Interactions
- Sildenafil (Viagra). Concomitant administration of isosorbide mononitrate and sildenafil (Viagra) can potentiate the vasodilatory effect of isosorbide mononitrate with the potential result of serious side effects such as syncope or myocardial infarction. Therefore, sildenafil should not be given to patients already receiving isosorbide mononitrate therapy.
- Sulfhydryl containing compounds. The metabolism of organic nitrates to nitric oxide is dependent on the presence of sulfhydryl groups in the muscle. The combination of oral N-acetylcysteine and a single dose of sustained release isosorbide mononitrate 60 mg significantly prolonged the total exercise time in patients with angina pectoris and angiographically proven significant coronary artery disease, when compared with isosorbide mononitrate alone. Concomitant administration of other exogenous sources of sulfhydryl groups such as methionine and captopril may produce a similar interaction.
- Phenylalkylamine calcium antagonists. The addition of a calcium channel blocker of the verapamil type, such as gallopamil 75 mg, has been shown to further improve left ventricular functional parameters when given in combination with isosorbide mononitrate in a sustained release formulation.
- Propranolol. The addition of isosorbide mononitrate to propranolol treatment in patients with cirrhosis and portal hypertension caused a marked fall in portal pressure, a reduction in hepatic blood flow, cardiac output and mean arterial blood pressure, but no additional change in azygos blood flow. The additional effect of isosorbide mononitrate was especially evident in patients whose portal pressure was not reduced by propranolol.
- Calcium antagonists (general). Marked symptomatic orthostatic hypotension has been reported when calcium antagonists and organic nitrates were used in combination. Dose adjustments of either class of agent may be necessary.
Read more about this topic: Isosorbide Mononitrate
Famous quotes containing the word interactions:
“The exercise of power is determined by thousands of interactions between the world of the powerful and that of the powerless, all the more so because these worlds are never divided by a sharp line: everyone has a small part of himself in both.”
—Václav Havel (b. 1936)
“In our interactions with people, a benevolent hypocrisy is frequently required—acting as though we do not see through the motives of their actions.”
—Friedrich Nietzsche (1844–1900)
“Whereas children can learn from their interactions with their parents how to get along in one sort of social hierarchy—that of the family—it is from their interactions with peers that they can best learn how to survive among equals in a wide range of social situations.”
—Zick Rubin (20th century)