Also indexed as: Isordil®, Sorbitrate®
Safetychecker Summary
for Isosorbide Dinitrate
(for details about the summarized interactions, read the full article)
 May be Beneficial: Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better. |
High fat meals
N-acetyl cysteine
|
 Avoid: Adverse interaction—Avoid these supplements
when taking this medication because taking them together may cause undesirable or dangerous
results. |
Alcohol
|
| Depletion or interference |
None known
|
| Side effect reduction/prevention |
None known
|
| Reduced drug
absorption/bioavailability |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
N-acetyl
cysteine
The beneficial effects of ISDN are reduced following long-term treatment with the drug through
a process known as tolerance. Controlled studies have shown that using intravenous and oral
N-acetyl cysteine (NAC) reverses or prevents tolerance to nitrates.1 2
Another controlled study revealed that intravenous NAC enhanced the beneficial effects of ISDN
on heart function.3 Therefore, people taking isosorbide dinitrate might benefit
from supplemental NAC.
Interactions with Foods and Other Compounds
Food
Taking sustained-release tablets of ISDN with a high-fat meal might increase the absorption of
the drug.4 Individuals who switch from a high-fat diet to a low-fat diet might require a change in the amount of ISDN taken
daily. Therefore, people taking ISDN should talk with their healthcare practitioner before
starting a low-fat diet.
Alcohol
People taking ISDN might experience lightheadedness on standing, especially after rising from
a lying-down or seated position. Drinking alcohol with ISDN may increase the frequency of this
side effect.5 Therefore, individuals taking ISDN should avoid drinking alcohol.
References:
1. Boesgaard S, Aldershvile J, Poulsen HE. Preventive administration of
intravenous N-acetylcysteine and development of tolerance to isosorbide dinitrate in patients
with angina pectoris. Circulation 1992;85:143–9.
2. Vincent J, Kongpatanakul S, Blaschke TF, Hoffman BB. Desensitization
of nitrate-induced venodilation: reversal with oral N-acetylcysteine in humans. J
Cardiovasc Pharmacol 1992;20:907–12.
3. Mehra A, Shotan A, Ostrzega E, et al. Potentiation of isosorbide
dinitrate effects with N-acetylcysteine in patients with chronic heart failure.
Circulation 1994;89:2595–600.
4. Sata H, Inoue K, Nii T, Juroda T. Influence of diet on the single-dose
pharmacokinetics of isosorbide 5-mononitrate and sustained-release isosorbide dinitrate.
Biol Pharm Bull 1997;20:1111–5.
5. Sifton DW, ed. Physicians’ Desk Reference. Montvale,
NJ: Medical Economics Company, Inc., 2000, 566–8.
Copyright © 2002 Healthnotes, Inc. All rights
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in this article.
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Safetychecker.
The information presented in Healthnotes is for informational
purposes only. It is based on scientific studies (human, animal, or in vitro),
clinical experience, or traditional usage as cited in each article. The results reported may
not necessarily occur in all individuals. For many of the conditions discussed, treatment with
prescription or over-the-counter medication is also available. Consult your doctor,
practitioner, and/or pharmacist for any health problem and before using any supplements or
before making any changes in prescribed medications. Information expires December 2003.
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