Drug
Isosorbide-Hydralazine
Common brand names:
BiDilSummary of Interactions with Vitamins, Herbs, & Foods
Supportive Interactions
3- Replenish Depleted Nutrients
Hydralazine
Vitamin B6
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Vitamin B6 can bind to hydralazine to form a complex that is excreted in the urine, increasing vitamin B6 loss. This may lead to vitamin B6 deficiency. People taking hydralazine should consult with their doctor to discuss the possibility of vitamin B6 supplementation.
Vitamin B6Hydralazine- Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 131-2.
- Raskin NH, Rishman RA. Pyridoxine-deficiency neuropathy due to hydralazine. N Engl J Med 1965;273:1182-5.
- Support Medicine
Isosorbide Dinitrate
N-Acetyl Cysteine
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
The beneficial effects of ISDN are reduced following long-term treatment with the drug through a process known as tolerance. Controlled studies have shown that using intravenous and oral N-acetyl cysteine (NAC) reverses or prevents tolerance to nitrates. Another controlled study revealed that intravenous NAC enhanced the beneficial effects of ISDN on heart function. Therefore, people taking isosorbide dinitrate might benefit from supplemental NAC.
N-Acetyl CysteineIsosorbide Dinitrate- 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.
- 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.
- 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.
- Support Medicine
Isosorbide Dinitrate
Vitamin C
This interaction is based on this drug belonging to a drug class. While this drug may differ from the text and references below, drugs within this class work in a similar way and this interaction is applicable to drugs within the same class.
Some persons taking nitroglycerin or isosorbide mononitrate may find that it loses efficacy over time. This is because the body adapts to the drug, a process known as developing tolerance. One study found that taking 2 grams three times daily of vitamin C can decrease this effect when nitroglycerin patches are simultaneously used. Similar benefits have been confirmed in another study. However, it should be noted that it is also possible to avoid tolerance to these drugs by simply changing the dosing schedule. People taking ISMN or nitroglycerin should talk with their pharmacists about avoiding drug tolerance.
Vitamin CIsosorbide Dinitrate- Watanabe H, Kakihana M, Ohtsuka S, Sugishita Y. Randomized, double-blind, placebo-controlled study of the preventive effect of supplemental oral vitamin C on attenuation of development of nitrate tolerance. J Am Coll Cardiol 1998;31:1323-9.
- Bassenge E, Fink N, Skatchkov M, Fink B. Dietary supplement with vitamin C prevents nitrate tolerance. J Clin Invest 1998;102:67-71.