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It is vital to be aware of the safety information and warnings associated with the use of isosorbide dinitrate (Isordil). Below are key points to consider, and you should discuss any concerns with your healthcare provider.

• Risk of Low Blood Pressure: Combining isosorbide dinitrate with erectile dysfunction medications or alcohol can significantly lower your blood pressure, posing a life-threatening risk. Be vigilant for symptoms such as faintness, irregular heartbeat, nausea, vomiting, visual changes, increased sweating, or cold and clammy skin. If you experience these symptoms, contact your healthcare provider immediately. It is also common to feel dizzy or unstable when moving from a sitting to a standing position; therefore, change positions slowly until your body acclimatizes to the medication. Persistent dizziness or a rapid heartbeat beyond a week of treatment should be reported to your provider. The risk is heightened for individuals using erectile dysfunction drugs, those over 65, and alcohol users.

• Development of Tolerance: Over time, your body may develop a tolerance to isosorbide dinitrate, diminishing its effectiveness. This condition cannot be resolved by increasing the dosage. To minimize the risk of tolerance, adhere strictly to the prescribed dosing schedule. If you find your chest pain worsening, consult your healthcare provider. Long-term use increases the risk of developing tolerance.

Please follow these guidelines carefully to ensure safe and effective use of isosorbide dinitrate.

Common side effects:

• Headaches
• Dizziness

Less common but important to monitor:

• Low blood pressure
• Fainting

Serious side effects:

• Feeling like you might faint, particularly when standing
• Slowed or irregular heartbeat
• Blurred vision or changes in vision
• Confusion

When taking isosorbide, it's important to be aware of potential interactions with other medications and substances that can affect its safety and effectiveness. Here are some key interactions to consider:

Medications to Avoid:

• Phosphodiesterase-5 (PDE-5) Inhibitors: Combining isosorbide with medications like Sildenafil, Tadalafil, Vardenafil, or Avanafil can lead to severe drops in blood pressure, which may be life-threatening.

• Riociguat: This medication, used for certain types of pulmonary hypertension, should not be taken with isosorbide due to the risk of dangerously low blood pressure.

Medications Requiring Caution:

• Blood Pressure Medications: Drugs such as beta-blockers, calcium channel blockers, and other antihypertensives can enhance the blood pressure-lowering effects of isosorbide, increasing the risk of dizziness or fainting.

• Diuretics: These medications can lead to dehydration and amplify the blood pressure-lowering effects of isosorbide, potentially causing severe hypotension.

• Alcohol: Consuming alcohol while on isosorbide can intensify its blood pressure-lowering effects, leading to dizziness or fainting.

Other Considerations:

• Certain Antifungal Medications: Drugs like Fluconazole can increase the levels of isosorbide in your body, potentially enhancing its effects and side effects.

• Sulfhydryl-Containing Compounds: Substances such as N-acetylcysteine may interact with isosorbide, potentially affecting its effectiveness.

Always inform your healthcare provider about all medications, supplements, and substances you are using to ensure safe and effective use of isosorbide.