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hydralazine/isosorbide dinitrate (BiDiL)

Indications: - heart failure Dosage: 1-2 tabs PO TID (8-12 hour nitrate-free interval overnight) Tabs: 37.5 mg hydralazine & 20 mg isosorbide dinitrate Adverse effects: 1) see hydralazine & isosorbide dinitrate 2) nitrate tolerance inlikely with TID dosing [3] Mechanism of action: - reduces mortality in African-Americans with systolic heart failure (HFrEF) [4] Notes: Cost up to $400/month, compared to $60/month for the two generic drugs separately.

Interactions

drug interactions

General

antihypertensive combination

References

  1. American Medical News
  2. Prescriber's Letter 12(1):2, 2005 Isosorbide Dinitrate Plus Hydralazine in Blacks with Heart Failure Detail-Document#: 210105 (subscription needed) http://www.prescribersletter.com
  3. Prescriber's Letter 12(8): 2005 New Formulation: BiDil (Isosorbide Dinitrate and Hydralazine Hydrochloride) Detail-Document#: 210808 (subscription needed) http://www.prescribersletter.com
  4. Taylor AL, Ziesche S, Yancy C et al Combination of isosorbide dinitrate and hydralazine in blacks with heart failure. N Engl J Med. 2004;351(20);2049-2057 PMID: 15533851 Free article

Components

hydralazine (Apresoline) isosorbide dinitrate (Isordil, Sorbitrate, Isordil Tembids, Dinitrate SR, ISDN)