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Overview	Photos	How To Use	Side Effects	Precautions	Missed Dose	Drug Interactions

BiDil Uses This medication is used with other medications to treat heart failure in selected patients. This combination drug is used when other heart failure medications are not controlling your symptoms. This product contains 2 drugs. Isosorbide belongs to a class of drugs known as nitrate vasodilators. Hydralazine is a different kind of vasodilator. Both drugs cause relaxation of blood vessels so blood can flow more easily. This effect allows the heart to work less, decreasing symptoms of heart failure. Notes Do not share this medication with others.Laboratory and/or medical tests (e.g., blood pressure, complete blood count, antinuclear antibody titer-ANA, liver/kidney function) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.Lifestyle changes such as stress-reduction programs, exercise, stopping smoking, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you. Storage Store at room temperature at 77 degrees F (25 degrees C) away from light and moisture. Brief storage between 59-86 degrees F (15-30 degrees C) is permitted. Do not store in the bathroom. Keep all medicines away from children and pets. Overdose Symptoms of overdose may include: persistent throbbing headache, severe dizziness, vision changes, fainting, confusion, fever, fast/weak heartbeat, severe nausea/vomiting, sweating, shortness of breath, cold/clammy skin, seizures. How To Use Take this medication by mouth, usually 3 times daily or exactly as directed by your doctor. Tablets may be split if they have a cutting line (score line).Dosage is based on your medical condition and response to treatment. Your doctor will slowly increase the dose to find the best dose for you.Because this combination product has fixed doses of isosorbide and hydralazine, it should be used only if your doctor has determined that the doses of both medications in this product are right for you.Use this medication regularly in order to get the most benefit from it. To help you remember, take it at the same times each day. It is important to continue taking this medication even if you feel well. It may take up to several weeks before the full benefit of this drug takes effect.Do not stop taking this medication without first consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased.Tell your doctor immediately if your heart failure symptoms persist or worsen (e.g., tiredness, swelling of feet/ankles/legs, decreased ability to do normal daily activities, shortness of breath when lying down). Side Effects Dizziness, lightheadedness, headache, loss of appetite, nausea, vomiting, diarrhea, constipation, flushing, eye watering/redness/itchiness, or stuffy nose may occur as your body adjusts to the medication. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Headache usually means that the medication is working. Treat headaches with an over-the-counter pain reliever (e.g., acetaminophen) as directed by your doctor. If the headaches continue or become severe, tell your doctor.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: fast/irregular heartbeat, chest pain, unusual/severe/persistent dizziness, fainting, shaking (tremor), paleness, sweating, blurred vision, dry mouth, muscle cramps, mental/mood changes (e.g., depression, unusual behavior, confusion), trouble urinating, severe vomiting, severe constipation, decreased sexual ability.This medication may infrequently cause nerve problems. Tell your doctor promptly if you experience numbness or tingling. Your doctor may recommend a vitamin B6 supplement (pyridoxine).This medication may infrequently cause a serious immune system problem (systemic lupus erythematosus), which may occur with or without a certain severe kidney problem (glomerulonephritis). Tell your doctor immediately if you experience any of these unlikely but serious side effects: unusual tiredness, joint/muscle aches, unusual fever, butterfly-shaped facial rash, swollen glands, bloody/pink urine, swelling of the feet/ankles.Your doctor may need to order special tests if you experience these symptoms. Keep all laboratory and medical appointments.Tell your doctor immediately if any of these rare but very serious side effects occur: signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding, yellowing eyes/skin, dark urine, persistent nausea/vomiting, abdominal pain, bluish lips/skin/nails, unusual tiredness, severe weakness, seizures.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching, swelling, severe dizziness, trouble breathing.If you notice other effects not listed above, contact your doctor or pharmacist. Precautions Before taking isosorbide/hydralazine, tell your doctor or pharmacist if you are allergic to either of these drugs; or to other nitrates (e.g., nitroglycerine); or if you have any other allergies.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe anemia, a certain heart valve problem (rheumatic heart disease of the mitral valve).Before using this medication, tell your doctor or pharmacist your medical history, especially of: low blood pressure, a severe loss of body water (dehydration), certain heart problems (e.g., recent heart attack, chest pain, angina), a certain type of enlarged heart (hypertrophic cardiomyopathy), increased pressure in the brain (e.g., due to head trauma, cerebral hemorrhage), exposure to nitrates while on the job, blood vessel problems, previous stroke, kidney failure, liver problems, a certain immune system disease (lupus), recent nerve surgery (e.g., sympathectomy).This drug may make you dizzy or lightheaded. Use caution while driving, using machinery, or doing any activity that requires alertness. Limit alcoholic beverages since they may worsen these side effects.To reduce dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially dizziness.Before having surgery, tell your doctor or dentist that you are taking this medication.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding. Missed Dose If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up. Drug Interactions Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.This drug should not be used with the following medications because very serious (possibly fatal) interactions may occur: drugs used to treat sexual problems (e.g., sildenafil, tadalafil, vardenafil).This drug should be used cautiously or not at all with the following medications because very serious interactions may occur: MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine).If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting isosorbide/hydralazine.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: alcohol, migraine drugs (e.g., ergotamine), water pills/diuretics (e.g., furosemide, hydrochlorothiazide), other drugs for heart failure (e.g., beta blockers, ACE inhibitors), epinephrine, certain medications for high blood pressure (e.g., diazoxide), calcium channel blockers (e.g., nifedipine, verapamil).Check the labels on all your medicines (e.g., cough-and-cold products, diet aids, nonsteroidal anti-inflammatory drugs-NSAIDs for pain/fever reduction) because they may contain ingredients that could increase your blood pressure, increase your body water, or cause a fast heartbeat. These effects will increase the work your heart must do. These drugs include pseudoephedrine, phenylephrine, chlorpheniramine, diphenhydramine, clemastine, ibuprofen, naproxen. Ask your pharmacist about using these products safely.This product can affect the results of a certain lab test (serum cholesterol), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgement of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.