Isosorbide dinitrate/ hydralazine

Generic Name: isosorbide dinitrate/hydralazine (eye-soe-SOR-bide die-NYE-trate/hye-DRAL-a-zeen)
Brand Name: BiDil

Isosorbide dinitrate/ hydralazine is used for:

Treating heart failure in certain patients. It may also be used for other conditions as determined by your doctor.

Isosorbide dinitrate/hydralazine is a vasodilator combination. It works by relaxing and dilating (opening) the blood vessels in the body, allowing blood to flow through the vessels easier and at a lower pressure.

Do NOT use isosorbide dinitrate/ hydralazine if:

  • you are allergic to nitrates or to any ingredient in isosorbide dinitrate/hydralazine
  • you are taking certain medicines for erectile or lung problems (eg, phosphodiesterase inhibitors [sildenafil, vardenafil, tadalafil])

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: 10 Common Symptoms That Should Never Be Ignored

Before using isosorbide dinitrate/ hydralazine:

Some medical conditions may interact with isosorbide dinitrate/hydralazine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have blood problems (eg, anemia), dehydration problems, heart problems, low blood pressure, liver problems, lupus, or an overactive thyroid, or you have had a recent head injury or recent heart attack

Some MEDICINES MAY INTERACT with isosorbide dinitrate/hydralazine. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Medicines that affect your blood vessels, medicines that treat high blood pressure, or other vasodilators because they may increase the risk of isosorbide dinitrate/hydralazine's side effects
  • Monoamine oxidase (MAO) inhibitors (eg, furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) or phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil) because the risk of severe low blood pressure may be increased or because serious side effects may occur
  • Beta-blockers (eg propranolol) or lisinopril because the risk of their side effects may be increased by isosorbide dinitrate/hydralazine

This may not be a complete list of all interactions that may occur. Ask your health care provider if isosorbide dinitrate/hydralazine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use isosorbide dinitrate/ hydralazine:

Use isosorbide dinitrate/hydralazine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take isosorbide dinitrate/hydralazine by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
  • Drinking extra fluids while you are taking isosorbide dinitrate/hydralazine is recommended. Check with your doctor for instructions.
  • Take isosorbide dinitrate/hydralazine on a regular schedule to get the most benefit from it. Taking isosorbide dinitrate/hydralazine at the same time each day will help you remember to take it.
  • Continue to take isosorbide dinitrate/hydralazine even if you feel well. Do not miss any doses.
  • If you miss a dose of isosorbide dinitrate/hydralazine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use isosorbide dinitrate/hydralazine.

Important safety information:

  • Isosorbide dinitrate/hydralazine may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use isosorbide dinitrate/hydralazine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using isosorbide dinitrate/hydralazine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Isosorbide dinitrate/hydralazine may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, fever, low fluid intake, excessive sweating, vomiting, or diarrhea can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of dizziness, lightheadedness, or weakness. If fainting occurs, notify your doctor as soon as possible.
  • Isosorbide dinitrate/hydralazine may cause a vitamin B6 deficiency. Talk with your doctor for more information.
  • Tell your doctor or dentist that you take isosorbide dinitrate/hydralazine before you receive any medical or dental care, emergency care, or surgery.
  • Lab tests, including blood pressure checks, may be performed while you use isosorbide dinitrate/hydralazine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use isosorbide dinitrate/hydralazine with caution in the ELDERLY; they may be more sensitive to its effects.
  • Isosorbide dinitrate/hydralazine should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using isosorbide dinitrate/hydralazine while you are pregnant. It is not known if isosorbide dinitrate/hydralazine is found in breast milk. If you are or will be breast-feeding while you use isosorbide dinitrate/hydralazine, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of isosorbide dinitrate/ hydralazine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; headache; lightheadedness; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); change in the amount of urine produced; chest pain; difficult urination; fainting; fast or irregular heartbeat; fever, chills, or sore throat; joint pain; numbness or tingling of the skin; persistent fatigue or weakness; runny nose; severe or persistent headache or dizziness; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include chest pain; confusion; fast or irregular heartbeat; flushing; severe headache; shock.

Proper storage of isosorbide dinitrate/hydralazine:

Store isosorbide dinitrate/hydralazine at 77 degrees F (25 degrees C) in a tightly closed container. Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep isosorbide dinitrate/hydralazine out of the reach of children and away from pets.

General information:

  • If you have any questions about isosorbide dinitrate/hydralazine, please talk with your doctor, pharmacist, or other health care provider.
  • Isosorbide dinitrate/hydralazine is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take isosorbide dinitrate/hydralazine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about isosorbide dinitrate/hydralazine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to isosorbide dinitrate/hydralazine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using isosorbide dinitrate/hydralazine.

Issue Date: November 5, 2014
Database Edition 14.4.1.002
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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