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Overview: Isosorbide dinitrate is a tablet taken to prevent chest pain from heart disease. It works by relaxing the blood vessels that deliver oxygen to the heart. Common side effects include headache and dizziness. Serious side effects are rare, but can include low blood pressure. Notify your healthcare provider right away if you have confusion or feel unusually weak or tired.

Uses

What is isosorbide dinitrate used for?

Isosorbide dinitrate is commonly used to prevent chest pain caused by heart disease. 

Isosorbide dinitrate may also be used for other conditions as determined by your healthcare provider.

How does isosorbide dinitrate work (mechanism of action)?

Isosorbide dinitrate helps your blood vessels relax so that blood can move through them more easily and bring oxygen to your heart. This helps prevent chest pain from happening.

How is isosorbide dinitrate supplied (dosage forms)?

Brand and other names

  • Isordil

Dosage forms and strengths

  • 5 mg, 10 mg, 20 mg, 30 mg, 40 mg oral tablets

How should I store isosorbide dinitrate?

Isosorbide dinitrate should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store tightly closed in a cool, dry place. Protect from light. 

Side Effects

What are the most common side effects of isosorbide dinitrate?

The most common side effects of isosorbide dinitrate are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Headache
  • Dizziness or lightheadedness
  • Low blood pressure (see below)
  • Fast heartbeat

There may be other side effects of isosorbide dinitrate that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of isosorbide dinitrate?

While less common, the most serious side effects of isosorbide dinitrate are described below, along with what to do if they happen.

Low Blood Pressure (Hypotension). Isosorbide dinitrate may cause low blood pressure. Low blood pressure is more likely to occur if you have excessive sweating or persistent or severe vomiting or diarrhea. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

Chest Pain. While isosorbide dinitrate is commonly used to prevent chest pain, it may cause chest pain in certain people, which can be a symptom of a heart attack. The risk of chest pain is increased in people with existing heart disease. Do not take isosorbide dinitrate if you have had a recent heart attack without talking to your healthcare provider. Get emergency help if you have any of the following symptoms of a heart attack.

  • Chest pain or pressure
  • Fast or abnormal heartbeat
  • Trouble breathing
  • Pain in your back, jaw, throat, or arm
  • Sweating, upset stomach, vomiting, or dizziness

Severe Allergic Reactions. Isosorbide dinitrate may cause allergic reactions, which can be serious. Stop taking isosorbide dinitrate and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use isosorbide dinitrate?

Allergies to Ingredients. People who are allergic to any of the following should not take isosorbide dinitrate.

  • Isordil
  • ISDN
  • Isosorbide dinitrate
  • Any of the ingredients in the specific product dispense

Your pharmacist can tell you all of the ingredients in the specific isosorbide dinitrate products they stock.

Drug Interactions. Isosorbide dinitrate should not be taken while you are using certain other medicines. Before taking isosorbide dinitrate, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about isosorbide dinitrate before using it?

Do not take isosorbide dinitrate unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share isosorbide dinitrate with other people, even if they have the same condition as you. It may harm them.

Keep isosorbide dinitrate out of the reach of children.

Isosorbide dinitrate should be taken regularly, on a specific schedule, to prevent chest pain. It does not start working quickly enough to be taken to treat acute episodes of chest pain. Get help right away if you develop chest pain.

When taking isosorbide dinitrate, you may feel lightheaded when standing up, especially after getting up from lying down or sitting. Be sure to rise slowly to avoid dizziness.

Isosorbide dinitrate can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how isosorbide dinitrate affects you.

Headaches are a common side effect with isosorbide dinitrate. Headaches often go away over time. If headaches continue, do not adjust your dose or stop taking isosorbide dinitrate. Ask your healthcare provider about how to handle this. 

What should I tell my healthcare provider before using isosorbide dinitrate?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if isosorbide dinitrate is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart problems, including heart failure and hypertrophic cardiomyopathy
  • Recent heart attack
  • Low blood pressure
  • At risk for dehydration, such as with persistent or severe vomiting or diarrhea

Pregnancy. It is not known if or how isosorbide dinitrate could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if isosorbide dinitrate passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take isosorbide dinitrate while breastfeeding.

Interactions

Does isosorbide dinitrate interact with foods or drinks?

There are no known interactions between isosorbide dinitrate and foods or drinks.

The risk of dizziness and low blood pressure may be increased if you drink alcohol while taking isosorbide dinitrate.

Does isosorbide dinitrate interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking isosorbide dinitrate.

  • A phosphodiesterase-5 (PDE-5) inhibitor, such as avanafil (Stendra), sildenafil (Viagra, Revatio, and others), tadalafil (Cialis and others), or vardenafil (Levitra, Staxyn), which is a medicine used for erectile dysfunction or pulmonary arterial hypertension (PAH)
  • Riociguat (Adempas), which is a medicine used for pulmonary arterial hypertension (PAH)
  • A medicine for high blood pressure

This may not be a complete list of medicines that can interact with isosorbide dinitrate. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much isosorbide dinitrate?

If you or someone else has used too much isosorbide dinitrate, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of isosorbide dinitrate?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.