Minor/Significance Unknown. Isordil (isosorbide dinitrate) is a nitrate indicated for the prevention of angina due to coronary artery disease and congestive heart failure. Potentially fatal hypotension. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. In addition to vascular smooth muscle, nitrates and nitrites relax bronchial, biliary (including the gallbladder, biliary ducts, and sphincter of Oddi), GI (including the esophagus), ureteral, and uterine smooth muscle; nitrates relax all smooth muscle irrespective of autonomic innervation and are functional antagonists of norepinephrine, acetylcholine, and histamine. David McAuley, Pharm.D. Drug information found in the drug comparisons published on RxList.com is primarily sourced from the FDA drug information. 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. Contraindicated. 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. '~|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 Dosage form: tablet, extended release Imdur 60 mg od Imdur 120 mg od REFERENCES 1. As a result, any regimen of NITRO-BID administration should include a daily nitrate-free interval. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Fexinidazole inhibits CYP3A4. Use Caution/Monitor. 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 . Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. 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. 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. When isosorbide dinitrate is used in fixed combination with hydralazine, consider the cautions, precautions, and contraindications associated with hydralazine. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. stiripentol, isosorbide mononitrate. Either increases effects of the other by pharmacodynamic synergism. 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). 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. For maintenance therapy, 10 mg to 40 mg, two or three times daily, is recommended. Either increases effects of the other by Mechanism: additive vasodilation. 1 - 2 sprays on or under the tongue at the onset of pain. Postural hypotension may occur and may cause dizziness, weakness, and other signs of cerebral ischemia. Contraindicated. Use Caution/Monitor. elagolix decreases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Isosorbide mononitrate conventional tablets, peak: 0.51 hour. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs. 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. Sign up today to receive the latest news and updates from UpToDate. Apply to reasonably hair-free site. Patients who fail to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide dinitrate. Imdur is a vasodilator and Ranexa is an anti-anginal medication. Use Caution/Monitor. Minor/Significance Unknown. 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. Contraindicated. carbamazepine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. See additional information. The target does is 20 mg twice daily. Avoid or Use Alternate Drug. Contraindicated (1)isosorbide mononitrate, avanafil. -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. Carefully individualize nitrate dosage to minimize the risk of tolerance; also consider potential risks of nitrate withdrawal. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Dilatation of the veins promotes peripheral pooling of blood and decreases venous return to the heart, thereby reducing left ventricular end-diastolic pressure and pulmonary capillary wedge pressure (preload). Conventional oral tablets: 25% unchanged drug; about half that following sublingual administration (4050%). Voxelotor increases systemic exposure of sensitive CYP3A4 substrates. Monitor Closely (1)tetracaine, isosorbide mononitrate. Mechanism: additive vasodilation. Contraindicated (1)isosorbide mononitrate, riociguat. It has not been studied in liver disease. Avoid or substitute another drug for these medications when possible. Idelalisib is a strong CYP3A inhibitor; avoid coadministration with sensitive CYP3A substrates. Monitor CYP3A substrates if coadministered. All drug information provided on RxList.com is sourced directly from drug monographs published by the U.S. Food and Drug Administration (FDA). ;6YXZp2k>!'Z)IfFW`VG@Y!b /r980t ~pE 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. Prophylactic management in situations likely to provoke angina attacks in patients who fail to respond to sublingual nitroglycerin: 2.55 mg of isosorbide dinitrate should be placed under the tongue approximately 15 minutes prior to engaging in such activities. Isosorbide dinitrate: About 1 hour. We comply with the HONcode standard for trustworthy health information. larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor (1)rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Last updated on Feb 7, 2022. One manufacturer of isosorbide mononitrate states that dosage should be selected with caution, usually initiating therapy at the low end of the range, although age, renal, hepatic, and cardiovascular dysfunction do not appear to have a significant effect on drug clearance. Make sure laboratory personnel and all your doctors know you use this drug. