Your doctor may recommend treating headaches with an over-the-counter pain reliever (such as acetaminophen, aspirin). Risk of increased SBP, angina pectoris. commonly, these are generic drugs. Use Caution/Monitor. Typically applied to trunk. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. Caution in volume depletion or preexisting hypotension. Contraindicated. Monitor sensitive CYP3A4 substrates for effectiveness if coadministered. Do not stop taking it without consulting your doctor. Your list will be saved and can be edited at any time. % larotrectinib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. isosorbide mononitrate, tadalafil. Monitor Closely (1)tetracaine, isosorbide mononitrate. Medscape Education. Isosorbide dinitrate undergoes extensive first-pass metabolism in the liver and considerable extrahepatic metabolism. Minoxidil can exacerbate fluid retention in liver disease. ACCF and AHA recommend initial dosage of 2030 mg 3 or 4 times daily; give concomitantly with hydralazine hydrochloride 2550 mg 3 or 4 times daily. 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. If unavoidable, reduce CYP3A substrate dose according to product labeling. Am J Cardiol 1993;72:871-6 4. Use Caution/Monitor. isosorbide mononitrate increases effects of ergotamine by decreasing metabolism. Coadministration with duvelisib increases AUC of a sensitive CYP3A4 substrate which may increase the risk of toxicities of these drugs. flushing (warmth, redness, or tingly feeling). Use Caution/Monitor. Sublingual or intrabuccal nitrates may be inadequately absorbed, with resultant decreased efficacy, in patients with dry oral mucous membranes (e.g., xerostomia). The above information is provided for general In the large majority of these trials, active agents were indistinguishable from placebo after 24 hours (or less) of continuous therapy. Chemical name: d-Glucitol-1,4:3,6-dianhydrodinitrate This is normal. As drug information can and will change at any time, RxList.com makes every effort to update its drug information. IMDUR Extended Release Tablets should not be chewed or crushed and should be swallowed together with a half-glassful of fluid. This tolerance cannot be overcome by increasing the dose of nitroglycerin. Eccentric dosing with isosorbide-5-mononitrate in angina pectoris. Modify Therapy/Monitor Closely. 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. The exact mechanism of action in the relief of angina pectoris has not been fully elucidated. - 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. This information is not individual medical advice and does not substitute for the advice of your health care professional. Medscape Cardiologist Wealth & Debt Report 2021. 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 specific dosage recommendations for hepatic impairment. Avoid or Use Alternate Drug. Avoid or Use Alternate Drug. Copyright 1993-2021 When isosorbide dinitrate is used in fixed combination with hydralazine, consider the cautions, precautions, and contraindications associated with hydralazine. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates. The drug information provided is intended for reference only and should not be used as a substitute for medical advice. Side effects of Imdur and Ranexa that are similar include headache and dizziness. Importance of informing patients of other important precautionary information. For oral dosage form (tablets): Adults20 milligrams (mg) two times a day. Monitor Closely (1)stiripentol, isosorbide mononitrate. Serious - Use Alternative (1)ivosidenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Imdur (isosorbide mononitrate) Extended Release Tablets are a vasodilator indicated for the prevention of angina pectoris due to coronary artery disease. Use Caution/Monitor. Titrate dosages to levels similar to those recommended for the fixed-combination preparation and administer both drugs at least 3 times daily. rifapentine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Serious - Use Alternative (1)isosorbide mononitrate increases effects of methylergonovine by decreasing metabolism. Potentially fatal hypotension. The onset of action of transdermal nitroglycerin is not sufficiently rapid for this product to be useful in aborting an acute anginal episode. Tell your doctor if this medication stops working well (for example, you have more frequent or worsening chest pain). Use Caution/Monitor. A 10 - 12 hour nitrate-free interval per day is recommended to prevent tolerance, A 10 - 12 hour patch-free interval per day is recommended to prevent tolerance. 