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BIDIL (ISOSORBIDE DINITRATE/HYDRALAZINE HCL)
- Chronic heart failure
20 mg-37.5 mg tablet
- 2 tablets by oral route 3 times per day
20 mg-37.5 mg tablet
- 2 tablets by oral route 3 times per day
Chronic heart failure
- 1 tablet by oral route 3 times per day
- 2 tablets by oral route 3 times per day
- one-half tablet by oral route 3 times per day
- Adcirca
- Adempas
- avanafil
- Cialis
- Levitra
- Revatio
- riociguat
- sildenafil
- Stendra
- tadalafil
- vardenafil
- Viagra
Contraindicated
- bromocriptine
- Cafergot
- Cycloset
- D.h.e.45
- dihydroergotamine
- ergoloid
- Ergomar
- ergotamine tartrate
- ergotamine-caffeine
- methylergonovine
- Migergot
- Migranal
- Parlodel
Severe
Moderate
- Dutoprol
- Inderal La
- Inderal Xl
- Innopran Xl
- Lopressor
- Lopressor Hct
- metoprolol su-hydrochlorothiaz
- metoprolol succinate
- metoprolol ta-hydrochlorothiaz
- metoprolol tartrate
- propranolol
- propranolol-hydrochlorothiazid
- Toprol Xl
- None
Contraindicated
- 30 day risk period post-myocardial infarction
- Coronary artery disease
- Hypotension
- Hypovolemia
- Intracerebral hemorrhage
- Intracranial hypertension
- Methemoglobinemia
- N-acetyltransferase slow acetylator
- Severe anemia
Severe
Moderate
- Acute myocardial infarction
- Cerebrovascular accident
- Hypertrophic cardiomyopathy
- Hypotension
- Intracranial hypertension
- Lupus-like syndrome
- Malabsorption states
BIDIL (ISOSORBIDE DINITRATE/HYDRALAZINE HCL)
- Chronic heart failure
- Syncope
- Anorexia
- Diarrhea
- Dizziness
- Flushing
- Headache disorder
- Hypotension
- Nausea
- Nervousness
- Orthostatic hypotension
- Palpitations
- Paresthesia
- Tachycardia
- Vomiting
More Frequent
Severe
Less Severe
- Angina
- Edema
- Lupus-like syndrome
- Peripheral neuropathy
- Pruritus of skin
- Skin rash
- Urticaria
- Constipation
- Dizziness
- Dyspnea
- Eye tearing
- Flushing
- Hypotension
- Nasal congestion
- Nausea
- Palpitations
- Tachycardia
- Vomiting
Less Frequent
Severe
Less Severe
Rare / Very Rare
Severe
- Agranulocytosis
- Allergic dermatitis
- Anaphylaxis
- Anemia
- Blurred vision
- Eosinophilia
- Exfoliative dermatitis
- Glomerulonephritis
- Hepatitis
- Leukopenia
- Lymphadenopathy
- Methemoglobinemia
- Neutropenic disorder
- Paralytic ileus
- Purpura
- Severe headache disorder
- Splenomegaly
- Xerostomia
Less Severe
- Acute confusion
- Arthralgias
- Chills
- Conjunctivitis
- Depression
- Drowsy
- Dyspnea
- Dysuria
- Fever
- General weakness
- Peripheral neuritis
- Skin rash
- Symptoms of anxiety
- Tremor
- Vertigo
Contraindicated
None
Severe Precaution
None
Management or Monitoring Precaution
Isosorbide
No established safety and efficacy.
- 1 Day – 18 Years
- No established safety and efficacy.
Hydralazine
- Severity Level:
C
- Additional Notes:
Isosorbide Dinitrate
- Severity Level:
C
- Additional Notes: Insufficient human data; animal data suggest developmental toxicity
Contraindicated
None
| General | Excretion Potential | Effect on Infant | Notes |
| None |
Precaution Exists
Isosorbide Dinitrate
Insuff data avail; molecular wt low enough for possible breastmilk excretion
| General | Excretion Potential | Effect on Infant | Notes |
| Evaluate use carefully | Unknown | Not known; no or inclusive data | Insuff data avail; molecular wt low enough for possible breastmilk excretion |
No Known Risk
Hydralazine
Limited data suggest infant exposure is minimal with no adv effects
| General | Excretion Potential | Effect on Infant | Notes |
| No known risks; does not adversely affect lactation | Excreted | Not known; no or inclusive data | Limited data suggest infant exposure is minimal with no adv effects |
Contraindicated
None
Precaution Exists
Hydralazine
Cardiovascular-Elderly are more sensitive to hypotensive effects. Other-More sensitive to drug-induced hypothermia.
Cardiovascular-Elderly may be more sensitive to the hypotensive effects of vasodilation.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | Y | N | Y | N | N | N |
BEERS: N HEDIS: N STOPP: Y
Isosorbide(dinitrate)
Cardiovascular-Elderly are more sensitive to hypotensive effects. Other-More sensitive to drug-induced hypothermia.
Cardiovascular-Elderly may be more sensitive to the hypotensive effects of vasodilation.
| Organ / System | HEP | REN | CARD | ENDO | NEURO / PSYCH | PULM |
| Increased Risk / Adverse Effects | N | N | Y | N | N | N |
BEERS: N HEDIS: N STOPP: Y
No Known Risk
None
- None
| Chronic heart failure | |
| I50.22 | Chronic systolic (congestive) heart failure |
| I50.32 | Chronic diastolic (congestive) heart failure |
| I50.42 | Chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.812 | Chronic right heart failure |
| I50.814 | Right heart failure due to left heart failure |
| 0-9 | A-Z |
|---|---|
| I50.22 | Chronic systolic (congestive) heart failure |
| I50.32 | Chronic diastolic (congestive) heart failure |
| I50.42 | Chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.812 | Chronic right heart failure |
| I50.814 | Right heart failure due to left heart failure |
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