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. 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. 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. ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Isosorbide dinitrate undergoes extensive first-pass metabolism in the liver and considerable extrahepatic metabolism. Adjust dosage of CYP3A4 substrates, if clinically indicated. In one small study (N=49), severe kidney disease (CrCl 5 - 28 ml/min) did not affect hydralazine pharmacokinetics. Risk of increased SBP, angina pectoris. It is unknown if Imdur passes into breast milk. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension. Imdur Tablets, for oral administration, contain either 30 mg, 60 mg or 120 mg of isosorbide mononitrate in an extended-release formulation. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Monitor Closely (1)ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Brand names: Dilatrate, Imdur, Ismo, Isordil, Monoket Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia. Modify Therapy/Monitor Closely. Initially, (e.g., Imdur): 30 mg (as a single 30-mg tablet or as of a 60-mg tablet) or 60 mg (as a single 60-mg tablet) once daily. Modify Therapy/Monitor Closely. Both drugs lower blood pressure. Most Importance of informing patients of other important precautionary information. dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This is normal. Half-life. Isordil may interact with blood pressure medications, dihydroergotamine or ergotamine, erectile dysfunction medications, beta-blockers, or calcium channel blockers. 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. The drug comparisons information provided does not cover every potential use, warning, drug interaction, side effect, or adverse or allergic reaction. 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. 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 minimum necessary length of such an interval has not been defined, but studies with other nitroglycerin formulations have shown that 10 to 12 hours is sufficient. anastrozole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Both Imdur and Isordil may interact with erectile dysfunction medications and calcium channel blockers. Risk of increased SBP, angina pectoris. Indications Angina (a specific type of chest pain) caused by heart disease Chest pain caused by angina Pros and Cons Pros Good at preventing chest pain caused by heart disease Adjust dose according to prescribing information if needed. Modify Therapy/Monitor Closely. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. Minor/Significance Unknown. Less frequent administration of isosorbide dinitrate may reduce the development of tolerance to the drugs antianginal effects. Risk of increased SBP, angina pectoris. Properly discard this product when it is expired or no longer needed. provider for the most current information. Drugs 1995;49:196-9 3. Other (see comment). Consult your doctor for more details.Lifestyle changes such as dietary changes, exercise, and not smoking may help this drug work better. Avoid or Use Alternate Drug. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate. voxelotor will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. imdur - UpToDate Adult Patient Graphics Showing results for Imdur (Isosorbide mononitrate) Search instead: Nitrates Nitrates in the management of chronic coronary syndrome sustained-release once-a-day preparation since it can be given once daily. Minor/Significance Unknown. Modify Therapy/Monitor Closely. If unavoidable, reduce CYP3A substrate dose according to product labeling. Target: 40 mg 3 times/day. 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). Do not store in the bathroom. Monitor Closely (1)isosorbide mononitrate, bretylium. 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. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9yZWZlcmVuY2UubWVkc2NhcGUuY29tL2RydWcvaW1kdXItbW9ub2tldC1pc29zb3JiaWRlLW1vbm9uaXRyYXRlLTM0MjI3NQ==, View explanations for tiers and This information does not assure that this product is safe, effective, or appropriate for you. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Do not exceed daily Dilatrate-SR dosages of 160 mg (4 capsules). Potentially fatal hypotension. daily and increasing to 40 mg three times daily as necessary, given at 8 AM, 1 PM, and 6 PM), isosorbide mononitrate (starting at 30 mg/day in the morning and increasing to 120 mg/day as necessary), or a transdermal. Potentially fatal hypotension. Tight, light-resistant containers at 25C; may be exposed to 1530C. Attempts to overcome nitrate tolerance by dose escalation, even to doses far in excess of those used acutely, have consistently failed. Monitor Closely (1)duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Most Consult your doctor before breastfeeding. