← All drugs
Drug · FAERS side-effect profile with label screen

Isosorbide Dinitrate side effects: what 19,411 FDA adverse event reports show

Isosorbide Dinitrate · 1,182 reaction terms · 101,329 drug–reaction co-reports · data 2026-09-14
Share: X Facebook Reddit Email

Drug class

Nitrate Vasodilator

FDA label (Established Pharmacologic Class) · compare the class

Who reports

19,411 reports · 75% serious · 2,553 with death outcome · 47% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Isosorbide dinitrate tablets are indicated for the prevention of angina pectoris due to coronary artery disease. The onset of action of immediate-release oral isosorbide dinitrate is not sufficiently rapid for this product to be useful in aborting an acute anginal episode.

FDA label, Indications and Usage

What it is

DESCRIPTION Isosorbide dinitrate, an organic nitrate, is a vasodilator with effects on both arteries and veins.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled (related wording) 2Likely indication confounding 2Lab value / disease marker 1Not in label — unassessed 35
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,142 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Cardiospasm3752,269.2
1,898.2–2,712.8ROR 2,313.9 · calibrated p 1e-21 ✓
699.4 EB05 642.0 · IC025 +8.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–2.0)
Not in label — unassessedserious n=375no trial data cached
Immunisation2451,425.9
1,178.0–1,725.9ROR 1,444.1 · calibrated p 6e-19 ✓
582.3 EB05 523.6 · IC025 +7.9
3/3 methods agree
vs other Nitrate Vasodilators: PRR 2.0 (1.7–2.4)
Not in label — unassessedserious n=245no trial data cached
Palmoplantar keratoderma3661,129.9
976.0–1,308.0ROR 1,151.6 · calibrated p 7e-18 ✓
533.4 EB05 489.1 · IC025 +8.1
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–2.0)
Not in label — unassessedserious n=366no trial data cached
Atrial tachycardia382239.3
214.4–267.2ROR 244.1 · calibrated p 7e-11 ✓
193.7 EB05 177.9 · IC025 +7.1
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–1.9)
Not in label — unassessedserious n=382no trial data cached
Pruritus genital370204.3
182.9–228.1ROR 208.2 · calibrated p 3e-10 ✓
170.1 EB05 156.0 · IC025 +7.0
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–1.9)
Not in label — unassessedserious n=369no trial data cached
Carotid artery occlusion388128.2
115.5–142.3ROR 130.8 · calibrated p 2e-8 ✓
113.9 EB05 104.7 · IC025 +6.5
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.6 (1.4–1.9)
Not in label — unassessedserious n=387no trial data cached
Sleep terror368103.6
93.1–115.2ROR 105.6 · calibrated p 8e-8 ✓
94.0 EB05 86.2 · IC025 +6.2
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–2.0)
Not in label — unassessedserious n=368no trial data cached
Facial pain37847.8
43.1–52.9ROR 48.7 · calibrated p 2e-5 ✓
45.7 EB05 41.9 · IC025 +5.3
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–1.9)
Not in label — unassessedserious n=374no trial data cached
Subarachnoid haemorrhage42046.3
42.0–51.0ROR 47.3 · calibrated p 2e-5 ✓
44.3 EB05 40.9 · IC025 +5.2
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.6 (1.4–1.8)
Not in label — unassessedserious PRR 34.3no trial data cached
Chronic kidney disease-mineral and bone disorder4446.0
