Hydralazine / Isosorbide Dinitrate Side Effects
Medically reviewed by Drugs.com. Last updated on Apr 2, 2025.
Applies to hydralazine / isosorbide dinitrate: oral tablet.
Precautions
It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.
Do not take avanafil (Stendra®), riociguat (Adempas®), sildenafil (Viagra®), tadalafil (Cialis®), or vardenafil (Levitra®) while you are using this medicine. Using these medicines together may cause blurred vision, severe dizziness, lightheadedness, or fainting. If you are taking these medicines and you experience an angina attack, you must go to the hospital right away.
Dizziness, lightheadedness, or faintness may occur, especially when you get up quickly from a lying or sitting position. Getting up slowly may help.
Dizziness, lightheadedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. While you are taking this medicine, be careful to limit the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time.
Call your doctor right away if you have chest pain, fever, joint pain, or unusual tiredness or weakness. These may be symptoms of an autoimmune disease called systemic lupus erythematosus.
This medicine may cause nerve problems. Call your doctor right away if you have burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings.
Serious side effects
Along with its needed effects, hydralazine/isosorbide dinitrate may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking hydralazine/isosorbide dinitrate:
More common side effects
- blurred vision
- confusion
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- sweating
- unusual tiredness or weakness
Less common side effects
- fainting
- fast, pounding, or irregular heartbeat or pulse
Incidence not known
- abdominal or stomach cramps or pain
- black, tarry stools
- bloating or swelling of the face, arms, hands, lower legs, or feet
- chest pain or discomfort
- dark urine
- diarrhea
- difficult or labored breathing
- fever or chills
- headache, severe and throbbing
- joint pain
- light-colored stools
- lower back or side pain
- mood or mental changes
- muscle aches, cramps, or stiffness
- pain in the arms or legs
- painful or difficult urination
- pale skin
- shortness of breath
- sores, ulcers, or white spots on the lips or inside the mouth
- unusual behavior, such as disorientation to time or place, failure to recognize people, hyperactivity, or restlessness
- unusual bruising or bleeding
- unusual weight gain or loss
- yellow eyes and skin
Other side effects
Some side effects of hydralazine / isosorbide dinitrate may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common side effects
- constipation
- headache
- nausea or vomiting
Less common side effects
- burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
- cough
- pain or tenderness around the eyes and cheekbones
- stuffy or runny nose
Incidence not known
- change in urine color
- continuing ringing, buzzing or other unexplained noise in the ears
- feeling of constant movement of self or surroundings
- feeling of warmth
- inability to have or keep an erection
- pinpoint red or purple spots on the skin
- redness of the face, neck, arms and occasionally, upper chest
- sensation of spinning
- stomach soreness or discomfort
For healthcare professionals
Applies to hydralazine / isosorbide dinitrate: oral tablet.
General adverse events
The most common side effects were headache, dizziness, asthenia, and nausea.[Ref]
Nervous system
- Very common (10% or more): Headache (50%), dizziness (32%)
- Common (1% to 10%): Paresthesia
- Postmarketing reports: Tinnitus, dysgeusia, hypoesthesia, migraine, syncope[Ref]
Other
- Very common (10% or more): Asthenia (14%)
- Postmarketing reports: Vertigo, facial pain, chest discomfort, chest pain, peripheral edema[Ref]
Gastrointestinal
- Very common (10% or more): Nausea (10%)
- Common (1% to 10%): Vomiting
- Postmarketing reports: Abdominal discomfort, constipation[Ref]
Cardiovascular
- Common (1% to 10%): Hypotension, ventricular tachycardia
- Postmarketing reports: Palpitations, flushing[Ref]
Ocular
- Common (1% to 10%): Amblyopia
- Postmarketing reports: Eyelid edema, vision blurred[Ref]
Respiratory
Dermatologic
Genitourinary
- Postmarketing reports: Chromaturia, erectile dysfunction[Ref]
Musculoskeletal
- Postmarketing reports: Pain in extremity, myalgia[Ref]
Renal
- Postmarketing reports: Pulmonary renal syndrome[Ref]
See also:
Jardiance
Jardiance (empagliflozin) is used to treat type 2 diabetes, chronic kidney disease and reduce the ...
Farxiga
Farxiga (dapagliflozin) is an oral prescription medication that may be given to certain adults with ...
Botox
Botox is used for cosmetic purposes and to treat overactive bladder symptoms, urinary incontinence ...
Lasix
Lasix is a loop diuretic used to treat fluid retention from heart, liver, or kidney conditions, and ...
Triamcinolone
Triamcinolone is used to treat allergies, skin conditions, ulcerative colitis, and arthritis. Learn ...
Warfarin
Warfarin is an anticoagulant used to prevent heart attacks, strokes, and blood clots. Learn about ...
Diltiazem
Diltiazem is used to treat high blood pressure, angina and certain heart rhythm disorders. Included ...
Spironolactone
Spironolactone is a potassium-sparing diuretic that is primarily used to treat heart failure, high ...
Carvedilol
Carvedilol (Coreg) is used to treat heart failure and hypertension (high blood pressure). Includes ...
Furosemide
Furosemide is a loop diuretic used to treat fluid retention and high blood pressure by increasing ...
References
1. (2005) "Product Information. BiDil (hydralazine-isosorbide dinitrate)." NitroMed Inc
More about hydralazine / isosorbide dinitrate
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (1)
- Imprints, shape & color data
- Dosage information
- During pregnancy
- Drug class: miscellaneous antihypertensive combinations
- En español
Patient resources
- Hydralazine and isosorbide dinitrate drug information
- Isosorbide dinitrate and hydralazine (Advanced Reading)
- Isosorbide Dinitrate and Hydralazine
Other brands
Professional resources
Other brands
Related treatment guides
Further information
Hydralazine/isosorbide dinitrate side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.