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Phosphodiesterase-5 Inhibitors: Phosphodiesterase-5 inhibitors eg, sildenafil potentiate the hypotensive effects of Isosorbide Dinitrate (Isoket). This might lead to life-threatening cardiovascular complications. Therefore Isosorbide Dinitrate (Isoket) must not be given to patients receiving phosphodiesterase-5-inhibitors (see Contraindications; Precautions).
Blood Pressure Lowering Drugs: Concurrent intake of drugs with blood pressure lowering properties eg, beta-blockers, calcium antagonists vasodilators etc and/or alcohol may potentiate the hypotensive effect of Isosorbide Dinitrate (Isoket). This might also occur with neuroleptics and tricyclic antidepressants.
Dihydroergotamine: Reports suggest that, when administered concomitantly, Isosorbide Dinitrate (Isoket) may increase the blood level of dihydroergotamine and its hypertensive effect.
Riociguat: The use of isosorbide dinitrate (ISDN) with riociguat, a soluble guanylate cyclase stimulator, is contraindicated (see Contraindications) since concomitant use can cause hypotension.