34.1–62.2ROR 46.1 · calibrated p 3e-5 ✓
43.4 EB05 33.7 · IC025 +4.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.6 (0.4–0.8)
Not in label — unassessedserious n=44no trial data cached
Nephrogenic anaemia17742.5
36.6–49.3ROR 42.9 · calibrated p 4e-5 ✓
40.7 EB05 35.9 · IC025 +5.0
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.6–0.8)
Not in label — unassessedserious n=177no trial data cached
Jugular vein distension2141.0
26.5–63.4ROR 41.1 · calibrated p 9e-5 ✓
38.3 EB05 26.4 · IC025 +3.7
3/3 methods agree
vs other Nitrate Vasodilators: only this drug
Not in label — unassessedserious n=21no trial data cached
Vascular stent stenosis1540.3
24.1–67.5ROR 40.4 · calibrated p 1e-4 ✓
37.2 EB05 23.9 · IC025 +3.3
3/3 methods agree
vs other Nitrate Vasodilators: only this drug
Not in label — unassessedserious n=15no trial data cached
Mediastinal disorder1339.2
22.6–68.2ROR 39.2 · calibrated p 2e-4 ✓
36.0 EB05 22.4 · IC025 +3.1
3/3 methods agree
vs other Nitrate Vasodilators: only this drug
Not in label — unassessedserious n=13no trial data cached
Vasculitis38236.6
33.1–40.5ROR 37.3 · calibrated p 8e-5 ✓
35.3 EB05 32.5 · IC025 +4.9
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.6 (1.4–1.9)
Not in label — unassessedserious PRR 29.4no trial data cached
Hyperparathyroidism secondary7733.9
27.0–42.5ROR 34.0 · calibrated p 2e-4 ✓
32.6 EB05 26.9 · IC025 +4.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.5 (0.4–0.6)
Not in label — unassessedserious n=77no trial data cached
Ventricular tachycardia47031.5
28.8–34.5ROR 32.3 · calibrated p 2e-4 ✓
30.6 EB05 28.3 · IC025 +4.7
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.2 (1.0–1.3)
Not in label — unassessedserious PRR 23.8no trial data cached
Prinzmetal angina2629.0
19.6–42.8ROR 29.0 · calibrated p 5e-4 ✓
27.7 EB05 19.9 · IC025 +3.6
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.4–1.1)
Likely indication confounding
shares a disease stem with the indications wording
serious n=26 · 100% clinicianno trial data cached
Anosmia (loss of smell)37528.7
25.9–31.7ROR 29.2 · calibrated p 3e-4 ✓
27.9 EB05 25.6 · IC025 +4.6
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–2.0)
Not in label — unassessedserious n=370no trial data cached
Pericarditis38825.7
23.3–28.4ROR 26.2 · calibrated p 5e-4 ✓
25.1 EB05 23.1 · IC025 +4.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.6 (1.4–1.8)
Not in label — unassessedserious PRR 19.6no trial data cached
Lip erosion1522.4
13.5–37.4ROR 22.5 · calibrated p 0.002 ✓
21.4 EB05 13.5 · IC025 +2.8
3/3 methods agree
vs other Nitrate Vasodilators: only this drug
Not in label — unassessedserious n=15no trial data cached
Ischaemic cardiomyopathy6322.4
17.5–28.8ROR 22.5 · calibrated p 0.001 ✓
21.8 EB05 17.7 · IC025 +3.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.5 (0.4–0.7)
Not in label — unassessedserious n=63no trial data cached
Rebound acid hypersecretion6121.9
17.0–28.2ROR 22.0 · calibrated p 0.002 ✓
21.4 EB05 17.2 · IC025 +3.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.6 (0.4–0.8)
Not in label — unassessedserious n=61no trial data cached
Angina unstable11419.1
15.9–23.0ROR 19.2 · calibrated p 0.003 ✓
18.7 EB05 16.0 · IC025 +3.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.4 (0.4–0.5)
