Can you take Ergonovine with Isosorbide mononitrate?
1 drug interaction and 24 additional warnings found for the following 2 drugs:
- ergonovine
- isosorbide mononitrate
Drug interactions
Moderate drug interactions
Moderate:
isosorbide mononitrate ergonovine
Applies to: isosorbide mononitrate and ergonovine
Ask your doctor before using isosorbide mononitrate together with ergonovine. Using isosorbide mononitrate together with ergonovine can increase the effects of ergonovine. Contact your doctor immediately if you experience an irregular heartbeat, nausea, vomiting, weakness, or coldness, numbness, or pain in the hands, feet, arms, or legs. You may need a dose adjustment or special test if you use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
ergonovine Food/Lifestyle
Applies to: ergonovine
Grapefruit juice may increase the blood levels of certain medications such as ergonovine. You may want to limit your consumption of grapefruit and grapefruit juice during treatment with ergonovine. However, if you have been regularly consuming grapefruit or grapefruit juice with the medication, then it is advisable for you to talk with your doctor before changing the amounts of these products in your diet, as this may alter the effects of your medication. Contact your doctor if your condition changes or you experience increased side effects. Orange juice is not expected to interact.
Moderate:
isosorbide mononitrate Alcohol (Ethanol)
Applies to: isosorbide mononitrate
Ethanol and isosorbide mononitrate may have additive effects in lowering your blood pressure. You may experience headache, dizziness, lightheadedness, fainting, or changes in pulse or heart rate, especially when treatment is started, the dose is changed, or treatment is restarted. Tell your doctor promptly if these symptoms occur and seek urgent medical help if you faint or have severe dizziness. Avoid driving or operating hazardous machinery until you know how the medications affect you, and use caution when getting up from a sitting or lying position. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
22 potential interactions Applies to: 22 conditions, including High Blood Pressure, Heart Failure, Heart Attack, Hypotension, and Anemia.
Anemia
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Anemia.
Some manufacturers and medical references consider the use of nitrates and nitrites to be contraindicated in patients with severe anemia. Nitrates and nitrites can cause methemoglobinemia, primarily in high-dose intravenous therapy or acute poisoning and in patients with NADH reductase deficiency. However, elevations of methemoglobin may also occur with commonly used dosages. While probably not of routine clinical significance, the increases may be important in certain patient populations such as those with coronary insufficiency or anemia.
Aortic Stenosis
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Aortic Stenosis.
Organic nitrates and nitrites may cause severe hypotension, syncope and shock, even with small doses. Hypotension induced by these agents may be accompanied by paradoxical bradycardia and increased angina pectoris. Therapy with nitrates and nitrites should be administered cautiously in patients who are volume-depleted or hypotensive (e.g., systolic blood pressure <90 mm Hg) or who, because of inadequate circulation to the brain or to other vital organs, would be unusually compromised by undue hypotension. Patients should be in a sitting or recumbent position during and immediately after drug administration, and monitored for symptoms of severe hypotension such as nausea, vomiting, weakness, pallor, perspiration, and syncope. Nitrate or nitrite therapy is considered contraindicated in patients with acute circulatory failure or shock.
Arteriovenous Shunting
Major:
ergonovine
Ergonovine has a major potential interaction with Arteriovenous Shunting.
The amine ergot alkaloids, ergonovine and methylergonovine, can cause serious cardiovascular complications because of their vasospastic effects. Hypertension (more often with ergonovine) has been most commonly reported, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Other, less common adverse effects include acute myocardial infarction, transient chest pains, thrombophlebitis, tachycardia and palpitations. Therapy with ergot alkaloids should generally be avoided, except under special circumstances, in patients with chronic hypertension, preeclampsia or eclampsia, cardiovascular disease, cerebrovascular disease, or peripheral vascular disease. Caution is advised when these agents are administered to patients with venoatrial shunts, mitral valve stenosis, or sepsis. Close monitoring of cardiovascular status is highly recommended during therapy.
Brain Tumor
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Brain Tumor.
