Isorey Contraindications

Isosorbide dinitrate is contraindicated in patients with known hypersensitivity to the active substance, to any of the excipients, or to other nitrates or nitrites. It must not be used in conditions associated with low filling pressure, hypertrophic obstructive cardiomyopathy, constrictive pericarditis, cardiac tamponade, or cardiogenic shock, unless measures are in place to maintain adequate diastolic pressure. The use of isosorbide dinitrate is also contraindicated in circulatory collapse, severe aortic or mitral valve stenosis, severe hypotension (systolic blood pressure <90 mmHg), head trauma, cerebral hemorrhage, or diseases associated with increased intracranial pressure.
Isosorbide dinitrate should not be administered to patients with marked anemia, hypovolemia, or closed-angle glaucoma. Concomitant use with phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil, vardenafil) or with the soluble guanylate cyclase stimulator riociguat is contraindicated.