Drug interactions
Isosorbide mononitrate + Riociguat
Severity: Contraindicated
Isosorbide mononitrate and Riociguat: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Riociguat stimulates soluble guanylate cyclase and nitrates supply nitric oxide, producing additive vasodilation. Severe, potentially life-threatening hypotension can result. Labeling contraindicates concomitant use of riociguat with nitrates in any form.
What this interaction means in plain words
Isosorbide mononitrate and Riociguat are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Isosorbide mononitrate belongs to Cardiovascular; Riociguat belongs to Cardiovascular.
Why it happens
Additive cGMP-mediated vasodilation from nitric oxide donation and soluble guanylate cyclase stimulation.
What to do
Do not co-administer. Use a non-nitrate antianginal while on riociguat.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Isosorbide mononitrate
- Avanafil + Isosorbide mononitrate Contraindicated
- Isosorbide mononitrate + Sildenafil Contraindicated
- Isosorbide mononitrate + Tadalafil Contraindicated
- Isosorbide mononitrate + Vardenafil Contraindicated
- Ergotamine + Isosorbide mononitrate Major
- Isosorbide mononitrate + Methylergonovine Major
Other interactions of Riociguat
- Avanafil + Riociguat Contraindicated
- Dipyridamole + Riociguat Contraindicated
- Isosorbide dinitrate + Riociguat Contraindicated
- Nitroglycerin + Riociguat Contraindicated
- Riociguat + Sildenafil Contraindicated
- Riociguat + Tadalafil Contraindicated
Frequently asked questions
Can I take Isosorbide mononitrate with Riociguat?
MediHelp rates the interaction as contraindicated. Isosorbide mononitrate and Riociguat are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Riociguat stimulates soluble guanylate cyclase and nitrates supply nitric oxide, producing additive vasodilation. Severe, potentially life-threatening hypotension can result. Labeling contraindicates concomitant use of riociguat with nitrates in any form.
How serious is the interaction between Isosorbide mononitrate and Riociguat?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not co-administer. Use a non-nitrate antianginal while on riociguat.
What other medicines interact with Isosorbide mononitrate?
MediHelp also lists interactions of Isosorbide mononitrate with, for example, Avanafil, Sildenafil, Tadalafil. The full list is on the Isosorbide mononitrate page.
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