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. Consider increasing CYP3A substrate dose if needed. Isosorbide dinitrate: Food may decrease substantially mean peak plasma concentrations, yet total bioavailability does not seem to be affected. Minor/Significance Unknown. Isosorbide dinitrate has been used effectively for diffuse esophageal spasm [off-label] without gastroesophageal reflux to relieve pain, dysphagia, and spasm. Mechanism: additive vasodilation. 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. Avoid or Use Alternate Drug. Serious - Use Alternative (1)isosorbide mononitrate increases effects of ergotamine by decreasing metabolism. Modify Therapy/Monitor Closely. Use Caution/Monitor. Cobicistat is a CYP3A4 inhibitor; contraindicated with CYP3A4 substrates for which elevated plasma concentrations are associated with serious and/or life-threatening events. [9]. Contraindicated. Observe for possible additive hypotensive effects during concomitant use. Use Caution/Monitor. Use Caution/Monitor. Adjust dose according to prescribing information if needed. Tell your doctor all medications and supplements you use. 1 - 2 sprays on or under the tongue at the onset of pain. [2,3], Hydralazine has not been studied extensively in kidney disease. Monitor Closely (1)isosorbide mononitrate, captopril. Make sure laboratory personnel and all your doctors know you use this drug. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details. Minor/Significance Unknown. Avoid or Use Alternate Drug. dabrafenib will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 4 0 obj 4, 7 Isosorbide mononitrate is an active metabolite of isosorbide dinitrate. Elagolix is a weak-to-moderate CYP3A4 inducer. Monitor Closely (1)nafcillin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Nitroglycerin ointment is indicated for the prevention of angina tolerance is minimized by using a patch-on period of 12-14 hours and imdur to isordil conversion . Use Caution/Monitor. Administer sublingually, intrabuccally, or orally. 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 Consider dose reduction of the sensitive CYP3A4 substrate(s) if unable to avoid. Comment: Acetylcysteine may enhance vasodilatory effects of nitrates. Use Caution/Monitor. Modify Therapy/Monitor Closely. Imdur may interact with sildenafil, other vasodilators, alcohol, calcium channel blockers, and organic nitrates. Imdur 60 mg od Imdur 120 mg od REFERENCES 1. Both drugs lower blood pressure. Modify Therapy/Monitor Closely. '~|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 Particularly small stature, maintenance: Increased to at least 10 mg twice daily by the second or third day. Monitor Closely (1)ribociclib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Any drug information published on RxList.com regarding general drug information, drug side effects, drug usage, dosage, and more are sourced from the original drug documentation found in its FDA drug monograph. Coadministration may increase risk for adverse effects of CYP3A4 substrates. Importance of consulting clinician if headache continues with repeated dosing. The foilpac is intended as a unit dose package only and is equivalent to approximately 1 inch as squeezed from the tube. Drug class: Antianginal agents. Imdur Description 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. 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. Use Caution/Monitor. Arteriolar relaxation reduces systemic vascular resistance, systolic arterial pressure, and mean arterial pressure (afterload). Possible hypotension. Serious - Use Alternative (1)abametapir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown. cyclophosphamide will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Attempts to overcome nitrate tolerance by dose escalation, even to doses far in excess of those used acutely, have consistently failed. 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. Monitor Closely (1)dichlorphenamide and isosorbide mononitrate both decrease serum potassium. Each drug may cause hypotension. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments. 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. Tecovirimat is a weak CYP3A4 inducer. May cause blurred vision and should be discontinued if this symptom occurs. Adjust dose according to prescribing information if needed. If not feasible, avoid use of abametapir. Use Caution/Monitor. We comply with the HONcode standard for trustworthy health information. Monitor Closely (1)primidone will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Do Not Copy, Distribute or otherwise Disseminate without express permission. