Taking isosorbide mononitrate and isosorbide dinitrate with other medicines and herbal supplements

Some medicines can affect the way isosorbide mononitrate and isosorbide dinitrate work.

If you take other medicines that lower blood pressure with isosorbide mononitrate or isosorbide dinitrate, it can sometimes lower your blood pressure too much. This might make you feel dizzy or faint.

Tell your doctor if this happens to you. They may need to change your dose.

Check with a pharmacist or your doctor before starting to take isosorbide mononitrate or isosorbide dinitrate if you're taking:

• medicines for erection problems including sildenafil, avanafil, tadalafil or vardenafil
• riociguat, used to treat pulmonary hypertension
• medicines for high blood pressure or heart problems
• medicines for depression or other mental health conditions
• medicines for migraine that contain ergotamine such as Migril
• sapropterin, a medicine for phenylketonuria (PKU)

Taking isosorbide mononitrate or isosorbide dinitrate with painkillers

Paracetamol is safe to take with isosorbide mononitrate or isosorbide dinitrate.

Do not take non-steroidal anti-inflammatory drugs (NSAIDs) regularly, such as ibuprofen, aspirin and naproxen (unless it's prescribed by your doctor). These may make your angina or heart failure worse.

Talk to your pharmacist if you need a painkiller stronger than paracetamol.