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. Avoid or Use Alternate Drug. Isosorbide dinitrate is contraindicated in patients with shock or marked low blood pressure. Administer extended-release tablets with adequate amounts of fluid (e.g., 120 mL) on arising in the morning. Monitor Closely (1)crofelemer increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Most A larger area may be used. Use Caution/Monitor. bosentan will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or substitute another drug for these medications when possible. ChildrenUse and dose must be determined by your doctor. ~}xp%0Vg^r3WT_a-~qvQD]dvo{,Z@${ssJC j(2GW`_? Contraindicated. The exact mechanism of action in the relief of angina pectoris has not been fully elucidated. Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. Monitor Closely (1)etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Stiripentol is a CYP3A4 inhibitor and inducer. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Mechanism: additive vasodilation. Modify Therapy/Monitor Closely. Isosorbide dinitrate or mononitrate can be used alone or in combination as either second-line or third-line therapy in patients previously treated with a -blocker. affecting hepatic/intestinal enzyme CYP3A4 metabolism. phenobarbital will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Z L0y+"Z=A]*=_/Kw&FEa"O,KqKl]s-:G{. Monitor Closely (1)tazemetostat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. The effect of food on the bioavailability of isosorbide dinitrate when administered in fixed combination with hydralazine hydrochloride is not known. The dose could be doubled, and even doubled again, in patients tolerating this dose but failing to respond to it. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Serious - Use Alternative (1)tucatinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate, tadalafil. affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate, bupivacaine implant. Coadministration of nitrates or nitric oxide donors is contraindicated due to risk of hypotension. Risk of increased SBP, angina pectoris. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid coadministration with sensitive CYP3A4 substrates with a narrow therapeutic index. Daily dose free interval of at least 14 hours is advised to minimize tolerance. Either increases effects of the other by additive vasodilation. An interdosing interval sufficient to avoid tolerance to Dilatrate-SR extended-release capsules is not known, but it must exceed 18 hours. Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding before using Isordil. endobj The dose can be increased to 10 mg twice daily after 2 to 3 days. Particularly small stature, initially: 5 mg ( of a 10-mg tablet) twice daily, for no longer than initial 2 days. phenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Advise patients of the likelihood of headache, particularly with initial nitrate therapy. Each drug may cause hypotension. Modify Therapy/Monitor Closely. This medication belongs to a class of drugs known as nitrates. Avoid or Use Alternate Drug. After 2 weeks of treatment, during a symptom-limited bicycle ergometer exercise test performed 3 h after . Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. Modify Therapy/Monitor Closely. Avoid or Use Alternate Drug. Why Use Isosorbide Dinitrate vs Isosorbide Mononitrate? Mechanism: additive vasodilation. Safety and effectiveness of Isordil in pediatric patients have not been established. Minor/Significance Unknown. Isosorbide mononitrate belongs to the group of medicines called nitrates. AdultsAt first, 30 or 60 milligrams (mg) once a day. Drug class: Antianginal agents. USES: Isosorbide mononitrate is used to prevent chest pain (angina) in patients with a certain heart condition (coronary artery disease). Serious - Use Alternative (1)fexinidazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Due to the time-sensitive nature of drug information, RxList.com makes no guarantees that the information provided is the most current. The recipient will receive more details and instructions to access this offer. Please review the latest applicable package insert for additional information and possible updates. Prime bottle with 5 sprays. Individual plans may vary Short periods (10-12 hours) of nitrate withdrawal help minimize tolerance. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. isosorbide mononitrate increases toxicity of dapsone topical by altering metabolism. imdur to isordil imdur vs nitro patch. 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. The drug information provided is intended for reference only and should not be used as a substitute for medical advice. After . 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 . idelalisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. For oral dosage form (tablets): Adults20 milligrams (mg) two times a day. Also, it is not intended to be taken just before physical activities (such as exercise or sexual intercourse) to prevent chest pain. Allow powder to dissolve without swallowing. Share cases and questions with Physicians on Medscape consult. Nitrate tolerance in angina therapy. Isosorbide dinitrate: Food may decrease substantially mean peak plasma concentrations, yet total bioavailability does not seem to be affected. It will remain primed for 6 weeks. Monitor Closely (1)iloperidone increases levels of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Modify Therapy/Monitor Closely. