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Isosorbide-5-mononitrate may enhance the hypotensive effect of other vasodilators, antihypertensives (e.g., ACE-inhibitors, angiotensin-II receptor antagonists, beta-blockers, calcium channel blockers, diuretics), neuroleptics, tricyclic antidepressants and alcohol.
Isosorbide-5-mononitrate may increase the serum concentration of ergot derivatives by increasing its oral availability that can enhance the hypertensive effect (i.e., increase standing systolic blood pressure).
Phosphodiesterase-5 inhibitors (e.g., avanafil, sildenafil, tadalafil, vardenafil) may enhance vasodilatory effect of Isosorbide-5-mononitrate. Use of phosphodiesterase-5 inhibitors during treatment with Isosorbide-5-mononitrate is contraindicated.
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