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Does Isosorbide Mononitrate Interact with Riociguat?

Isosorbide Mononitrate and Riociguat have a contraindicated drug interaction according to U.S. FDA drug labeling data. Concomitant use of isosorbide mononitrate with riociguat, a soluble guanylate cyclase stimulator, is contraindicated. The mechanism involves soluble guanylate cyclase stimulation. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.

Severity
Contraindicated
Isosorbide Mononitrate Class
Nitrate Vasodilator
Riociguat Class
Soluble Guanylate Cyclase Stimulator
Management
Do not take together
Data Source
U.S. FDA via OpenFDA

How This Interaction Works

The interaction between Isosorbide Mononitrate and Riociguat occurs because soluble guanylate cyclase stimulation. Clinically, this means concomitant use of isosorbide mononitrate with riociguat, a soluble guanylate cyclase stimulator, is contraindicated. Because of the severity of this interaction, these medications are contraindicated — meaning they should not be taken together under any circumstances. If you are currently taking both, contact your healthcare provider immediately to discuss alternatives.

What To Tell Your Doctor or Pharmacist

If you are taking Isosorbide Mononitrate and your doctor is considering prescribing Riociguat (or vice versa), make sure to:

  • Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
  • Ask whether the benefits of combining these medications outweigh the risks for your specific situation
  • Ask what symptoms to watch for that would indicate the interaction is causing problems
  • Ask about alternative medications that do not interact with your current regimen
  • Ask how frequently you should be monitored while these are co-prescribed
  • Never stop or change either medication without first consulting your healthcare provider
💊 Isosorbide Mononitrate(Isosorbide Mononitrate)+💊 Riociguat(Adempas)

Severity & Interaction Details

⛔
contraindicated
Avoid this combination
FDA labeling lists this pair as contraindicated. The risk outweighs the benefit in nearly all cases.
Severity scale
MinorContra
On record
Yes
Drug A class
Nitrate Vasodilator
Drug B class
Soluble Guanylate Cyclase Stimulator
Source
NLP:isosorbide mononitrate

What this means in plain English

Concomitant use of isosorbide mononitrate with riociguat, a soluble guanylate cyclase stimulator, is contraindicated.

What the FDA label says

"soluble guanylate cyclase stimulation"

📖 Source: NLP:isosorbide mononitrate

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Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine. For informational purposes only. Always consult your pharmacist or physician.