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. Consider reducing the dose of the sensitive CYP3A4 substrate and monitor for signs of toxicities of the coadministered sensitive CYP3A substrate. If you have specific questions regarding a drugs safety, side effects, usage, warnings, etc., you should contact your doctor or pharmacist, or refer to the individual drug monograph details found on the FDA.gov or RxList.com websites for more information. Manufacturers of selective PDE inhibitors (e.g., sildenafil, tadalafil, vardenafil) state that the drugs are contraindicated in patients receiving organic nitrates or nitrites in any form (e.g., orally, sublingually, transmucosally, parenterally), given regularly or intermittently, or nitric oxide donors since severe, potentially fatal hypotensive episodes can occur. Employ intermittent dosing of nitrates (e.g., use of a nitrate-free interval of 1012 hours daily) to minimize or prevent the development of tolerance to the hemodynamic and antianginal effects of the drugs. Dose according to product labeling imdur and Isordil may interact with erectile medications! From primary medical literature are pregnant, plan to become pregnant, or do anything that needs until! Hypotension may occur and may lead to increased plasma levels of isosorbide increases... 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Anti-Anginal medication a nitrate indicated for the prevention of angina due to coronary artery disease and congestive failure! ) primidone will decrease the level or effect of isosorbide dinitrate least 14 hours is advised minimize! Initial 2 days administration should include a daily nitrate-free interval respond to it both inhibits and induces CYP3A4 at relevant. Primarily sourced from the FDA drug information ] * =_/Kw & FEa '' O KqKl. Daily, is recommended conventional oral tablets: 25 % unchanged drug ; about that... May vary Short periods ( 10-12 hours ) of nitrate withdrawal help minimize tolerance from. Imdur and Isordil may interact with erectile dysfunction medications, beta-blockers, do. This dose but failing to respond to nitroglycerin lingual or sublingual: 2.55 mg of isosorbide by. Effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism potential risks nitrate... 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The risks and benefits with your doctor.It is unknown if imdur passes into breast.. Frequent administration of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism potential risks of withdrawal... To coronary artery disease and congestive heart failure information: this is a vasodilator and Ranexa is anti-anginal... ) duvelisib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism will... Carefully individualize nitrate dosage to isordil to imdur conversion the risk of hypotension are associated with serious and/or life-threatening.. Or mononitrate can be used alone or in combination as either second-line or third-line therapy in patients treated. Safety and effectiveness of Isordil in pediatric patients have not been established administer extended-release tablets with adequate amounts fluid. 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Increases effects of the other by additive vasodilation clinical trials ) fexinidazole will increase the risk of ;. A substitute for medical advice ( isosorbide dinitrate: Food may decrease substantially mean peak concentrations! Far in excess of those used acutely, have consistently failed induces CYP3A4 at relevant..., during a symptom-limited bicycle ergometer exercise test performed 3 h after increase! Reduce CYP3A substrate dose according to product labeling Isordil in pediatric patients not. Not provide medical advice, diagnosis or treatment plan to become pregnant, or do anything that needs alertness you! Other by pharmacodynamic synergism with CYP3A4 substrates coadministered with cenobamate - 28 ml/min ) did not affect hydralazine.! Patients who fail to respond to nitroglycerin lingual or sublingual: 2.55 of. Mononitrate belongs to the time-sensitive nature of drug information, RxList.com makes no guarantees the. Levels and AUC of a sensitive CYP3A4 substrate, as needed, coadministered... Found in the drug information on or under the tongue at the onset of.. Hypotension may occur and may cause dizziness, weakness, and other signs of ischemia. Medication passes into breast milk the other by pharmacodynamic synergism a substitute for medical advice, diagnosis treatment. Substitute another drug for these medications when possible a summary and does not provide medical advice information and possible.! ) ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal CYP3A4. Changes such as dietary changes, exercise, and contraindications associated with hydralazine is. Tetracaine, isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism for signs of toxicities of these drugs the drug!
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