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Drugs & Supplements

Hydralazine-Nitrate Combination

Medication names

isosorbide dinitrate (Dilatrate-SR, Iso-Bid, Isonate, Isorbid, Isordil, Isotrate, Sorbitrate)
hydralazine (Apresoline)
isosorbide mononitrate (IMDUR)

Why these medications are prescribed

The combination of hydralazine (an arterial vasodilator that relaxes arterial blood vessels) and a nitrate (a venous dilator that relaxes veins) is used for patients who cannot take an ACE inhibitor or angiotensin II receptor blocker or for patients who need an extra medication to control symptoms of heart failure. The combination is indicated for African Americans with moderate or severe heart failure already taking an ACE inhibitor.

When to take

Follow the label directions on how often to take the combination pill or each individual medication. Generally, these medications are not taken at evenly spaced times, but may be given with meals.

The number of doses you take each day, the time allowed between doses and how long you need to take the medication will depend on your condition and whether you are taking the combination pill or two separate medications.

Special directions
  • While taking these medications, have your blood pressure checked regularly, as advised by your doctor.
  • These medications may cause dizziness. Do not drive a car or operate dangerous machinery until you know how these drugs affect you.

Side effects and how to manage them

  • Headache—This is a very common occurrence as about 50% of patients may have this side effect. Use acetaminophen (Tylenol) as soon as you feel a headache and take as prescribed on the bottle. This effect may decrease over time.
  • Rapid, irregular or pounding heartbeat; numbness or tingling of the fingers or toes; loss of appetite and diarrhea—Your doctor will probably prescribe additional medication to control these side effects. If side effects persist, contact your doctor or nurse.
  • Upset stomach, flushing of face or neck—Contact your doctor or nurse if these side effects are persistent or severe.
  • Fever, joint or chest pain, sore throat, skin rash (especially on the face), unusual bleeding or bruising, weight gain, swelling of the ankles—Contact your doctor or nurse right away.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/20/2006…#12882