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Phosphodiesterase-5 inhibitors: Phosphodiesterase-5 inhibitors e.g. sildenafil, potentiate the hypotensive effects of isosorbide dinitrate. This might lead to life-threatening cardiovascular complications. Therefore, isosorbide dinitrate must not be given to patients receiving phosphodiesterase-5-inhibitors (see Contraindications).
Blood pressure lowering drugs: Concurrent intake of drugs with blood pressure lowering properties, e.g. beta-blockers, calcium antagonists, vasodilators etc. and/or alcohol may potentiate the hypotensive effect of isosorbide dinitrate. This might also occur with neuroleptics and tricyclic antidepressants.
Dihydroergotamine: Reports suggest that, when administered concomitantly, isosorbide dinitrate may increase the blood level of dihydroergotamine and its hypertensive effect.
