Isosorbide dinitrate interactions

Isosorbide dinitrate (Isordil, Dilatrate), a nitrate has 29 documented interactions across the FDA labels and fact sheets we index: 7 major, 16 moderate, 6 minor, and 0 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (7)

  • AvanafilPDE5 inhibitorMajor

    Do not use Isosorbide Dinitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide dinitrate label, Contraindications)

  • Cilostazolantiplatelet agentMajor

    Do not use Isosorbide Dinitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide dinitrate label, Contraindications)

  • NitroglycerinnitrateMajor

    Hypersensitivity to Nitroglycerin Lingual Spray or to other nitrates or nitrites or any excipient. (Nitroglycerin label, Contraindications)

  • RiociguatvasodilatorMajor

    Do not use Isosorbide Dinitrate in patients who are taking the soluble guanylate cyclase stimulator riociguat. (Isosorbide dinitrate label, Contraindications)

  • SildenafilPDE5 inhibitorMajor

    Do not use Isosorbide Dinitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide dinitrate label, Contraindications)

  • TadalafilPDE5 inhibitorMajor

    Do not use Isosorbide Dinitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide dinitrate label, Contraindications)

  • VardenafilPDE5 inhibitorMajor

    Do not use Isosorbide Dinitrate in patients who are taking certain drugs for erectile dysfunction (phosphodiesterase inhibitors), such as sildenafil, tadalafil, or vardenafil. (Isosorbide dinitrate label, Contraindications)

Moderate interactions (16)

  • AlcoholAlcoholModerate

    Alcohol, in particular, has been found to exhibit additive effects of this variety. (Isosorbide dinitrate label, Drug interactions)

  • Alfuzosinalpha blockerModerate

    Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

  • CaptoprilACE inhibitorModerate

    Valvular Stenosis: There is concern, on theoretical grounds, that patients with aortic stenosis might be at particular risk of decreased coronary perfusion when treated with vasodilators because they do not develop as much afterload reduction as others. (Captopril label, Precautions)

  • Dexmedetomidinealpha-adrenergic agonistModerate

    • Co-administration with Other Vasodilators or Negative Chronotropic Agents: Use with caution due to additive pharmacodynamic effects. (Dexmedetomidine label, Warnings and precautions)

  • DicyclomineanticholinergicModerate

    …drugs including dicyclomine hydrochloride: amantadine, antiarrhythmic agents of Class I (e.g., quinidine), antihistamines, antipsychotic agents (e.g., phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics (e.g., meperidine), nitrates and nitrites, sympathomimetic agents, tricyclic antidepressants, and other drugs having anticholinergic activity. (Dicyclomine label, Drug interactions)

  • DofetilideantiarrhythmicModerate

    …oral anticoagulants, calcium channel blockers, beta blockers, cardiac glycosides, inducers of CYP3A4, substrates and inhibitors of CYP3A4, substrates and inhibitors of P-glycoprotein, nitrates, sulphonylureas, loop diuretics, potassium sparing diuretics, thiazide diuretics, substrates and inhibitors of tubular organic cation transport, and QTc-prolonging drugs. (Dofetilide label, Drug interactions)

  • Econazoleazole antifungalModerate

    Most cases reported product application with use under occlusion, genital application, or application to a large body surface area which may increase the systemic absorption of econazole nitrate. (Econazole label, Drug interactions)

  • HydralazinevasodilatorModerate

    Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

  • Isosorbide dinitrate and hydralazinenitrateModerate

    Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

  • Isosorbide mononitratenitrateModerate

    Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

  • Lidocaine and prilocainelocal anestheticModerate

    …methemoglobinemia when concurrently exposed to the following drugs, which could include other local anesthetics: Examples of Drugs Associated with Methemoglobinemia: Class Examples Nitrates/Nitrites nitric oxide, nitroglycerin, nitroprusside, nitrous oxide Local anesthetics articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine,… (Lidocaine and prilocaine label, Drug interactions)

  • MinoxidilvasodilatorModerate

    Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

  • NiacinModerate

    Caution should also be used when niacin extended-release tablets are used in patients with unstable angina or in the acute phase of an MI, particularly when such patients are also receiving vasoactive drugs such as nitrates, calcium channel blockers, or adrenergic blocking agents. (Niacin label, Warnings and precautions)

  • Treprostinilprostaglandin analogModerate

    Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

  • Verapamilcalcium channel blockerModerate

    Antihypertensive Agents Verapamil administered concomitantly with oral antihypertensive agents (e.g., vasodilators, angiotensin-converting enzyme inhibitors, diuretics, beta blockers) will usually have an additive effect on lowering blood pressure. (Verapamil label, Drug interactions)

  • VericiguatvasodilatorModerate

    Drug Interactions The vasodilating effects of isosorbide dinitrate may be additive with those of other vasodilators. (Isosorbide dinitrate label, Drug interactions)

Minor mentions (6)

  • Dutasteride and tamsulosin5-alpha reductase inhibitorMinor

    Alpha-adrenergic antagonists and PDE-5 inhibitors are both vasodilators that can lower blood pressure. (Dutasteride and tamsulosin label, Warnings and precautions)

  • EpinephrinesympathomimeticMinor

    Drugs antagonizing pressor effects of epinephrine α-blockers, such as phentolamine Vasodilators, such as nitrates Diuretics Antihypertensives Ergot alkaloids Drugs potentiating pressor effects of epinephrine • Sympathomimetics • β-blockers, such as propranolol • Tricyclic anti-depressants • Monoamine oxidase (MAO) inhibitors • Catechol-O-methyl transferase (COMT)… (Epinephrine label, Drug interactions)

  • Finasteride5-alpha reductase inhibitorMinor

    …acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, H 2 antagonists and quinolone anti-infectives without evidence of clinically… (Finasteride label, Drug interactions)

  • Lisinopril and hydrochlorothiazideACE inhibitorMinor

    Other Agents: Lisinopril has been used concomitantly with nitrates and/or digoxin without evidence of clinically significant adverse interactions. (Lisinopril and hydrochlorothiazide label, Drug interactions)

  • Nifedipinedihydropyridine calcium channel blockerMinor

    Long-acting Nitrates Nifedipine may be safely co-administered with nitrates, but there have been no controlled studies to evaluate the antianginal effectiveness of this combination. (Nifedipine label, Drug interactions)

  • Tamsulosinalpha blockerMinor

    Alpha-adrenergic blockers and PDE5 inhibitors are both vasodilators that can lower blood pressure. (Tamsulosin label, Warnings and precautions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.