Isosorbide mononitrate interactions
Isosorbide mononitrate (Imdur, Monoket), a nitrate has 36 documented interactions across the FDA labels and fact sheets we index: 7 major, 24 moderate, 5 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.
Major interactions (7)
Do not use isosorbide mononitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide mononitrate label, Contraindications)
Do not use isosorbide mononitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide mononitrate label, Contraindications)
Hypersensitivity to Nitroglycerin Lingual Spray or to other nitrates or nitrites or any excipient. (Nitroglycerin label, Contraindications)
Do not use isosorbide mononitrate in patients who are taking the soluble guanylate cyclase stimulator riociguat. (Isosorbide mononitrate label, Contraindications)
Do not use isosorbide mononitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide mononitrate label, Contraindications)
Do not use isosorbide mononitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide mononitrate label, Contraindications)
Do not use isosorbide mononitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide mononitrate label, Contraindications)
Moderate interactions (24)
Alcohol, in particular, has been found to exhibit additive effects of this variety. (Isosorbide mononitrate label, Drug interactions)
Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- Amlodipine and benazeprildihydropyridine calcium channel blockerModerate
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- CaptoprilACE inhibitorModerate
Valvular Stenosis: There is concern, on theoretical grounds, that patients with aortic stenosis might be at particular risk of decreased coronary perfusion when treated with vasodilators because they do not develop as much afterload reduction as others. (Captopril label, Precautions)
- Dexmedetomidinealpha-adrenergic agonistModerate
• Co-administration with Other Vasodilators or Negative Chronotropic Agents: Use with caution due to additive pharmacodynamic effects. (Dexmedetomidine label, Warnings and precautions)
…drugs including dicyclomine hydrochloride: amantadine, antiarrhythmic agents of Class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity. (Dicyclomine label, Drug interactions)
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- DofetilideantiarrhythmicModerate
…oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular organic cation transport, and QTc-prolonging drugs. (Dofetilide label, Drug interactions)
- Econazoleazole antifungalModerate
Most cases reported product application with use under occlusion, genital application, or application to a large body surface area which may increase the systemic absorption of econazole nitrate. (Econazole label, Drug interactions)
- Felodipinedihydropyridine calcium channel blockerModerate
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)
- Isosorbide dinitratenitrateModerate
The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)
- Isosorbide dinitrate and hydralazinenitrateModerate
The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)
- Isradipinedihydropyridine calcium channel blockerModerate
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- Lidocaine and prilocainelocal anestheticModerate
…methemoglobinemia when concurrently exposed to the following drugs, which could include other local anesthetics: Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine,… (Lidocaine and prilocaine label, Drug interactions)
- MinoxidilvasodilatorModerate
The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)
- NiacinModerate
Caution should also be used when niacin extended-release tablets are used in patients with unstable angina or in the acute phase of an MI, particularly when such patients are also receiving vasoactive drugs such as nitrates, calcium channel blockers, or adrenergic blocking agents. (Niacin label, Warnings and precautions)
- Nicardipinedihydropyridine calcium channel blockerModerate
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- Nisoldipinedihydropyridine calcium channel blockerModerate
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- Treprostinilprostaglandin analogModerate
The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)
Marked symptomatic orthostatic hypotension has been reported when calcium channel blockers and organic nitrates were used in combination. (Isosorbide mononitrate label, Drug interactions)
- VericiguatvasodilatorModerate
The vasodilating effects of isosorbide mononitrate may be additive with those of other vasodilators. (Isosorbide mononitrate label, Drug interactions)
Minor mentions (5)
- Dutasteride and tamsulosin5-alpha reductase inhibitorMinor
Alpha-adrenergic antagonists and PDE-5 inhibitors are both vasodilators that can lower blood pressure. (Dutasteride and tamsulosin label, Warnings and precautions)
- EpinephrinesympathomimeticMinor
Drugs antagonizing pressor effects of epinephrine α-blockers, such as phentolamine Vasodilators, such as nitrates Diuretics Antihypertensives Ergot alkaloids Drugs potentiating pressor effects of epinephrine • Sympathomimetics • β-blockers, such as propranolol • Tricyclic anti-depressants • Monoamine oxidase (MAO) inhibitors • Catechol-O-methyl transferase (COMT)… (Epinephrine label, Drug interactions)
…acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives without evidence of clinically… (Finasteride label, Drug interactions)
- Lisinopril and hydrochlorothiazideACE inhibitorMinor
Other Agents: Lisinopril has been used concomitantly with nitrates and/or digoxin without evidence of clinically significant adverse interactions. (Lisinopril and hydrochlorothiazide label, Drug interactions)
Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. (Tamsulosin label, Warnings and precautions)
Check Isosorbide mononitrate against everything you take. Add your full list; every pair is checked at once.
Open in the checkerNot medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.