Generic Name: hydralazine and isosorbide dinitrate (hi dral LA zeen and I so zor bi da din eye treyt)Brand Names: BiDil
Hydralazine is a vasodilator. It relaxes (widens) veins and arteries, which makes it easier for your heart to pump.
Isosorbide dinitrate is in a class of drugs called nitrates. Isosorbide dinitrate dilates (widens or relaxes) blood vessels (arteries and veins). When blood vessels are dilated, it is easier for the heart to pump. Also, more blood, which is rich in oxygen, can flow to the heart.
Hydralazine and isosorbide dinitrate is used to treat heart failure.
Hydralazine and isosorbide dinitrate may also be used for purposes other than those listed in this medication guide.What is the most important information I should know about hydralazine and isosorbide dinitrate?
You may develop a headache because of this medicine, but do not stop taking it. Take aspirin or acetaminophen to treat the headache. Ask your doctor which is best for you. This side effect usually goes away with continued hydralazine and isosorbide dinitrate treatment.Do not stop taking hydralazine and isosorbide dinitrate suddenly. Talk to your doctor before you stop taking the drug completely. Do not drink alcohol while taking this medication. Use caution when driving, operating machinery, or performing other hazardous activities. Hydralazine and isosorbide dinitrate may cause dizziness. If you experience dizziness, avoid these activities.What should I discuss with my healthcare provider before taking hydralazine and isosorbide dinitrate?
Before taking this medication, tell your doctor if you
have low blood pressure;
have had a stroke, a transient ischemic attack (TIA, or mini-stroke), or a serious head injury;
have an allergy to nitrates;
have closed-angle glaucoma;
suffer from migraines;
have systemic lupus erythematosus;
have high levels of cholesterol or triglycerides (types of fat) in your blood;
have pulmonary hypertension;
You may not be able to take hydralazine and isosorbide dinitrate, or you may require a dosage adjustment or special monitoring during therapy.Hydralazine and isosorbide dinitrate is in the FDA pregnancy category C. This means that it is not known whether hydralazine and isosorbide dinitrate will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. It is also not known whether hydralazine or isosorbide dinitrate pass into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby. If you are over 60 years of age, you may be more likely to experience dizziness from hydralazine. You may require a lower dose or special monitoring during therapy.
Take hydralazine and isosorbide dinitrate exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.Take each dose with a full glass of water. Do not stop taking hydralazine and isosorbide dinitrate suddenly. Talk to your doctor before you stop taking the drug completely. Store this medication at room temperature away from moisture and heat.
See also: Hydralazine and isosorbide dinitrate dosage in more detail
Take the missed dose as soon as you remember. If your next regularly scheduled dose is within 2 hours, skip the dose you missed and take only the next dose. Do Not take a double dose of this medication.
Symptoms of an hydralazine and isosorbide dinitrate overdose include a severe throbbing headache, difficult or slow breathing, muscle cramps, nausea, vomiting, diarrhea, fever, dizziness, fainting, an irregular or slow heart beat, changes in vision, confusion, flushing, and seizures.
an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
blurred vision and dry mouth;
irregular heartbeat; or
blood in your urine or stools;
numbness, tingling, pain, or weakness of your arms or legs;
Other, less serious side effects may be more likely to occur. If you experience any of the following side effects, continue to take isosorbide and talk to your doctor:
headache or dizziness;
flushing (redness of the face, neck and chest);
nausea or vomiting;
swollen ankles; or
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose for Congestive Heart Failure:
Initial: 1 tablet (37.5 mg-20 mg) orally three times a day.The initial dose may be titrated to a maximum tolerated dose not to exceed two tablets three times a day. Although titration can be rapid (3 to 5 days), some patients experience side effects and may take longer to reach their maximum tolerated dose.
Before taking hydralazine and isosorbide dinitrate, tell your doctor if you are taking any of the following medicines:
dihydroergotamine (D.H.E. 45); or
any other heart medicines, especially those used to treat high blood pressure or irregular heartbeats.
You may require a dosage adjustment or special monitoring during your treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with hydralazine and isosorbide dinitrate or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.