Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Potassium levels may be depleted.1
• Take on an empty stomach with a full glass of water for best results.2
• Avoid alcohol.3
• Salicylate herbs: meadowsweet, poplar, willow and wintergreen may interact with nitrates to increase their effect due to the known interaction between nitrates and aspirin.4
• These herbs have cardioactive properties and may theoretically interact with nitrates: Broom, Calamus, Cereus, Coltsfoot, Devil'sClaw, Ginseng ,Panax, Goldenseal, Hawthorn, Horehound, Mate, Mistletoe, Motherwort, Shepherd's Purse, Squill, Wild Carrot.5
• N-Acetyl-Cysteine - People taking isosorbide dinitrate might benefit from supplements of the amino acid N-acetyl-Cysteine. Controlled studies have shown that using intravenous and oral N-acetyl cysteine (NAC) reverses or prevents tolerance to nitrates.6
• Another controlled study revealed that intravenous NAC enhanced the beneficial effects of ISDN on heart function.7
References1 Pronsky, Z Food Medication Interactions, 11th edition, 1999.
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999.
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999.
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
4 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998.
4 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000.
4 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996
5 Facts and Comparisons, Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
5 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
6 Boesgaard S, Aldershvile J, Poulsen HE. Preventive administration of intravenous N-acetylcysteine and development of tolerance to isosorbide dinitrate in patients with angina pectoris. Circulation 1992;85:143–9.
6 Vincent J, Kongpatanakul S, Blaschke TF, Hoffman BB. Desensitization of nitrate-induced venodilation: reversal with oral N-acetylcysteine in humans. J Cardiovasc Pharmacol 1992;20:907–12
7 Mehra A, Shotan A, Ostrzega E, et al. Potentiation of isosorbide dinitrate effects with N-acetylcysteine in patients with chronic heart failure. Circulation 1994;89:2595–600.
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.