Likely indication confounding
shares a disease stem with the indications wording
serious n=113no trial data cached
Left atrial dilatation2218.8
12.3–28.7ROR 18.8 · calibrated p 0.004 ✓
18.1 EB05 12.5 · IC025 +3.0
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.4 (0.3–0.7)
Not in label — unassessedserious n=22no trial data cached
Muscle twitching39518.8
17.0–20.7ROR 19.1 · calibrated p 0.002 ✓
18.4 EB05 17.0 · IC025 +4.0
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.5 (1.3–1.8)
Not in label — unassessedserious PRR 22.0no trial data cached
Renal atrophy2118.4
12.0–28.4ROR 18.4 · calibrated p 0.004 ✓
17.7 EB05 12.0 · IC025 +3.0
3/3 methods agree
vs other Nitrate Vasodilators: only this drug
Not in label — unassessedserious n=21no trial data cached
Mucosal erosion1518.2
10.9–30.2ROR 18.2 · calibrated p 0.005 ✓
17.2 EB05 10.6 · IC025 +2.7
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.9 (0.5–1.7)
Not in label — unassessedserious n=15no trial data cached
Orthopnoea5117.5
13.3–23.1ROR 17.6 · calibrated p 0.004 ✓
17.1 EB05 13.5 · IC025 +3.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.5–1.0)
Not in label — unassessedserious n=51no trial data cached
End stage renal disease28917.2
15.3–19.3ROR 17.5 · calibrated p 0.004 ✓
16.9 EB05 15.4 · IC025 +3.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.6–0.8)
Not in label — unassessedserious PRR 13.1no trial data cached
Sick sinus syndrome1816.9
10.6–27.0ROR 16.9 · calibrated p 0.006 ✓
16.1 EB05 10.4 · IC025 +2.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.4–1.3)
Not in label — unassessedserious n=18no trial data cached
Therapeutic agent toxicity5116.5
12.5–21.8ROR 16.6 · calibrated p 0.005 ✓
16.2 EB05 12.7 · IC025 +3.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.1 (0.8–1.5)
Not in label — unassessedserious n=51no trial data cached
Diplopia (double vision)38816.4
14.8–18.1ROR 16.7 · calibrated p 0.005 ✓
16.1 EB05 14.8 · IC025 +3.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.0 (0.9–1.2)
Not in label — unassessedserious PRR 16.9no trial data cached
Transient ischaemic attack (mini-stroke)48715.7
14.4–17.2ROR 16.1 · calibrated p 0.005 ✓
15.5 EB05 14.4 · IC025 +3.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.0 (0.9–1.2)
Not in label — unassessedserious PRR 12.2no trial data cached
Atrioventricular block first degree6215.6
12.1–20.0ROR 15.6 · calibrated p 0.007 ✓
15.2 EB05 12.3 · IC025 +3.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.5–0.9)
Not in label — unassessedserious n=62no trial data cached
Pain of skin38015.4
13.9–17.0ROR 15.7 · calibrated p 0.006 ✓
15.2 EB05 13.9 · IC025 +3.7
3/3 methods agree
vs other Nitrate Vasodilators: PRR 1.7 (1.5–1.9)
Not in label — unassessedserious PRR 43.8no trial data cached
Left ventricular hypertrophy5915.1
11.7–19.5ROR 15.1 · calibrated p 0.008 ✓
14.7 EB05 11.8 · IC025 +3.3
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.9 (0.6–1.2)
Not in label — unassessedserious n=58no trial data cached
Echocardiogram abnormal1914.9
9.5–23.4ROR 14.9 · calibrated p 0.010 ✓
14.1 EB05 9.0 · IC025 +2.7
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.8 (0.5–1.4)
Lab value / disease markerserious n=19no trial data cached

