Isosorbide dinitrate is contraindicated in: known hypersensitivity to the active substance, to any of the excipients, or to other nitrates or nitrites, low filling pressure, hypertrophic obstructive cardiomyopathy (HOCM), constrictive pericarditis, cardiac tamponade, cardiogenic shock (unless some means of maintaining an adequate diastolic pressure is undertaken), circulatory collapse, aortic and/or mitral valve stenosis, severe hypotension (systolic blood pressure less than 90 mmHg), head trauma, cerebral haemorrhage, diseases associated with an increased intracranial pressure, marked anaemia, hypovolaemia, closed angle glaucoma, patients receiving phosphodiesterase-5 inhibitors (e.g. sildenafil, tadalafil, vardenafil) (see Interactions), patients receiving the soluble guanylate cyclase stimulator riociguat (see Interactions).
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