NutriStack
Isosorbide Mononitrate and L-Arginine, a caution.
Isosorbide mononitrate and L-arginine both increase nitric-oxide-mediated vasodilation. In a human crossover study, L-arginine enhanced the blood pressure and pulse-wave effects of isosorbide mononitrate in some older hypertensive patients. This can be useful in supervised care but can also cause excessive dizziness, headache, or fainting when added without monitoring.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
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At a glance
- Substances
- Isosorbide Mononitrate and L-Arginine
- Pair type
- Caution
- Evidence (highest tier)
- Moderate
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Moderate evidence
Caution
What is happening. Isosorbide mononitrate and L-arginine both increase nitric-oxide-mediated vasodilation. In a human crossover study, L-arginine enhanced the blood pressure and pulse-wave effects of isosorbide mononitrate in some older hypertensive patients. This can be useful in supervised care but can also cause excessive dizziness, headache, or fainting when added without monitoring.
Mechanism. Isosorbide mononitrate is an organic nitrate that increases nitric oxide and cGMP signaling in vascular smooth muscle. L-arginine supplies substrate for nitric oxide synthase, potentially amplifying vasodilatory tone.
Recommendation. Do not add high-dose L-arginine to isosorbide mononitrate unless your prescriber is aware. If combined, check sitting and standing blood pressure during the first week, rise slowly, and stop the supplement if you develop faintness or unusually low readings.
Sources (2)
- Stokes GS, Barin ES, Gilfillan KL, Kaesemeyer WH. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724. PMID 12944028
- Shiraseb F, Asbaghi O, Bagheri R, Wong A, Figueroa A, Mirzaei K. Effect of l-Arginine Supplementation on Blood Pressure in Adults: A Systematic Review and Dose-Response Meta-analysis of Randomized Clinical Trials. Adv Nutr. 2022;13(4):1226-1242. PMID 34967840
Stack Score
How this pair moves the number.
Effect on the composite score
If both Isosorbide Mononitrate and L-Arginine are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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