hydralazine/isosorbide dinitrate
Brand names: BiDil
BiDil is a medicine that combines two drugs to help treat heart failure. It contains isosorbide dinitrate and hydralazine hydrochloride, which work together to widen blood vessels.
Drug Pricing (NADAC)
Brand Price
$4.38/unit
Generic Available
No
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
BiDil is used to treat heart failure in self-identified Black patients.
Common side effects
Headache, Dizziness
Key warnings
BiDil can cause low blood pressure, especially when you stand up.
How It Works
BiDil contains two medicines that work in different ways to widen your blood vessels. Isosorbide dinitrate widens both arteries and veins. Hydralazine hydrochloride mainly widens arteries.
How to Take It
Start by taking one BiDil tablet three times a day. Your doctor may increase the dose up to two tablets three times a day, if you can handle it. If you have side effects, your doctor may lower the dose to one-half tablet three times a day. Try to increase the dose again as soon as the side effects get better.
Pregnancy & Breastfeeding
It is not known if BiDil is safe to use during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if BiDil passes into breast milk. Talk to your doctor about the best way to feed your baby if you are taking BiDil.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.
Storage
Store BiDil tablets at room temperature (between 59°F and 86°F) in a tightly closed container, protected from light.
Side Effects (from patient reports)
Based on 17,575 FDA adverse event reports.
Serious Warnings
BiDil can cause low blood pressure, especially when you stand up. This is more likely if you are dehydrated or have low salt levels. Hydralazine hydrochloride, one of the medicines in BiDil, can cause a lupus-like syndrome. If you have symptoms, your doctor may tell you to stop taking BiDil. BiDil can also worsen chest pain, especially if you have certain heart conditions.
Known Drug Interactions
7 DRUG INTERACTIONS 7.1 Phosphodiesterase Inhibitors BiDil is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), PDE5 inhibitors such as avanafil, sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates.
Mechanism: Both drugs work to relax blood vessels, and taking them together can cause your blood pressure to drop to a dangerously low level.
What to do: Do not take these two medications together.
7 DRUG INTERACTIONS 7.1 Phosphodiesterase Inhibitors BiDil is contraindicated in patients who are using a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5), PDE5 inhibitors such as avanafil, sildenafil, vardenafil, and tadalafil have been shown to potentiate the hypotensive effects of organic nitrates.
Mechanism: These medicines both lower blood pressure in a similar way, and using them at the same time can cause a severe and unsafe drop in blood pressure.
What to do: You should not use these drugs together as it is strictly advised against.
Common Questions
What should I avoid while taking BiDil?
Can I drive while taking BiDil?
How long does it take for BiDil to work?
What if I have kidney problems?
What if I have liver problems?
Can I take BiDil with other medications?
What are the ingredients in BiDil?
What do the tablets look like?
How do I dispose of unused BiDil?
What if I have side effects?
What are the common side effects of hydralazine/isosorbide dinitrate?
Does hydralazine/isosorbide dinitrate interact with other medications?
What drug class is hydralazine/isosorbide dinitrate?
Is hydralazine/isosorbide dinitrate safe during pregnancy?
Related Medications in Vasodilator / Nitrate Combination
Other drugs grouped near hydralazine/isosorbide dinitrate — same-class peers and common alternatives.
adenosine
Adenocard
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amiodarone
Cordarone, Pacerone
Amiodarone (Pacerone) is a medicine used to treat life-threatening, irregular heartbeats.
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atropine
AtroPen
Atropine is a medicine that can temporarily block severe effects on your body.
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bumetanide
Bumex
Bumetanide is a water pill (diuretic).
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carvedilol
Coreg
Carvedilol is a medicine that lowers blood pressure and helps your heart work better.
Compare with hydralazine/isosorbide dinitrate →
Compare hydralazine/isosorbide dinitrate vs adenosine side-by-side →
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What the FDA Data Shows for hydralazine/isosorbide dinitrate
The FDA label for hydralazine/isosorbide dinitrate (sold under brand names such as BiDil) classifies it as a prescription-only medication in the Vasodilator / Nitrate Combination class. BiDil is used to treat heart failure in self-identified Black patients. Official labeling lists 2 commonly reported side effects, including Headache, Dizziness.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 17,575 voluntary reports. The database also lists 2 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: November 30, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages