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Isosorbide Dinitrate

Drug Information

Isosorbide dinitrate (ISDN) is used primarily to prevent and treat angina, and in the treatment of acute heart attacks and heart failure.

Common brand names:

Dilatrate-SR, Isordil Titradose

Summary of Interactions with Vitamins, Herbs, & Foods

What Are Nutrient Interactions
Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • High-Fat

    Taking sustained-release tablets of ISDN with a high-fat meal might increase the absorption of the drug.1 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.

  • 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.3 , 4 Another controlled study revealed that intravenous NAC enhanced the beneficial effects of ISDN on heart function.5 Therefore, people taking isosorbide dinitrate might benefit from supplemental NAC.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required 

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. 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.

2. 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.

3. 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.

4. 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.

5. 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.

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