Alternate Drug. If unavoidable, reduce CYP3A substrate dose according to product labeling. Do not stop taking it without consulting your doctor. By clicking send, you acknowledge that you have permission to email the recipient with this information. Use Caution/Monitor. Consult your doctor for more details. Contraindicated (1)isosorbide mononitrate, sildenafil. Use Caution/Monitor. Most Avoid or Use Alternate Drug. Advise patients to take nitrates as directed, particularly since tolerance can occur. Serious - Use Alternative (1)carbamazepine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Last updated on Feb 6, 2023. Dilatation of the coronary arteries also occurs. Contraindicated. Either increases effects of the other by Mechanism: additive vasodilation. Adding plans allows you to compare formulary status to other drugs in the same class. Supplied: Regular release tablets: 10 mg, 20 mg. Extended release tablets: 30 mg, 60 mg, 120 mg. CLINICAL PHARMACOLOGY The principal pharmacological action of nitroglycerin is relaxation of vascular smooth muscle and consequent dilatation of peripheral arteries and veins, especially the latter. 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. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. Modify Therapy/Monitor Closely. Either increases effects of the other by pharmacodynamic synergism. Take the dose in the morning right after you wake up. Consider dose reduction of sensitive CYP3A4 substrates. Monitor Closely (1)istradefylline will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. 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. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. You may report side effects to Health Canada at 1-866-234-2345. Risk of increased SBP, angina pectoris. Use Caution/Monitor. Either increases toxicity of the other by Other (see comment). Clinical Trials: Controlled trials have demonstrated that nitroglycerin ointment can effectively reduce exercise-related angina for up to 7 hours after a single application. To avoid development of tolerance to nitroglycerin, drug-free intervals of 10 - 12 hours are known to be sufficient; shorter intervals have not been well studied. See additional information. Minor (1)rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered. Isosorbide dinitrate: About 1 hour. Tolerance can only be overcome by short periods of nitrate absence from the body. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. Both drugs lower blood pressure. Use Caution/Monitor. Use Caution/Monitor. Not known whether isosorbide dinitrate and isosorbide mononitrate are distributed into milk. 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. Either increases effects of the other by pharmacodynamic synergism. Mechanism: additive vasodilation. Monitor Closely (1)isosorbide mononitrate, bupivacaine implant. folds, scar tissue, burned or irritated areas. In some controlled trials of other organic nitrate formulations, efficacy has declined with time. Distribution into human body tissues and fluids has not been fully characterized. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Consult your doctor before breastfeeding. Monitor Closely (1)iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. MEDICAL ALERT: Your condition can cause complications in a medical emergency. Known hypersensitivity to isosorbide or any ingredient in the respective formulation. Monitor Closely (1)lorlatinib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Please confirm that you would like to log out of Medscape. Potentially fatal hypotension. The approximate onset and duration of action of various dosage forms of isosorbide dinitrate (ISDN) and isosorbide mononitrate (ISMN) are as follows: Onset and duration of action following intrabuccal administration are probably similar to those after sublingual administration of isosorbide dinitrate. The above information is provided for general The addition of a fixed dose of isosorbide dinitrate plus hydralazine to standard therapy for heart failure including neurohormonal blockers is efficacious and increases survival among black. Postural hypotension may occur and may cause dizziness, weakness, and other signs of cerebral ischemia. May cause a burning or tingling sensation when administered sublingually. 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. Available for Android and iOS devices. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Modify Therapy/Monitor Closely. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. Nitroglycerin undergoes metabolism in the liver and at sites outside of the liver. Avoid or Use Alternate Drug. Minor/Significance Unknown. Abstract. Use entire contents of foilpac to obtain full dose and discard immediately after use. It does not work fast enough to relieve the pain of an angina attack that has already started. Monitor Closely (1)isosorbide mononitrate, bretylium. The recipient will receive more details and instructions to access this offer. Symptoms of overdose may include: slow heartbeat, vision changes, severe nausea/vomiting, sweating, cold/clammy skin, bluish fingers/toes/lips. Monitor Closely (1)tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Rapid titration (over 35 days) may be possible; however, slower titration may be needed due to adverse effects. Tell your doctor all medications and supplements you use. 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. Headache, the most frequent adverse effect, may be severe (persistent or transient) and is perceived as a pulsating, throbbing sensation; frequent early in therapy, usually diminishes rapidly, and may disappear within several days to weeks of continuous therapy. Serious - Use Alternative (1)tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. Only after nitrates had been absent from the body for several hours was their anti-anginal efficacy restored. All Rights Reserved. Suggested schedules: Usually, at 7 a.m., 12 p.m., and 5 p.m. in chronic stable angina or at 7 a.m. and 12 p.m. in less severely symptomatic angina in order to allow for a nitrate-free interval of 1014 hours. Imdur Dosage Generic name: isosorbide mononitrate 30mg Dosage form: tablet, extended release Drug class: Antianginal agents Medically reviewed by Drugs.com. Mechanism: additive vasodilation. Most This effect was not observed with istradefylline 20 mg/day. Minor/Significance Unknown. Comes in 4.1g (90 sprays) and 8.5g (230 sprays) bottle. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It will remain primed for 6 weeks. If you log out, you will be required to enter your username and password the next time you visit. Modify Therapy/Monitor Closely. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Monitor Closely (1)fedratinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Otherwise, call a poison control center right away. Short periods (10-12 hours) of nitrate withdrawal help minimize tolerance. It will remain primed for 6 weeks. Serious - Use Alternative (1)apalutamide will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Molecular formula: C6H8N2O8C6H9NO6 Prime bottle with 10 sprays initially. Properly discard this product when it is expired or no longer needed. After therapeutic doses, cardiac output may increase transiently and then decrease. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated. Risk of increased SBP, angina pectoris. Shop cheap from $1.07 for pill imdur 40 mg pharmacy. The dose could be doubled, and even doubled again, in patients tolerating this dose but failing to respond to it. endobj 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. Because controlled, long-term trials of nitroglycerin ointment have not been reported, it is not known how the efficacy of nitroglycerin ointment may vary during extended therapy. USES: Isosorbide mononitrate is used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery disease). 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. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Take on empty stomach, 30 minutes before meals or 1 hour after meal, Take on empty stomach, 30 minutes before or 1 hour after meal, Extended-release tablet should be swallowed whole; must not be chewed, crushed, or split, elvitegravir/cobicistat/emtricitabine/tenofovir DF. 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 . Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. Generally considered for monotherapy in the prophylactic management of angina pectoris only when -blockers or calcium-channel blocking agents are contraindicated, associated with unacceptable adverse effects, or are ineffective. Use Caution/Monitor. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Either increases effects of the other by additive vasodilation. 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. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. A larger area may be used. We comply with the HONcode standard for trustworthy health information. rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. provider for the most current information. Use Caution/Monitor. Use Caution/Monitor. 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). imdur dose imdur vs nitroglycerinNov 1, 2011 . Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. isosorbide mononitrate increases effects of ergoloid mesylates by decreasing metabolism. etravirine will decrease 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. Monitor Closely (1)isosorbide mononitrate, captopril. Side effects of Imdur and Isordil that are similar include headache and dizziness. 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 is used to prevent angina (chest pain) caused by coronary artery disease (heart disease). Dosing regimens for most chronically used drugs are designed to provide plasma concentrations that are continuously greater than a minimally effective concentration. affecting hepatic/intestinal enzyme CYP3A4 metabolism. tecovirimat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Extended-release tablets: Approximately 7780%. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Use Caution/Monitor. Serious - Use Alternative (1)isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. May repeat in 5 minutes if needed. Isosorbide dinitrate used in fixed combination with hydralazine (BiDil) as adjunct to standard therapy for the treatment of heart failure in self-identified black patients to improve survival, decrease rate of hospitalization for worsened heart failure, and improve patient-reported functional status. Use Caution/Monitor. Tight, light-resistant containers at room temperature (25C); do not expose to extremes in temperature. Potentially fatal hypotension. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Contact the applicable plan 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. encoded search term (isosorbide mononitrate (Imdur%2C Monoket)) and isosorbide mononitrate (Imdur, Monoket), ECG Challenge: Lightheadedness and Extremely Slow Pulse. Serious - Use Alternative (1)voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. You are being redirected to 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. Although many clinicians do not gradually reduce the dosage when discontinuance of oral nitrates is planned, it appears prudent that dosage be gradually reduced (e.g., over a period of about 12 weeks) to avoid withdrawal manifestations. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. 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. Avoid or Use Alternate Drug. Rarely, 240 mg may be required. National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. isosorbide mononitrate, arginine. ChildrenUse and dose must be determined by your doctor. Serious - Use Alternative (1)phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate sublingual, peak: 1015 minutes. After . Serious - Use Alternative (1)levoketoconazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Fexinidazole inhibits CYP3A4. 2 0 obj Principal pharmacologic property is relaxation of vascular smooth muscle, resulting in generalized vasodilation. Paradoxical bradycardia and angina exacerbation may accompany hypotension. Usual initial dosage of conventional tablets (e.g., Monoket): 20 mg twice daily, with the 2 doses administered 7 hours apart. rifampin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). belzutifan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate increases toxicity of dapsone topical by altering metabolism. Minoxidil can exacerbate fluid retention in kidney disease. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Drug class: Nitrates and Nitrites VA class: CV250 Chemical name: d-Glucitol-1,4:3,6-dianhydrodinitrate Molecular formula: C 6 H 8 N 2 O 8 C 6 H 9 NO 6 . apalutamide will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. The recommended starting dose of isosorbide mononitrate is 5 to 10 mg of immediate release tablets twice daily. Potentially fatal hypotension. Avoid or Use Alternate Drug. If it is within 2 hours of the next dose, skip the missed dose. x][7~_cNv2}LN ` 8ql'O_}U%zwZ]U{_U]V?/*S~[~|^bn[zHsxuy][^,;}.oO^mweU^.Wn>{l .6=(r#n*xW7| J{{or`}|4^r <> Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed. Call your doctor for medical advice about side effects. 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. elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Crofelemer has the potential to inhibit CYP3A4 at concentrations expected in the gut; unlikely to inhibit systemically because minimally absorbed. Minor/Significance Unknown. Avoid or Use Alternate Drug. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. endobj Increased risk of orthostatic hypotension. acetylcysteine (Antidote) increases effects of isosorbide mononitrate by Other (see comment). (See Selective Phosphodiesterase (PDE) Inhibitors under Cautions.). Isosorbide dinitrate or mononitrate is used for the acute relief of angina pectoris, for prophylactic management in situations likely to provoke angina attacks, and for long-term prophylactic management of angina pectoris. Isosorbide mononitrate: Metabolized principally in the liver, but unlike isosorbide dinitrate, does not undergo first-pass metabolism; metabolites appear to be pharmacologically inactive. Monitor Closely (1)dichlorphenamide and isosorbide mononitrate both decrease serum potassium. 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. -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. Is Low-Dose Aspirin Linked to Risk for Gastric Ulcers? Warn all patients taking either selective PDE inhibitors or organic nitrates or nitrites of the potential consequences of taking the drugs within close proximity (e.g., within 24 hours of sildenafil; possibly more prolonged periods of risk with longer-acting PDE inhibitors) of taking a nitrate- or nitrite-containing preparation. (See Geriatric Patients under Dosage.). Ask your doctor before using any headache pain medication. isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. Monitor Closely (1)maraviroc, isosorbide mononitrate. Risk of increased SBP, angina pectoris. Avoid or Use Alternate Drug. Use Caution/Monitor. Avoid or Use Alternate Drug. Use caution. It is important to take the drug at the same times each day. 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. May cause blurred vision and should be discontinued if this symptom occurs. Isosorbide dinitrate (Isordil Titradose, Dilatrate-SR, Isochron) is prescribed for the treatment of angina (heart pain), coronary artery disease, and congestive heart failure. 1 - 2 sprays on or under the tongue at the onset of pain. Use Caution/Monitor. Clinicians unfamiliar with their patients drug history, especially those involved in emergency care (e.g., for presumed myocardial infarction or ischemia), should take a careful history so that concomitant use of organic nitrates or nitrites with selective PDE inhibitors can be avoided. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode. elvitegravir/cobicistat/emtricitabine/tenofovir DF increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. It works by relaxing and widening blood vessels so blood can flow more easily to the heart.This medication will not relieve chest pain once it occurs. Monitor Closely (1)tecovirimat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. The dose can be increased to 10 mg twice daily after 2 to 3 days. Last updated on Feb 7, 2022. Please review the latest applicable package insert for additional information and possible updates. Extended-release tablets can be administered as whole or halved tablets, but swallow intact and do not chew or crush. Do not rinse mouth for 5 - 10 minutes following spray, Administer one or two packets (400 mcg of NTG) under the tongue at the onset of an attack, One additional packet may be administered every five minutes as needed, No more than three packets are recommended within a 15-minute period, 1 packet 5 - 10 minutes prior to engaging in activity, Administer at rest, ideally in the sitting position. Use Caution/Monitor. 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. Congestive heart failure: Oral: Initial: 10 mg 3 times/day. Your doctor may recommend treating headaches with an over-the-counter pain reliever (such as acetaminophen, aspirin). nafcillin 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. ivosidenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. May repeat in 5 minutes if needed. In one well-controlled clinical trial, subjects receiving nitroglycerin appeared to exhibit a rebound or withdrawal effect, so that their exercise tolerance at the end of the daily drug-free interval was less than that exhibited by the parallel group receiving placebo. Potentially fatal hypotension. Controlled studies in pregnant women show no evidence of fetal risk. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Selective PDE inhibitors can potentiate the hypotensive effects of organic nitrates and nitrites, possibly resulting in potentially life-threatening hypotension and/or hemodynamic compromise. Each day, take the first dose when you wake up, then take the second dose 7 hours later. 2 0 obj Avoid or Use Alternate Drug. Minor/Significance Unknown. Carefully individualize nitrate dosage to minimize the risk of tolerance; also consider potential risks of nitrate withdrawal. Either increases effects of the other by additive vasodilation. stream Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. Tecovirimat is a weak CYP3A4 inducer. Published studies using older techniques provide results that often differ, in similar experimental settings, by an order of magnitude. This information does not assure that this product is safe, effective, or appropriate for you. isosorbide mononitrate, captopril. Do not double the dose to catch up. An interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must exceed 18 hours. Isosorbide dinitrate in fixed combination with hydralazine hydrochloride: About 2 hours. cenobamate will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

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