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Drugs reference index «BiDil»


Generic name: Isosorbide dinitrate, Hydralazine hydrochlorideBrand names: BiDil

Why is BiDil prescribed?

BiDil is prescribed for the treatment of heart failure in African American patients. BiDil works by causing the blood vessels in your body to increase in diameter. When used in combination with other heart medications that your doctor may prescribe, BiDil may delay future hopitalizations for heart problems and improve your ability to function. BiDil has not been well tested in the most severe forms of heart failure.

Most important fact about BiDil

BiDil has been shown to be effective specifically in African American patients. Other heart medications have been found to be less effective in African Americans than in patients of other races. While BiDil may be of benefit to the general heart failure population, it has been tested specifically in African Americans.

How should you take BiDil?

Take BiDil as prescribed by your doctor. Your doctor will most likely start by prescribing one tablet three times a day. Depending on how you react to the medication, your dosage may gradually increase, up to two tablets three times a day.

  • If you miss a dose...Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.
  • Storage instructions...Store at room temperature. Protect from light and keep BiDil in its original light-resistant container.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Bidil.

  • Side effects may include:bronchitis, chest pain, dizziness, headache, heart palpitations, low blood pressure, nasal congestion, nausea, rapid heartbeat, sinus congestion, tingling or burning sensation, visual problems, vomiting, weakness

Why should BiDil not be prescribed?

Do not take BiDil if you are allergic to organic nitrates.

Special warnings about BiDil

BiDil may cause low blood pressure. Be sure to discuss this with your doctor, especially if you are taking blood pressure medication. Low blood pressure is especially a risk if you fail to drink enough fluids or lose too much fluid from sweating, diarrhea, or vomiting. You may experience some lightheadedness, especially upon standing. If you faint, discontinue BiDil and notify your doctor immediately.

Hydralazine hydrochloride, one of the components of BiDil, can cause an increase in heart rate, which could lead to a heart attack or angina attack. Hydralazine hydrochloride can also cause a type of nerve damage associated with a numbness or tingling sensation. Notify your doctor if you have any of these symptoms.

BiDil may aggravate certain types of angina.

Headaches often accompany treatment with BiDil and they tend to subside with continued treatment.

BiDil has not been tested in children.

Possible food and drug interactions when taking BiDil

BiDil combined with certain other medications may result in an extreme drop in blood pressure that can cause fainting, chest pain, or a heart attack. These medications, known as phosphodiesterase-5 inhibitors, are prescribed for the treatment of erectile dysfinction or pulmonary hypertension and include the medications sildenafil, vardenafil, and tadalafil.

Notify your doctor if you are taking any of the following medications, since they may increase the likelihood of a serious reaction to BiDil:

  • blood pressure medication
  • a class of antidepressants known as monoamine oxidase inhibitors

Special information if you are pregnant or breastfeeding

The effects of BiDil during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately.

It is not known whether BiDil appears in human breast milk. If BiDil is essential to your health, your doctor may advise you to stop nursing until your treatment is finished.

Recommended dosage for BiDil

Your doctor will prescribe the dosage that is appropriate for you, and dosage may be adjusted depending on how you respond to BiDil. Each tablet contains 20 milligrams of isosorbide dintrate plus 37.5 milligrams of hydralazine hydrochloride. The usual starting dose is one tablet three times a day. Your doctor may gradually increase it to as high as two tablets three times a day or lower it to a half a tablet three times a day.


If you suspect an overdose, seek emergency treatment immediately.

  • Symptoms of overdose may include:confusion, fainting, flushed skin, headache, rapid heart beat
  • BiDil Prescribing Information (FDA)
  • BiDil MedFacts Consumer Leaflet (Wolters Kluwer)
  • BiDil Consumer Overview