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This safety information outlines critical warnings regarding the use of isosorbide dinitrate (Isordil). Please read these details carefully and consult with your healthcare provider if you have any questions or concerns.

• Low Blood Pressure Risks: Isosorbide dinitrate can significantly lower your blood pressure, particularly when taken with erectile dysfunction medications or alcohol. This could lead to life-threatening conditions. Seek immediate medical attention if you experience symptoms such as feeling faint, irregular heartbeat, nausea, vomiting, blurred vision, excessive sweating, or cold, clammy skin. Some individuals may feel dizzy or faint when changing positions quickly, such as moving from sitting to standing. To reduce these effects, change positions gradually until your body adjusts to the medication. Contact your healthcare provider if dizziness or rapid heart rate persists a week after starting treatment. Those at higher risk include individuals over 65 years of age, users of erectile dysfunction medications, and those who consume alcohol.

• Development of Tolerance: Over time, your body may develop a tolerance to isosorbide dinitrate, reducing its effectiveness. This occurs more frequently if doses are not taken as scheduled. It is crucial to adhere strictly to your healthcare provider's dosing instructions. If you notice worsening chest pain, consult your provider. Increasing the medication dose will not overcome tolerance. Long-term users are particularly at risk.

Please make sure to follow your healthcare provider's guidance and report any adverse effects promptly.

When taking Dilatrate-SR (isosorbide dinitrate), it's important to be aware of potential interactions with other medications and substances that can affect your health. Here are some key interactions to consider:

Medications to Avoid:

• Erectile Dysfunction Drugs: Combining Dilatrate-SR with medications like Sildenafil, Tadalafil, Vardenafil, or Avanafil can lead to a dangerous drop in blood pressure, potentially causing severe hypotension, fainting, or even heart problems.

• Riociguat: This medication, used to treat certain types of high blood pressure in the lungs, should not be taken with Dilatrate-SR due to the risk of significant blood pressure reduction.

Medications to Use with Caution:

• Other Blood Pressure Medications: Using Dilatrate-SR alongside other drugs that lower blood pressure can enhance the blood pressure-lowering effect, increasing the risk of dizziness, lightheadedness, or fainting.

• Vasodilators: Medications that widen blood vessels, when taken with Dilatrate-SR, may amplify the vasodilating effects, leading to excessive blood pressure reduction.

Substances to Limit or Avoid:

• Alcohol: Drinking alcohol while on Dilatrate-SR can intensify its blood pressure-lowering effects, resulting in dizziness, lightheadedness, or fainting. It's advisable to limit or avoid alcohol consumption during treatment.

General Advice:

Always inform your healthcare provider about all the medications, supplements, and herbal products you are currently using. This helps in assessing potential interactions and ensuring your treatment plan is safe and effective. If you experience symptoms like dizziness, fainting, or an irregular heartbeat while taking Dilatrate-SR, contact your doctor promptly.