hydralazine/isosorbide dinitrate vs tadalafil
Side-by-side comparison of hydralazine/isosorbide dinitrate and tadalafil. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
major Known Drug Interaction
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.
Recommendation: You should not use these drugs together as it is strictly advised against.
Cialis
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.
Tadalafil (Cialis) is a medicine that helps men with erectile dysfunction (ED) or enlarged prostate (BPH). It belongs to a class of drugs called PDE5 inhibitors.
BiDil is used to treat heart failure in self-identified Black patients. It is used along with other standard heart failure treatments. BiDil can help you live longer, spend less time in the hospital because of heart failure, and feel better overall.
This medicine can help men who have trouble getting or keeping an erection (ED). It can also treat the symptoms of an enlarged prostate, also known as benign prostatic hyperplasia (BPH). BPH can cause difficulty with urination.
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.
Tadalafil works by relaxing the muscles in the penis and prostate. This increases blood flow to these areas. For BPH, it relaxes muscles in the prostate and bladder, which can improve urinary symptoms.
- • Headache
- • Dizziness
- • Headache
- • Upset stomach
- • Back pain
- • Muscle aches
- • Nasal congestion
- Long-term kidney disease 2,819
- Sudden kidney damage 2,616
- Kidney failure 2,097
- Final stage of kidney failure 1,585
- Tiredness 1,541
- Shortness of breath 11,663
- Headache 10,690
- Diarrhea 7,800
- Feeling sick to your stomach 6,498
- Death 5,896
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.
If you have chest pain, tell your doctor. If you need nitrates for a heart problem, wait 48 hours after taking tadalafil before taking nitrates. If you get an erection that lasts more than 4 hours, get medical help right away. If you have sudden vision loss in one or both eyes, stop taking this medicine and get medical help right away. If you have a sudden decrease or loss of hearing, stop taking this medicine and get medical help right away.
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.
This medicine is not for use in women. It is not known if this medicine will harm an unborn baby. It is also not known if this medicine passes into breast milk.
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How to Read This hydralazine/isosorbide dinitrate vs tadalafil Comparison
hydralazine/isosorbide dinitrate is classified in the Vasodilator / Nitrate Combination drug class, while tadalafil sits within the PDE5 Inhibitor class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, hydralazine/isosorbide dinitrate has 10,658 submissions while tadalafil has 42,547. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known major interaction flagged in FDA labeling, attributed to 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.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between hydralazine/isosorbide dinitrate and tadalafil - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.