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:
“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)
“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)
“In child rearing it would unquestionably be easier if a child were to do something because we say so. The authoritarian method does expedite things, but it does not produce independent functioning. If a child has not mastered the underlying principles of human interactions and merely conforms out of coercion or conditioning, he has no tools to use, no resources to apply in the next situation that confronts him.”
—Elaine Heffner (20th century)