Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Take on an empty stomach with water to increase the rate of absorption.1
• Avoid alcohol2
• May decrease potassium levels, monitor for changes.3
• Vitamin C may play a role in helping to prevent nitrate tolerance from developing with long term use of nitrate agents.4
• A study suggests N-acetyl cysteine may improve the effectiveness of isosorbide mononitrate.5
• These herbs may have cardioactive properties and should therefore be avoided while using Monoket: black hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy root, squill bulb leaf scales, white horehound, mate, scotch broom flower, shepherd's purse, and wild carrot.6
• Avoid natural licorice, ginseng, and Ma huang or ephedra with Monoket, because the herbs may cause hypertension.7
References1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Bassenge E, Fink N, Skatchkov M, Fink B. Dietary supplement with vitamin C prevents nitrate tolerance. J Clin Invest 1998;102:67-71.
4 Watanabe H, Kakihana M, Ohtsuka S, Sugishita Y. Randomized, double-blind, placebo-controlled study of the preventive effect of supplemental oral vitamin C on attenuation of development of nitrate tolerance. J Am Coll Cardiol 1998;31:1323-29.
5 Svendsen JH, Klarlund K, Aldershvile J, Waldorff S. N-Acetylcysteine modifies the acute effects of isosorbide-5-mononitrate in angina pectoris patients evaluated by exercise testing. J Cardiovasc Pharmacol 1989;13:320-23
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
6 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
7 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
7 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.