Drug General Information (ID: DDIVFXC5BH)
  Drug Name Isosorbide mononitrate Drug Info Amifostine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Vasodilator Agents Cytoprotective Agent
  Structure

 Mechanism of Isosorbide mononitrate-Amifostine Interaction (Severity Level: Moderate)
     Additive hypotensive effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Isosorbide mononitrate Amifostine
      Mechanism 1 Hypotensive effects
Guanylate cyclase  Agonist
Antihypertensive agent
      Key Mechanism Factor 1
Factor Name Guanylate cyclase soluble Structure Sequence
Protein Family Adenylyl cyclase class-4/guanylyl cyclase family
Protein Function
There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions.
    Click to Show/Hide
      Mechanism Description
  • Additive hypotensive effects by the combination of Isosorbide mononitrate and Amifostine 
      Mechanism 2 Hypotensive effects
Guanylate cyclase  Agonist
Hypotensive effects
      Key Mechanism Factor 2
Factor Name Guanylate cyclase soluble Structure Sequence
Protein Family Adenylyl cyclase class-4/guanylyl cyclase family
Protein Function
There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions.
    Click to Show/Hide
      Mechanism Description
  • Additive hypotensive effects by the combination of Isosorbide mononitrate and Amifostine 

Recommended Action
      Management If medically feasible, antihypertensive medications should be interrupted 24 hours prior to amifostine administration. Blood pressure should be closely monitored during and after treatment. In addition to hypotension, transient hypertension or exacerbation of preexisting hypertension may occur from intravenous hydration, discontinuation of antihypertensive medications, or other causes. Patients who continue their hypotensive medication(s) during amifostine therapy should be carefully monitored for the development of hypotension.

References
1 Bailey DG, Dresser GK "Natural products and adverse drug interactions." Can Med Assoc J 170 (2004): 1531-2. [PMID: 15136542]
2 Product Information. Xatral (alfuzosin). Sanofi-Synthelabo Canada Inc, Markham, ON.
3 Product Information. Ethyol (amifostine). Alza, Palo Alto, CA.