Isosorbide mononitrate pharmacokinetics

Other nitrates are similar to nitroglycerin in their pharmacokinetics and pharmacodynamics. Isosorbide dinitrate is another commonly used nitrate it is available in sublingual and oral forms. Isosorbide dinitrate is rapidly denitrated in tbe liver to isosorbide mononitrate, which is also active. Isosorbide mononitrate is available as a separate drug for oral use. Several other nitrates are available for oral use and, like the oral nitroglycerin preparation, have an intermediate duration of action (4-6 hours). Amyl nitrite is a volatile and rapidly acting vasodilator that was used for angina by the inhalational route but is now rarely prescribed. 

Orthostatic hypotension occurred when levosimendan was given with isosorbide mononitrate. The haemodynamic effects of levosimendan were not significantly altered by captopiil, carvedilol or other unnamed beta blockers, or felodipine. Levosimendan does not alter the effects of warfarin. Itraconazole does not alter the pharmacokinetics of levosimendan. Levosimendan appears not to interact adversely with alcohoL... 

Vree TB, Dammers E, Valducci R. Sex-related differences in the pharmacokinetics of isosorbide-5-mononitrate (60 mg) after repeated oral administration of two different original prolonged release formulations. Int J Clin Pharmacol Ther 2004 42 463-72. 

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