Isosorbide Mononitrate (Imdur) and Ketamine Therapy | Tovani Health
Imdur (Isosorbide Mononitrate) (also: Monoket) — Long-acting organic nitrate (chronic angina)
Verdict at Tovani Health
Compatible; the absolute PDE5-inhibitor contraindication matters more than the KAP interaction.
Isosorbide and ketamine are compatible. Same framing as nitroglycerin: the direct interaction with KAP is minimal, but nitrates are absolutely contraindicated with PDE5 inhibitors (sildenafil, tadalafil, vardenafil) due to severe hypotension risk. That contraindication is independent of ketamine but worth flagging since erectile dysfunction medications are common in the cardiac patient population.
If you take Imdur regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Imdur interacts with ketamine
Isosorbide mononitrate releases nitric oxide, producing vasodilation. Long-acting oral nitrate for chronic angina prophylaxis. No direct ketamine PK interaction.
What we do at intake
Disclose use and dose. Do not take any PDE5 inhibitor without your cardiologist's awareness.
Bottom line
Isosorbide and ketamine are compatible. Same framing as nitroglycerin: the direct interaction with KAP is minimal, but nitrates are absolutely contraindicated with PDE5 inhibitors (sildenafil, tadalafil, vardenafil) due to severe hypotension risk. That contraindication is independent of ketamine but worth flagging since erectile dysfunction medications are common in the cardiac patient population.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Imdur (Isosorbide Mononitrate) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 19, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.