Drug & supplement interaction

Wine + Isosorbide Mononitrate

Isosorbide Mononitrate brand names: Imdur, Angeze, Dynamin, Elantan, Ismo, and others.

Moderate Interaction
The bottom line Moderate

Wine has a moderate interaction with Isosorbide Mononitrate. Concomitant use may increase the risk of acute hypotension.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Wine and Isosorbide Mononitrate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

VASODILATORS

Why this applies to Isosorbide Mononitrate

Isosorbide Mononitrate falls under VASODILATORS — the group Wine interacts with.

Concomitant use may increase the risk of acute hypotension.
Acute alcohol intoxication can increase the risk of hypotension and additive effects with vasodilators.
Severity Moderate Likelihood Probable Evidence C

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep in mind: both wine and isosorbide mononitrate lower your blood pressure by relaxing and widening your blood vessels. When you put them together, those effects can stack up. That means you may feel lightheaded, dizzy, flushed, or even faint, especially when you stand up quickly. A pounding headache is also common with this medication, and alcohol can make that worse.

This isn't a rare or far-fetched concern, it's a well-recognized one, though a small glass with dinner is usually less of an issue than several drinks at once. If you enjoy wine, it's worth chatting with your pharmacist or doctor about how much is reasonable for you, rather than stopping or changing anything on your own.

References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Wine Also Interacts With Other Medications

Wine has 656 major, 269 moderate known drug interactions in our database — the Isosorbide Mononitrate one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Wine

Covers the 2,830 medications we’ve checked against Wine. Pick one to open its full report.

From our Q&A

Questions About Wine or Isosorbide Mononitrate

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Wine or Isosorbide Mononitrate, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Isosorbide Mononitrate

This page covers Wine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Isosorbide Mononitrate page lists 22 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Mistletoe (major), Coleus (major), Hawthorn (major) and Beer (moderate).

By severity: 4 major · 9 moderate · 9 minor.

From our pharmacist’s overview on the Isosorbide Mononitrate page

“Isosorbide mononitrate (Imdur) is taken daily to prevent angina by keeping blood vessels relaxed, and the 22 supplements and herbs on this page deserve careful reading, not a shrug. Four carry major ratings, and they pull in different directions.”

Reviewed by 2 · Jul 18, 2026

Open the Isosorbide Mononitrate interaction page

One more smart check

Taking Wine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Wine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wine. Your product may carry other ingredients that interact with Isosorbide Mononitrate too, on top of Wine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Wine and Isosorbide Mononitrate Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Wine
Top half

#377 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Isosorbide Mononitrate
Steady interest

#1,753 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Wine

What is Wine?

  • Social and relaxation use
  • Heart health (popular belief)
  • Antioxidant intake
  • Aiding digestion (traditional use)
  • Culinary flavoring

Wine is an alcoholic beverage made from fermented grapes and is not a true dietary supplement or medicine. Despite popular claims about heart benefits, the alcohol it contains carries real health risks, and no amount of drinking can be recommended to improve health. If you drink, do so in moderation, and avoid alcohol entirely during pregnancy or if you have certain medical conditions.

Read the full Wine monograph & all interactions
Medication

About Isosorbide

What Is Isosorbide Used For?

Brand names: Imdur, Angeze, Dynamin, Elantan, Ismo, Chemydur 60XL, Elantan LA, Isib 60XL, Ismo Retard, Isodur, Isotard, Modisal LA, Modisal XL, Monomax SR, Monomax XL, Angeze SR, Monomil XL, Monosorb XL, Zemon

Isosorbide is used to prevent angina pectoris — chest pain or tightness caused by coronary artery disease. Both isosorbide dinitrate tablets and isosorbide mononitrate tablets (including Monoket and Isordil) are used for this purpose.

Important: none of these oral formulations work fast enough to stop a chest pain episode that has already started. They are taken on a schedule to prevent angina, not to treat it in the moment.

See full Isosorbide drug information
Keep checking

Other Drugs & Wine

Browse every other medication we’ve checked against Wine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

656Major
269Moderate
0Minor
1,904No known interaction
Major

656 interactions

Showing 60 of 656 major interactions — see all 656 on the Wine page.

Moderate

269 interactions

Showing 60 of 269 moderate interactions — see all 269 on the Wine page.

No interaction 1,904 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Wine and Isosorbide Mononitrate Together: Common Questions

Can you take Wine with Isosorbide Mononitrate?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Wine and Isosorbide Mononitrate interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Isosorbide Mononitrate and Wine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.