Organic nitrates and nitrites can increase cerebrospinal fluid pressure. Therapy with these agents should be administered cautiously, if at all, in patients with or at risk for intracranial hypertension, including those with cerebral hemorrhage, intracranial lesions, or recent head trauma.
Cardiovascular Conditions and Disorders
Major:
ergonovine
Ergonovine has a major potential interaction with Cardiovascular Conditions and Disorders.
The amine ergot alkaloids, ergonovine and methylergonovine, can cause serious cardiovascular complications because of their vasospastic effects. Hypertension (more often with ergonovine) has been most commonly reported, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Other, less common adverse effects include acute myocardial infarction, transient chest pains, thrombophlebitis, tachycardia and palpitations. Therapy with ergot alkaloids should generally be avoided, except under special circumstances, in patients with chronic hypertension, preeclampsia or eclampsia, cardiovascular disease, cerebrovascular disease, or peripheral vascular disease. Caution is advised when these agents are administered to patients with venoatrial shunts, mitral valve stenosis, or sepsis. Close monitoring of cardiovascular status is highly recommended during therapy.
Cerebrovascular Insufficiency
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Cerebrovascular Insufficiency.
Organic nitrates and nitrites may cause severe hypotension, syncope and shock, even with small doses. Hypotension induced by these agents may be accompanied by paradoxical bradycardia and increased angina pectoris. Therapy with nitrates and nitrites should be administered cautiously in patients who are volume-depleted or hypotensive (e.g., systolic blood pressure <90 mm Hg) or who, because of inadequate circulation to the brain or to other vital organs, would be unusually compromised by undue hypotension. Patients should be in a sitting or recumbent position during and immediately after drug administration, and monitored for symptoms of severe hypotension such as nausea, vomiting, weakness, pallor, perspiration, and syncope. Nitrate or nitrite therapy is considered contraindicated in patients with acute circulatory failure or shock.
Constrictive Pericarditis
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Constrictive Pericarditis.
Organic nitrates and nitrites may cause severe hypotension, syncope and shock, even with small doses. Hypotension induced by these agents may be accompanied by paradoxical bradycardia and increased angina pectoris. Therapy with nitrates and nitrites should be administered cautiously in patients who are volume-depleted or hypotensive (e.g., systolic blood pressure <90 mm Hg) or who, because of inadequate circulation to the brain or to other vital organs, would be unusually compromised by undue hypotension. Patients should be in a sitting or recumbent position during and immediately after drug administration, and monitored for symptoms of severe hypotension such as nausea, vomiting, weakness, pallor, perspiration, and syncope. Nitrate or nitrite therapy is considered contraindicated in patients with acute circulatory failure or shock.
Dehydration
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Dehydration.
Organic nitrates and nitrites may cause severe hypotension, syncope and shock, even with small doses. Hypotension induced by these agents may be accompanied by paradoxical bradycardia and increased angina pectoris. Therapy with nitrates and nitrites should be administered cautiously in patients who are volume-depleted or hypotensive (e.g., systolic blood pressure <90 mm Hg) or who, because of inadequate circulation to the brain or to other vital organs, would be unusually compromised by undue hypotension. Patients should be in a sitting or recumbent position during and immediately after drug administration, and monitored for symptoms of severe hypotension such as nausea, vomiting, weakness, pallor, perspiration, and syncope. Nitrate or nitrite therapy is considered contraindicated in patients with acute circulatory failure or shock.
Glaucoma/Intraocular Hypertension
Minor:
isosorbide mononitrate
Isosorbide mononitrate has a minor potential interaction with Glaucoma/Intraocular Hypertension.
Some medical references state that organic nitrates and nitrites may increase intraocular pressure and should be used with caution in patients with glaucoma. However, the effect on intraocular pressure is variable and brief, and there is no evidence that these drugs precipitate narrow-angle glaucoma. Amyl nitrate typically may cause a slight rise of 3+ mm for several seconds followed by a fall in intraocular pressure for 10 to 20 minutes, the latter secondary to a fall in blood pressure. Nitroglycerin rarely produces ocular side effects, and oral nitroglycerin appears to have few to no significant ocular side effects.