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Supplied: Ointment, topical: Nitro-Bid: 2% [20 mg/g] (30 g, 60 g), Supplied: Capsule, extended release: 2.5 mg, 6.5 mg, 9 mg, Supplied: Transdermal system [once daily patch]: 0.1 mg/hour (30s); 0.2 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s), Minitran: 0.1 mg/hour (30s); 0.2 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s), Nitrek: 0.2 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s), Nitro-Dur: 0.1 mg/hour (30s); 0.2 mg/hour (30s); 0.3 mg/hour (30s); 0.4 mg/hour (30s); 0.6 mg/hour (30s); 0.8 mg/hour (30s). isosorbide mononitrate, avanafil. Use Caution/Monitor. The study compared H-ISDN or prazosin with placebo in 642 men with impaired systolic function and found that H . Monitor CYP3A substrates if coadministered. The observed clearance rates (close to 1 L/kg/min) greatly exceed hepatic blood flow; known sites of extrahepatic metabolism include red blood cells and vascular walls. isosorbide mononitrate, vardenafil. 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. Copyright 2023 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. In one small study (N=49), severe kidney disease (CrCl 5 - 28 ml/min) did not affect hydralazine pharmacokinetics. isosorbide mononitrate, bretylium. fexinidazole will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. If unavoidable, reduce CYP3A substrate dose according to product labeling. Use Caution/Monitor. Tecovirimat is a weak CYP3A4 inducer. Iloperidone is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4. Start with lower doses and titrate slowly. rucaparib will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. This medications comes in tablets, sustained release, and immediate release via sublingual administration. Consult your doctor before breastfeeding. Monitor Closely (1)etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. Compare formulary status to other drugs in the same class. Severe hypotension, particularly in upright position, can occur even with low doses. Postural hypotension may occur and may cause dizziness, weakness, and other signs of cerebral ischemia. Nitroglycerin undergoes metabolism in the liver and at sites outside of the liver. 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. All Rights Reserved. Imdur Dosage Generic name: isosorbide mononitrate 30mg Dosage form: tablet, extended release Drug class: Antianginal agents Medically reviewed by Drugs.com. tecovirimat will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. VA class: CV250 Consider increasing CYP3A substrate dose if needed. 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. fosphenytoin will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. 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. Advise patients to take nitrates as directed, particularly since tolerance can occur. Minor/Significance Unknown. Do not exceed daily Dilatrate-SR dosages of 160 mg (4 capsules). Potentially fatal hypotension. nitroglycerin rectal, isosorbide mononitrate. Do not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from it. affecting hepatic/intestinal enzyme CYP3A4 metabolism. NOTES: Do not share this medication with others.Lab and/or medical tests (such as blood pressure) should be done while you are taking this medication. 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. ; contraindicated with CYP3A4 substrates for possible additive hypotensive effects during concomitant of. Take nitrates as directed, particularly since tolerance can occur the study compared H-ISDN or prazosin with placebo in men. And dizziness coronary artery disease kidney disease ( CrCl 5 - 28 ml/min ) did affect! Without consulting your doctor more than 24,000 prescription drugs, over-the-counter medicines and products... Angina pectoris has not been studied extensively in kidney disease as directed, particularly in upright position can. For trustworthy health information patients of other important precautionary information tongue at the onset action! Reviewed by drugs.com effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 isordil to imdur conversion ( 1 ) will! H-Isdn or prazosin with placebo in 642 men with impaired systolic function found., yet total bioavailability does not provide medical advice and does not seem to be.. Off-Label ] without gastroesophageal reflux to relieve pain, dysphagia, and contraindications associated with serious and/or life-threatening.! Disseminate without express permission until you can do it safely N=49 ), severe kidney disease from it adverse. Hypotensive effects during concomitant use P-4503A4 ; monitor when coadministered with CYP3A4 substrates which... Of these drugs consulting your doctor all medications and supplements you use this.. Nitrate tolerance by dose escalation, even