Is it safe to take isosorbide mononitrate with a betablocker and ACE inhibitor? Does any poster here take all three?

[Robbie1964]

Hi, I'm new here. I had to go to hospital on Sunday because I have been getting chest tightness / burning sensation in my chest for a couple of weeks. I was told that I most likely had angina. I had a heart attack back in 2010 and didn't want to take any chances. I was prescribed isosorbide mononitrate twice a day. Looking at the patient information leaflet when I got home I notice it says not to take the medication if taking betablockers or an ACE inhibitor. I am taking both (bisoprolol and lisinopril) though the bisoprolol is a low dose as a few years ago it had to be reduced in dosage due to my heart rate slowing down too much. I don't know whether I should be taking the isosorbide. Is there anyone here who does take medication for blood pressure and isosorbide? I'm guessing the warning is because it could lower blood pressure too much?

[shopman]

Do you have a GTN Spray? Could be given the timescale you need a medication review. Contact your GP for help or if that is too far in the future ring the BHF Helpline and speak to one of the nurses.

[Robbie1964 in reply to shopman]

Thanks shopman. I do have a GTN spray which until very recently I've hardly had to use in the almost 11 years since my heart attack. I've booked an appointment with my GP but the appointment isn't until Friday 12 March. I'll try the helpline tomorrow morning. I also think my medication is probably overdue for a review.

[WardijaWardija]

The short answer is no, according to my Cardiologist. He told me any medication ending in a . . . . pril should not be taken with Isorbide and Bisoprolol.

I am on both of the above medications and was also on Perindopril, which I was put on years ago by a GP. Which on the advice of my Cardiologist, I had to stop taking.

I believe there's quite a bit of information on here about it, or you could clarify with one of the BHF nurses.

Oh and by the way, I was also told to avoid Bananas if taking Bisoprolol, something to do with the Potassium from the fruit reducing the efficacy of the medication, if I remember correctly.

Hope this helps - stay safe 😷

[Stamford1]

Hi

I was prescribed isosorbide mononitrate alongside bisoprolol and ramapril, really struggled with the headaches side effects of isosorbide mononitrate so am now on Nicorandril which really suits me a lot better

Hope things work out for you

[MaiaK]

I take Bisoprolol, Ramipril plus Amlodipine with Isosorbide when I asked GP if OK for all these I was told they were for different things but I suffer horrible side effects, very interesting to read your post about this, I think a medication review for me is due.

[Hidden]

I’m on Bisoprolol and Isorobide Mononitrate (2 x 20mg tabs breakfast and lunch). Had two weeks of ghastly headaches with Isorobide but have been fine ever since and haven’t had to use GTN since taking it. I think I’m lucky though I know Isorobide isn’t for everyone. I was just so relieved that the chest pain was under control that I stuck with the devil I knew so to speak with the hopes that the headaches would go.

[mccaulref]

Hi Robbie... I take 120mg Isosorbide Mononitrate alongside 10mg Ramipril and 5mg Bisoprolol without any issues. All prescribed by my cardiologist at the Royal Papworth. The Isosorbide Mononitrate was added after a 3rd trip back to the lab in July following my HA in Nov 2019 where it was decided that stenting was not possible due to the nature of the latest blockage. It took a few weeks to conquer the headaches but now I am 95% angina pain free so well worth it. For the 5% of the time when I still have pain, I use my GTN spray which is mostly effective. IF you can't wait for your GP appointment to satisfy your curiosity, check with your pharmacist as they are well versed in mixology! Good luck

[richard_jw]

Looking at these posts, there appears to be no clear yes or no. I think a cardiologist needs to assess your meds. For what it's worth, I was prescribed isosorbide mononitrate. Because I have low blood pressure the cardiologist stopped the Ramapril. However the isosorbide mononitrate lowered the BP so much that I could not take it. So Nicorandil was prescribed. Which gave me a bad headache continuously.

[Cruise1]

I was prescribed isosorbide mononitrate, perindopril , and bisoprolol after my stents. I had been in the other two medications prior to stents. Hade side effects runny nose and white fingers with bisoprolol and GP suggested taking half bisoprolol dose to see if it improved. It didn’t so he took me off them completely and I am fine. Going to ask cardiologist if I need to continue isosorbide mononitrate on checkup next week as that dose has been halved too.

[Cruise1]

Have seen the cardiologist who has discharged me 6 weeks post angioplasty and discontinued Isosorbide Mononitrate . I am now on Perindopril which I was taking before stents plus Clopidogrel, aspirin and Lanzaprozole..I am not taking statins ( and always refused them) and my latest blood test showed cholesterol level of 2.98 due to changed diet and continued exercise since initial diagnosis in November. I have also renewed my annual travel policy today with an additional,premium of £152 because of my angioplasty.I am walking up to 4 miles a day, weather and my wife’s hip replacement permitting - could walk more but her new hip starts playing up at times. Just need my grandsons cleft lip surgery ( cancelled 4 times now) to go ahead and for better weather and life will be good.

[Sizzlerman]

Hi Robbie1964, this time last year I had chest pain when exerting myself and told I had had an heart attack and had two stents fitted during an angiogram one in each coronary artery. Apparently I have narrowing of the arteries put down to smoking although I had packed in 14 yrs ago but the damage was already done. Test in hospital found high cholesterol which I was told is contributing factor to clogged arteries so from no tablets ended up on Aspirin, Isosorbide Mononitrate, Clodiprogrel, bisoprolol, Ramipril and Avortastatin. To make matters worse all the acid tablets gave me GORD so I have to take Lansaprozole before these. However things have changed slightly a bit of tweaking here and there and finding life a bit more easier. Like you my Bisoprolol has been dropped to a low dose, my statin has changed to a low dose of Rovortastin and due to constant visits to the doctors I was originally told to stop taking Ramipril and Bisoprolol but that didn't help at first. But later told to take low dose of bisoprolol and see how I feel and I feel a lot better. I am keeping a check on my blood pressure with a monitor and it's fine. Had to change the statin originally because of cramp in my legs at night and back pain. Thought I was only to take all the tablets for 12 months then aspirin for life but told due to narrowing of the arteries I need to take them for life. They said it's not for now it's for later in life, so far so good, I have the odd day where I feel rough but its stomach related and it will pass after a few hours other than that I feel fine.