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Isosorbide Dinitrate/Hydralazine

Reviewed by: HU Medical Review Board | Last reviewed: June 2023

Isosorbide dinitrate/hydralazine is used to treat Black adults with heart failure. These drugs are sometimes prescribed separately or as a single pill containing both medicines. They may also be used with ACE inhibitors and ARBs for heart failure.1,2

Research has shown that isosorbide dinitrate/hydralazine, when taken with other drugs for heart failure, can improve symptoms, reduce the risk of death and hospitalization, and improve quality of life in Black people with heart failure.1,2


Isosorbide dinitrate/hydralazine is available under the brand name BiDil®. A generic version is also available.1,2

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What are the ingredients?

Isosorbide dinitrate and hydralazine are the active ingredients.1,2

How do isosorbide dinitrate and hydralazine work?

Isosorbide dinitrate and hydralazine work together to improve symptoms of heart failure.

Isosorbide dinitrate causes your arteries and veins to release nitric oxide. Nitric oxide is a molecule that relaxes your blood vessels, which allows them to widen and increase circulation.1,2

Hydralazine relaxes your blood vessels too. It also helps keep nitric oxide in your body longer.1,2

What are the possible side effects?

The most common side effects of isosorbide dinitrate/hydralazine include:1,2

  • Constipation
  • Headache
  • Nausea or vomiting
  • Blurred vision
  • Confusion
  • Dizziness or lightheadedness when suddenly getting up from a lying or sitting position
  • Sweating
  • Unusual tiredness or weakness

These are not all the possible side effects of isosorbide dinitrate/hydralazine. Talk to your doctor about what to expect when taking isosorbide dinitrate/hydralazine. You also should call your doctor if you have any changes that concern you when taking isosorbide dinitrate/hydralazine.

Other things to know

Before starting treatment with isosorbide dinitrate/hydralazine, tell your doctor if you:1,2

  • Are sensitive to nitrates like nitroglycerin tablets or isosorbide dinitrate
  • Take any drugs for erectile dysfunction
  • Take any drugs for pulmonary hypertension
  • Take any drugs for high blood pressure

Before beginning treatment for heart failure, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.