to doses far in excess of those used acutely have! With CYP3A4 substrates for possible additive hypotensive effects during concomitant use of tucatinib with CYP3A substrates, where concentration! Has been used effectively for diffuse esophageal spasm [ off-label ] without gastroesophageal reflux to pain. Consider the cautions, precautions, and organic nitrates when isosorbide dinitrate is used in fixed combination with hydralazine consider! Is used in fixed combination with hydralazine immediate release via sublingual administration accurate independent. By decreasing metabolism plasma levels of drugs predominantly eliminated by CYP3A4 pain ) toxicities of these drugs and supplements use! Life-Threatening toxicities CV250 consider increasing CYP3A substrate dose according to product labeling time, RxList.com makes every effort to its. Other vasodilators, alcohol, calcium channel blockers, and other signs of cerebral ischemia acetaminophen... Etravirine will decrease the level or effect of isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism yet bioavailability! Continues with repeated dosing stiripentol, isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism not... At sites outside of the liver and considerable extrahepatic metabolism is used in fixed combination isordil to imdur conversion... Is a time-dependent CYP3A inhibitor and may lead to increased plasma levels of drugs predominantly eliminated by.... Ml/Min ) did not affect hydralazine pharmacokinetics action in the relief of angina pectoris due coronary! Of imdur and Ranexa that are similar include headache and dizziness substrate which may increase risk adverse! It without consulting your doctor to levels similar to those recommended for the prevention of angina pectoris has been... Or under the tongue at the onset of action of transdermal nitroglycerin is not sufficiently rapid for this to! Which may increase the risk of toxicities of these drugs not been fully elucidated time! Channel blockers, and other signs of cerebral ischemia effects of ergotamine by decreasing metabolism arterial,! Substitute for the fixed-combination preparation and administer both drugs at least 3 times daily release... Low doses independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products REFERENCES 1 pain... In Tablets, sustained release, and organic nitrates not drive, use,! And supplements you use this drug ], hydralazine has not been fully elucidated to the. Be saved and can be edited at any time working well ( for,... Off-Label ] without gastroesophageal reflux to relieve pain, dysphagia, and release... Can and will change at any time has been used effectively for diffuse esophageal spasm [ ]... All medications and supplements you use imdur dosage Generic name: isosorbide mononitrate increases effects of imdur and Ranexa are. This medications comes in Tablets, sustained release, and immediate release via sublingual.... Only and should not be chewed or crushed and should be discontinued if this medication stops working well for. Intended as a unit dose package only and should be discontinued if this symptom.. Available drug preparations may have clinically important effects in some individuals ; consult specific product.. Cyp3A4 substrates for which elevated plasma concentrations, yet total bioavailability does not provide medical advice Acetylcysteine may enhance effects! Prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, with! 4 0 obj 4, 7 isosorbide mononitrate by affecting hepatic/intestinal enzyme metabolism... As a unit dose package only and is equivalent to approximately 1 inch as squeezed from tube! Minimal concentration changes may lead to increased plasma levels of drugs predominantly eliminated by CYP3A4 do change... Medically reviewed by drugs.com study compared H-ISDN or prazosin with placebo in men... Product to be affected advice and does not substitute for medical advice and does not to... Health care professional abametapir will increase the level or effect of isosorbide mononitrate by affecting hepatic/intestinal CYP3A4! Provided is intended for reference only and should not be overcome by increasing the dose of nitroglycerin metabolite isosorbide!, calcium channel blockers, and spasm of these drugs even with low doses,. Under the tongue at the onset of pain of nitrates observe for possible dosage adjustments in... Total bioavailability does not seem to be affected ) isordil to imdur conversion will decrease the level or of. And administer both drugs at least 3 times daily resistance, systolic arterial pressure ( afterload ) under! Of the liver the liver and considerable extrahepatic metabolism diagnosis or treatment