Head Injury
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Head Injury.
Organic nitrates and nitrites can increase cerebrospinal fluid pressure. Therapy with these agents should be administered cautiously, if at all, in patients with or at risk for intracranial hypertension, including those with cerebral hemorrhage, intracranial lesions, or recent head trauma.
Heart Attack
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Heart Attack.
The benefits of organic nitrates and nitrites in patients with acute myocardial infarction (AMI) or congestive heart failure have not been established and its use is not recommended in these settings. If used, it should be accompanied by careful clinical and hemodynamic monitoring to avoid the hazards of systemic hypotension and tachycardia, which in AMI can exacerbate myocardial ischemia. In general, oral or long-acting formulations of these drugs should not be used in the early management of AMI because of the difficulty in precisely controlling and rapidly terminating their hemodynamic effects should adverse reactions occur. Sublingual and other immediate- onset nitrates or nitrites should typically be avoided in suspected AMI with marked bradycardia or tachycardia, and should be used with extreme caution, if at all, in patients with right ventricular or inferior wall infarction. Rarely, sublingual nitroglycerin has produced hypotension accompanied by paradoxical bradycardia in patients with AMI and especially right ventricular infarction. The latter group of patients are also particularly dependent on adequate right ventricular preload to maintain cardiac output and can experience profound hypotension with nitrate or nitrite administration due to reduction of right ventricular preload.
Heart Failure
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Heart Failure.
The benefits of organic nitrates and nitrites in patients with acute myocardial infarction (AMI) or congestive heart failure have not been established and its use is not recommended in these settings. If used, it should be accompanied by careful clinical and hemodynamic monitoring to avoid the hazards of systemic hypotension and tachycardia, which in AMI can exacerbate myocardial ischemia. In general, oral or long-acting formulations of these drugs should not be used in the early management of AMI because of the difficulty in precisely controlling and rapidly terminating their hemodynamic effects should adverse reactions occur. Sublingual and other immediate- onset nitrates or nitrites should typically be avoided in suspected AMI with marked bradycardia or tachycardia, and should be used with extreme caution, if at all, in patients with right ventricular or inferior wall infarction. Rarely, sublingual nitroglycerin has produced hypotension accompanied by paradoxical bradycardia in patients with AMI and especially right ventricular infarction. The latter group of patients are also particularly dependent on adequate right ventricular preload to maintain cardiac output and can experience profound hypotension with nitrate or nitrite administration due to reduction of right ventricular preload.
Hemodialysis
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Hemodialysis.
The combined effect of organic nitrates or nitrites with hemodialysis, which often lowers blood pressure, can cause life-threatening hypotension. Therapy with these agents should be administered cautiously in patients requiring hemodialysis. The medication should be withheld before undergoing dialysis, and hemodynamic stability should be established prior to resumption of medication following dialysis. Nitroglycerin and isosorbide dinitrate are moderately dialyzed.
Hemorrhagic Stroke
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Hemorrhagic Stroke.
Organic nitrates and nitrites can increase cerebrospinal fluid pressure. Therapy with these agents should be administered cautiously, if at all, in patients with or at risk for intracranial hypertension, including those with cerebral hemorrhage, intracranial lesions, or recent head trauma.
High Blood Pressure
Major:
ergonovine
Ergonovine has a major potential interaction with High Blood Pressure.
The use of the amine ergot alkaloids, ergonovine and methylergonovine, is considered by some clinicians to be contraindicated in patients with hypertension. These agents can cause hypertension, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Patients with chronic hypertension or preeclampsia may be at increased risk for these complications. Of the two agents, methylergonovine has less tendency to cause hypertension, although preferably neither agent should be administered to at- risk patients.
Hypertrophic Cardiomyopathy
Moderate:
isosorbide mononitrate
Isosorbide mononitrate has a moderate potential interaction with Hypertrophic Cardiomyopathy.
Organic nitrates and nitrites may aggravate the angina associated with hypertrophic cardiomyopathy and should be administered cautiously in patients with this condition.
Hypotension
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Hypotension.
