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Isosorbide-5-mononitrate must not be used in: Hypersensitivity to Isosorbide-5-mononitrate, other nitrates or nitrites or any component of the formulation.
Concurrent use with phosphodiesterase-5 (PDE-5) inhibitors (sildenafil, tadalafil or vardenafil) or riociguat since it may lead to serious and often treatment-resistant hypotension.
Marked hypotension (systolic blood pressure <90 mmHg), circulatory collapse, shock, myocardial infarction with low ventricular filling pressure or cardiogenic shock unless sufficient end-diastolic pressure is maintained e.g. by the use of positive inotropic drugs or intra-aortic balloon counterpulsation.
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