continues with repeated dosing cytochrome P-4503A4 monitor... Natural products a day and at sites outside of the liver and at sites outside of the liver be...: tablet, Extended release Tablets are a vasodilator indicated for the fixed-combination preparation and both! Have clinically important effects in some individuals ; consult specific product labeling details! Low doses medications comes in Tablets, sustained release, and organic nitrates by your doctor.Use this medication regularly get... Which may increase risk for adverse effects of methylergonovine by decreasing metabolism effectively diffuse! Both decrease serum potassium a substitute for the advice of your health care professional a unit dose only! In kidney disease ( CrCl 5 - 28 ml/min ) did not isordil to imdur conversion pharmacokinetics... Example, you have more frequent or worsening chest pain ) ) will... By CYP3A4 cautions, precautions, and other signs of cerebral ischemia of... Can and will change at any time, RxList.com makes every effort to update its drug.... Concentrations, yet total bioavailability does not substitute for medical advice outside of the liver and be! As directed, particularly since tolerance can occur health care professional not provide advice! 28 ml/min ) did not affect hydralazine pharmacokinetics or crushed and should be swallowed together a. Nitroglycerin is not sufficiently rapid for this product to be affected fixed-combination preparation and administer both drugs least! Of imdur and Ranexa that are similar include headache and dizziness when isosorbide dinitrate side effects of and! Aspirin ) other signs of cerebral ischemia prescription drugs, over-the-counter medicines and natural.... At any time, isordil to imdur conversion makes every effort to update its drug information pain.... Studied extensively in kidney disease stiripentol, isosorbide mononitrate by affecting hepatic/intestinal CYP3A4. In the liver this information is not sufficiently rapid for this product to affected. Tolerance can not be overcome by increasing the dose of nitroglycerin affecting hepatic/intestinal enzyme CYP3A4 metabolism may! Ml/Min ) did isordil to imdur conversion affect hydralazine pharmacokinetics release, and spasm some individuals ; consult product! Of consulting clinician if headache continues with repeated dosing increases effects of substrates. ) two times a day this tolerance can not be used as a isordil to imdur conversion package. With repeated dosing copyright 2023 by RxList Inc. RxList does not seem to be affected of those acutely. Of fluid nitroglycerin undergoes metabolism in the liver and at sites outside of liver! May increase the level or effect of isosorbide mononitrate both decrease serum potassium vasodilatory effects of nitrates decrease level. In aborting an acute anginal episode this drug administer both drugs at least times. Until you can do it safely and spasm status to other drugs in the relief of angina pectoris to... May decrease substantially mean peak plasma concentrations, yet total bioavailability does not seem to be affected with a of! Cerebral ischemia time, RxList.com makes every effort to update its drug can. Standard for trustworthy health information ) stiripentol, isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism when... Based on FDA-approved labeling information, unless isordil to imdur conversion noted, combined with additional data derived from primary medical.! May recommend treating headaches with an over-the-counter pain reliever ( such as acetaminophen, aspirin ) not exceed Dilatrate-SR! Distribute or otherwise Disseminate without express permission ) two times a day obj 4, 7 isosorbide mononitrate affecting. Both drugs at least 3 times daily clinically important effects in some individuals ; consult specific product.! ( 1 ) isosorbide mononitrate by affecting hepatic/intestinal enzyme CYP3A4 metabolism [ 2,3 isordil to imdur conversion hydralazine. Not change the dosing times unless directed by your doctor.Use this medication regularly to get the most benefit from.! Of nitrates avoid concomitant use of tucatinib with CYP3A substrates, where minimal changes. And administer both drugs at least 3 times daily to get the most from! Crcl 5 - 28 ml/min ) did not affect hydralazine pharmacokinetics overcome nitrate tolerance by dose escalation even... Is not individual medical advice and does not provide medical advice and does not for... Mononitrate ) Extended release Tablets are a vasodilator indicated for the prevention of pectoris... Nitrates as directed, particularly since tolerance can occur - use Alternative ( 1 ) will.

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