Organic nitrates and nitrites may cause severe hypotension, syncope and shock, even with small doses. Hypotension induced by these agents may be accompanied by paradoxical bradycardia and increased angina pectoris. Therapy with nitrates and nitrites should be administered cautiously in patients who are volume-depleted or hypotensive (e.g., systolic blood pressure <90 mm Hg) or who, because of inadequate circulation to the brain or to other vital organs, would be unusually compromised by undue hypotension. Patients should be in a sitting or recumbent position during and immediately after drug administration, and monitored for symptoms of severe hypotension such as nausea, vomiting, weakness, pallor, perspiration, and syncope. Nitrate or nitrite therapy is considered contraindicated in patients with acute circulatory failure or shock.
Liver Disease
Moderate:
ergonovine
Ergonovine has a moderate potential interaction with Liver Disease.
The amine ergot alkaloids, ergonovine and methylergonovine, appear to be eliminated by both renal and hepatic routes. Patients with renal and/or liver disease may be at greater risk for adverse effects from these agents due to decreased drug clearance. Caution is advised if these agents are used. Dosage adjustments may be necessary.
Pseudotumor Cerebri
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Pseudotumor Cerebri.
Organic nitrates and nitrites can increase cerebrospinal fluid pressure. Therapy with these agents should be administered cautiously, if at all, in patients with or at risk for intracranial hypertension, including those with cerebral hemorrhage, intracranial lesions, or recent head trauma.
Renal Dysfunction
Moderate:
ergonovine
Ergonovine has a moderate potential interaction with Renal Dysfunction.
The amine ergot alkaloids, ergonovine and methylergonovine, appear to be eliminated by both renal and hepatic routes. Patients with renal and/or liver disease may be at greater risk for adverse effects from these agents due to decreased drug clearance. Caution is advised if these agents are used. Dosage adjustments may be necessary.
Shock
Major:
isosorbide mononitrate
Isosorbide mononitrate has a major potential interaction with Shock.
Organic nitrates and nitrites may cause severe hypotension, syncope and shock, even with small doses. Hypotension induced by these agents may be accompanied by paradoxical bradycardia and increased angina pectoris. Therapy with nitrates and nitrites should be administered cautiously in patients who are volume-depleted or hypotensive (e.g., systolic blood pressure <90 mm Hg) or who, because of inadequate circulation to the brain or to other vital organs, would be unusually compromised by undue hypotension. Patients should be in a sitting or recumbent position during and immediately after drug administration, and monitored for symptoms of severe hypotension such as nausea, vomiting, weakness, pallor, perspiration, and syncope. Nitrate or nitrite therapy is considered contraindicated in patients with acute circulatory failure or shock.
Tachyarrhythmia
Major:
ergonovine
Ergonovine has a major potential interaction with Tachyarrhythmia.
The amine ergot alkaloids, ergonovine and methylergonovine, can cause serious cardiovascular complications because of their vasospastic effects. Hypertension (more often with ergonovine) has been most commonly reported, particularly when administered IV undiluted or at an excessive rate or when used in conjunction with regional anesthesia or vasoconstrictors. Headaches, seizures, cerebrovascular accidents and death have been associated with the hypertensive episodes. Other, less common adverse effects include acute myocardial infarction, transient chest pains, thrombophlebitis, tachycardia and palpitations. Therapy with ergot alkaloids should generally be avoided, except under special circumstances, in patients with chronic hypertension, preeclampsia or eclampsia, cardiovascular disease, cerebrovascular disease, or peripheral vascular disease. Caution is advised when these agents are administered to patients with venoatrial shunts, mitral valve stenosis, or sepsis. Close monitoring of cardiovascular status is highly recommended during therapy.
More resources
ergonovine
A total of 284 drugs are known to interact with ergonovine.
- Ergonovine is in the drug class uterotonic agents.
- Ergonovine is used to treat the following conditions:
isosorbide mononitrate
A total of 239 drugs are known to interact with isosorbide mononitrate.
- Isosorbide mononitrate is in the drug class antianginal agents.
- Isosorbide mononitrate is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.