BiDil is a combination medication that contains isosorbide dinitrate (a nitrate) and hydralazine (an arteriolar vasodilator). It's used to treat heart failure in Black adults. But BiDil (isosorbide dinitrate / hydralazine) isn't a first-choice medication, but typically prescribed along with other heart failure medications. BiDil (isosorbide dinitrate / hydralazine) is taken by mouth three times per day. Common side effects of this medication include low blood pressure, dizziness, and weakness. BiDil is available as a brand-name medication and as lower-cost generics.
BiDil is a combination medication that contains two medications, isosorbide dinitrate (a nitrate) and hydralazine (an arteriolar vasodilator). Both medications work differently to keep levels of a chemical called nitric oxide high. Nitric oxide helps to relax your blood vessels. This allows more blood to get to your heart and other organs. Your heart won't work as hard, so you'll feel better and have less heart failure problems.
| Common Brands | BiDil |
|---|---|
| Drug Class | Vasodilator |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Contact your healthcare provider immediately if you experience any of the following.
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
BiDil (isosorbide dinitrate / hydralazine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
BiDil (isosorbide dinitrate / hydralazine) can cause your blood pressure to drop too much, which can make you feel dizzy, tired, or lightheaded. This side effect is more common when you first start BiDil (isosorbide dinitrate / hydralazine) or when the dose is raised. Your risk is higher if you're dehydrated or have medical conditions that cause you to become dehydrated, such as diarrhea or vomiting. If your blood pressure drops too much and you feel dizzy, make sure to sit down slowly while holding onto something and let your healthcare professional (HCP) know. If you fall and hit your head, get medical help right away. If you feel dizzy, lightheaded, faint, tired, or confused while taking BiDil (isosorbide dinitrate / hydralazine), contact your HCP right away.
Although rare, hydralazine in BiDil can cause lupus. If this does happen, it usually goes away when stopping the medication. Contact you prescriber right away notice muscle or joint pain, swelling, fatigue, or fever.
Hydralazine in BiDil can raise your heart rate and lower blood pressure. In people who have hypertrophic cardiomyopathy (HCM), this can worsen blood flow to the heart and raise the risk for chest pain. If you have HCM, your healthcare team can talk with you about the risks and benefits of taking BiDil (isosorbide dinitrate / hydralazine).
Hydralazine in BiDil can cause neuropathy, which can feel like numbness, tingling, or a "pins-and-needles" sensation. If you get these symptoms, let your prescriber know. They'll likely recommend taking a vitamin B6 (pyridoxine) supplement to help.
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg/37.5mg | 90 tablets | $67.65 | $0.75 |
Each tablet of BiDil contains 20 mg of isosorbide dinitrate and 37.5 mg of hydralazine.
Adults: The typical starting dose is 1 tablet by mouth three times per day. If needed, your cardiologist can slowly raise the dose to up to 2 tablets by mouth three times per day, as long as you're not having side effects.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because BiDil (isosorbide dinitrate / hydralazine) will not be safe for you to take.
Prescription savings
Stop paying too much for your prescriptions. Compare prices, get pharmacy coupons, and save up to 80%.
Find expert answers to your health questions so you can make the best decisions for yourself and your family.Health conditions
Medications & treatment
Access & affordability
Our monthly healthcare membership can help you save thousands on your prescription costs.Resources
Bidil is FDA-approved to treat heart failure in Black adults because research suggests that Bidil works better for Black adults than for adults in other groups. Talk with your healthcare team if you have more questions about whether Bidil is a good option for you.
Yes, both the BiDil brand name and generic are still available on the market. The heart failure guidelines recommend Bidil for Black adults who still have symptoms while taking other heart failure medications.
Research suggests that Bidil can improve ejection fraction (how well your heart pumps blood) after 8 weeks. Studies show that people who took Bidil along with other medications for heart failure for a year experienced improvements in physical symptoms and were less likely to die or be hospitalized for their condition, compared to those who didn't take Bidil. Make sure you continue to take this medication as directed, so that it continues to work well for you.
No, Bidil isn't a diuretic (water pill); it's a combination of a vasodilator and nitrate that relaxes your blood vessels to help blood flow to the heart. Diuretics are used in people with heart failure to get rid of extra fluid in the body. It's possible that your cardiologist will prescribe a diuretic (e.g., furosemide (Lasix) or bumetanide (Bumex)) to take along with Bidil. These medications work in different ways to help treat heart failure.
Yes, Bidil can lower blood pressure since it relaxes your blood vessels. This might lead to side effects, like dizziness or weakness. You must avoid taking Bidil with certain medications, such as PDE5 inhibitors, like sildenafil (Viagra)); this combination can result in dangerously low blood pressure. Let your prescriber know if you feel lightheaded or dizzy during treatment with Bidil because this could mean your blood pressure is too low and they might need to adjust your dose.
No, Bidil isn't known to affect your blood potassium levels. But other heart failure medications, such as diuretics (water pills), can cause low blood potassium levels. Talk with your healthcare team if you're concerned about your potassium levels.
No, Bidil doesn't seem to lower your heart rate as a side effect. Though rare, the hydralazine in Bidil might raise your heart rate. Contact your cardiologist if you notice quick changes to your heart rate after starting Bidil.
Bidil isn't known to cause kidney damage. But you might be taking other heart failure medications at the same time that can affect your kidneys and cause kidney-related problems, like dehydration. If you're dehydrated, you're more likely to experience low blood pressure from Bidil. Before you start treatment, your cardiologist will give you recommendations for how much fluid you can drink to stay hydrated without worsening heart failure.