Trial evidence (ClinicalTrials.gov)

Trial cross-check not yet run for this drug (ClinicalTrials.gov pull covers the 800 most-reported drugs first).

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Dyspnoea (shortness of breath)1,6643.2
3.0–3.3ROR 3.4 · calibrated p 0.513
3.2 EB05 3.0 · IC025 +1.6
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.6 (0.5–0.6)
Not in label — unassessedserious PRR 2.8no trial data cached
Nausea1,3761.9
1.8–2.0ROR 2.0 · calibrated p 0.918
1.9 EB05 1.8 · IC025 +0.8
vs other Nitrate Vasodilators: PRR 0.6 (0.6–0.6)
Not in label — unassessedserious PRR 2.2no trial data cached
Fatigue (tiredness)1,3521.9
1.8–2.0ROR 1.9 · calibrated p 0.915
1.9 EB05 1.8 · IC025 +0.8
vs other Nitrate Vasodilators: PRR 0.5 (0.5–0.6)
Not in label — unassessedserious PRR 2.1no trial data cached
Dizziness1,3112.8
2.7–3.0ROR 3.0 · calibrated p 0.632
2.8 EB05 2.7 · IC025 +1.4
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.6 (0.6–0.6)
Not in label — unassessedserious PRR 3.1no trial data cached
Diarrhoea (diarrhea)1,3052.2
2.1–2.3ROR 2.3 · calibrated p 0.912
2.2 EB05 2.1 · IC025 +1.0
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.6 (0.6–0.7)
Not in label — unassessedserious PRR 2.2no trial data cached
Myocardial infarction (heart attack)1,2127.5
7.1–7.9ROR 7.9 · calibrated p 0.069
7.4 EB05 7.1 · IC025 +2.8
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.5 (0.5–0.6)
Labeled adverse reaction
exact term
serious PRR 5.8no trial data cached
Chest pain1,1596.8
6.4–7.2ROR 7.2 · calibrated p 0.093
6.7 EB05 6.4 · IC025 +2.7
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.5 (0.5–0.6)
Not in label — unassessedserious PRR 6.3no trial data cached
Pain1,0651.9
1.8–2.0ROR 1.9 · calibrated p 0.901
1.9 EB05 1.8 · IC025 +0.8
vs other Nitrate Vasodilators: PRR 0.5 (0.4–0.5)
Not in label — unassessedserious PRR 2.0no trial data cached
Headache1,0241.8
1.7–1.9ROR 1.8 · calibrated p 0.836
1.8 EB05 1.7 · IC025 +0.7
vs other Nitrate Vasodilators: PRR 0.5 (0.5–0.6)
Labeled adverse reaction
exact term
serious PRR 2.2no trial data cached
Vomiting1,0062.3
2.2–2.5ROR 2.4 · calibrated p 0.860
2.3 EB05 2.2 · IC025 +1.1
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.7 (0.6–0.7)
Not in label — unassessedserious PRR 2.3no trial data cached
Malaise (feeling unwell)9012.2
2.1–2.4ROR 2.3 · calibrated p 0.914
2.2 EB05 2.1 · IC025 +1.0
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.6 (0.6–0.6)
Not in label — unassessedserious PRR 2.5no trial data cached
Off label use (used outside approved label)8621.1
1.0–1.1ROR 1.1 · calibrated p 0.357
1.1 EB05 1.0 · IC025 -0.0
PRR-only: not supported by EBGM or IC
vs other Nitrate Vasodilators: PRR 0.6 (0.5–0.6)
Reporting / coding artifactserious PRR 1.2no trial data cached
Asthenia (weakness)8092.3
2.2–2.5ROR 2.4 · calibrated p 0.864
2.3 EB05 2.2 · IC025 +1.1
3/3 methods agree
vs other Nitrate Vasodilators: PRR 0.5 (0.5–0.6)
Not in label — unassessedserious PRR 2.1no trial data cached
Arthralgia (joint pain)8062.1
2.0–2.3ROR 2.2 · calibrated p 0.976
2.1 EB05 2.0 · IC025 +1.0
vs other Nitrate Vasodilators: PRR 0.6 (0.6–0.7)
Not in label — unassessedserious PRR 2.5no trial data cached
Death8031.0
0.9–1.1ROR 1.0 · calibrated p 0.312
1.0 EB05 1.0 · IC025 -0.1
PRR-only: not supported by EBGM or IC
vs other Nitrate Vasodilators: PRR 0.5 (0.5–0.6)
Outcome field, not a reactionserious PRR 0.8no trial data cached

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Isosorbide Dinitrate?

In FDA FAERS, the most frequently co-reported reaction terms for Isosorbide Dinitrate are dyspnoea, nausea, fatigue, dizziness, diarrhoea, myocardial infarction. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Isosorbide Dinitrate have an FDA boxed warning?

No. The FDA label retrieved for Isosorbide Dinitrate has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Isosorbide Dinitrate causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.