When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to isosorbide.

How to Use This Medicine:
Long Acting Capsule, Tablet, Chewable Tablet, Long Acting Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Extended-release tablet or capsule: Swallow the tablet or capsule whole. Do not break, crush, or chew it.
• Sublingual tablet: Sit down while you take this medicine. Wet the tablet with water. Place it under your tongue and let it dissolve. Do not chew, crush, or swallow the tablet whole. Do not eat, drink, or smoke while the tablet is dissolving. If your chest pain lasts longer than 5 minutes, put a second tablet under your tongue. If the pain lasts another 5 minutes, use a third tablet. If your pain does not go away after the third dose, call your doctor and have someone take you to a hospital.
• Missed dose: If you miss a dose or forget to use your medicine, use it as soon as you can. If your next regular dose is less than 2 hours away, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine together with riociguat or with medicine for erectile dysfunction, such as avanafil, sildenafil, tadalafil, or vardenafil.
• Some foods and medicines can affect how isosorbide dinitrate works. Tell your doctor if you take blood pressure medicine or if you drink alcohol.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you had a heart attack or you have heart failure, an enlarged heart, low blood pressure, or other heart problems.
• Medicines that treat angina sometimes cause headaches. These headaches are a sign that the medicine is working. Do not stop taking the medicine or change the time you take it to avoid the headaches. Ask your doctor if you can take aspirin or acetaminophen to treat the headache.
• This medicine could cause low blood pressure, which may make you feel dizzy or lightheaded. Do not drive or do anything that could be dangerous until you know how this medicine affects you. You may feel lightheaded when standing, so stand up slowly. Drinking alcohol may make these symptoms worse.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blue lips or fingernails, trouble breathing
• Increased chest pain, slow heartbeat
• Severe or ongoing dizziness, lightheadedness, or fainting
• Throbbing or severe headache, confusion, fever, trouble seeing

If you notice these less serious side effects, talk with your doctor:

• Mild headache

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088