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Does Riociguat Interact with Isosorbide Mononitrate?

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

How This Interaction Works

The interaction between Riociguat and Isosorbide Mononitrate 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 Riociguat and your doctor is considering prescribing Isosorbide Mononitrate (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
💊 Riociguat(Adempas)+💊 Isosorbide Mononitrate(Isosorbide Mononitrate)

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
Soluble Guanylate Cyclase Stimulator
Drug B class
Nitrate Vasodilator
Source
NLP:isosorbide mononitrate

What this means in plain English

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

About Riociguat and Isosorbide Mononitrate

Riociguat is a Soluble Guanylate Cyclase Stimulator, while Isosorbide Mononitrate is a Nitrate Vasodilator. Riociguat is also sold under the brand name Adempas. Both medications are taken by mouth. Riociguat additionally carries an FDA boxed warning, the FDA's strongest safety alert.

What the FDA label says

"soluble guanylate cyclase stimulation"

📖 Source: NLP:isosorbide mononitrate

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Data integrity: Every interaction shown is extracted directly from official U.S. FDA drug labeling via openFDA and the U.S. National Library of Medicine (NIH) — no interactions are invented, inferred, or manually edited. Maintained by CheckDrugInteractions.com. See our methodology or report a correction at support@checkdruginteractions.com.

Data sourced from U.S. FDA drug labeling via openFDA and the NIH National Library of Medicine, supplemented with a small number of well-established interactions from curated clinical references. For informational purposes only. Always consult your pharmacist or physician.