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Isosorbide Dinitrate/Hydralazine, Oral eye-soh-SOR-bide dy-NY-trate hy-DRAL-a-zeen

What are other names for this medicine?

Type of medicine: vasodilator; antihypertensive

Generic and brand names: isosorbide dinitrate/hydralazine, oral; BiDil

What is this medicine used for?

This medicine is taken by mouth to treat heart failure in self-identified black patients. It may be prescribed for other patients or other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

  • an allergic reaction to any medicine
  • a stroke or head injury
  • anemia
  • glaucoma
  • heart attack, heart valve disease, or angina
  • kidney disease
  • low blood pressure or high blood pressure that you take medicine to treat

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more or less than prescribed. Do not stop taking this medicine without your healthcare provider's approval. Take it regularly, even if you feel better.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: weakness, fainting, lightheadedness, dizziness, fast heartbeat, flushing, headache.

What should I watch out for?

Do not take sildenafil (Viagra, Revatio), tadalafil (Cialis), or vardenafil (Levitra) while you are taking this medicine. Using these medicines together may cause severe or life-threatening low blood pressure. Taken with high blood pressure medicines, this medicine may cause extreme low blood pressure. Tell your provider about all the medicines you take.

Your healthcare provider may want to see you regularly to check your blood pressure.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. If you feel dizzy or faint while you are standing, lie down for a while and then get up slowly. Do not drive or operate machinery unless you are fully alert.

You may have a headache for a short time after you take a dose of this medicine. It is a sign that the medicine is working. If you try to eliminate the headaches by reducing your dosage, you will reduce the effectiveness of the medicine. Ask your healthcare provider whether you should take aspirin or acetaminophen (Tylenol) to relieve these headaches.

This medicine may increase the risk of dizziness or fainting if you drink alcohol, exercise, stand for a long time, or are active in hot weather. Do not drink alcohol unless your healthcare provider approves.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist that you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Chest pain; joint pain; sore throat; fever; numbness, tingling, pain, or weakness in hands or feet; pounding or irregular heartbeat; fainting; severe thirst; unusual bleeding or bruising; yellowish eyes or skin; trouble urinating; confusion.

Other: Diarrhea, headache, nausea, vomiting, dizziness, drowsiness, stuffy nose, weakness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

  • antibiotics such as ciprofloxacin (Cipro), clarithromycin (Biaxin), and erythromycin (Ery-Tabs, E.E.S.)
  • beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), pindolol, propranolol (Inderal LA), sotalol (Betapace), and timolol
  • calcium channel blockers such as diltiazem (Cardizem), felodipine, isradipine (DynaCirc), nicardipine (Cardene), and verapamil (Calan, Covera-HS, Isoptin, Verelan)
  • diazoxide (Proglycem)
  • diuretics such as amiloride, amiloride/hydrochlorothiazide, bumetanide, chlorthalidone (Hygroton), furosemide (Lasix), hydrochlorothiazide (Microzide), metolazone (Zaroxolyn), spironolactone (Aldactone), spironolactone/hydrochlorothiazide (Aldactazide), torsemide (Demadex), triamterene (Dyrenium), and triamterene/hydrochlorothiazide (Dyazide, Maxzide)
  • natural remedies such as dong quai, ephedra, and yohimbe
  • isoxsuprine
  • MAO inhibitor antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
  • medicines to treat erectile dysfunction such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
  • nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Voltaren, Cataflam), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Naprosyn, Anaprox, Aleve, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
  • nitrate medicines such as isosorbide (Isordil) and nitroglycerin (Nitro-Bid, Minitran, Nitrek, Nitro-Dur)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.


This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.


Developed by RelayHealth.
Medication Advisor 2012.1 published by RelayHealth.
Last modified: 2011-04-15
Last reviewed: 2009-12-28
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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