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BiDil
BiDil is a combination medication containing isosorbide dinitrate and hydralazine. It is primarily used to treat heart failure in patients, specifically self-identified African American patients. This medication was specifically approved for African Americans based on clinical studies showing improved outcomes in this population. Isosorbide dinitrate works by relaxing blood vessels, reducing the workload on the heart, while hydralazine lowers blood pressure by dilating arteries, improving the heart's efficiency in pumping blood.
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Frequently Asked Questions
Why is BiDil specifically recommended for African American patients?
BiDil was specifically studied and shown to be effective in self-identified African American patients in reducing the risk of heart failure-related death. African Americans tend to have a higher prevalence of heart failure and may respond differently to certain medications.
Can I take BiDil if I am not African American?
Although BiDil is marketed primarily for African American patients, it may be prescribed to others at the discretion of a healthcare provider if it is deemed appropriate for the management of heart failure.
What should I do if I miss a dose?
If you miss a dose of BiDil, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and take the next one at the regular time. Do not double up doses.
Can I drink alcohol while taking BiDil?
You should avoid or limit alcohol consumption while taking BiDil, as it can increase the risk of dizziness and low blood pressure.
How long does it take for BiDil to work?
BiDil starts working to reduce heart failure symptoms relatively quickly, but it may take several weeks of consistent use to notice significant improvements in heart function and overall symptoms.
Comprehensive Drug Guide
How Does BiDil Work?
- Isosorbide dinitrate relaxes the blood vessels (veins), reducing the amount of blood returning to the heart, which decreases the heart’s workload.
- Hydralazine dilates the arteries, reducing the resistance the heart has to overcome to pump blood, improving circulation and decreasing blood pressure.
Common Dosages
- Tablets: Each tablet contains 20 mg of isosorbide dinitrate and 37.5 mg of hydralazine.
Typical Dosing
- The usual dose of BiDil is one tablet three times daily, with the dosage possibly increasing based on individual patient needs and tolerance, up to two tablets three times daily.
Typical Dosing
FDA Approved Indications
- Treatment of heart failure in self-identified African American patients as an adjunct to standard therapies (such as ACE inhibitors and beta-blockers).
Who Shouldn't Take BiDil?
- Known hypersensitivity to either isosorbide dinitrate, hydralazine, or any other components of the formulation.
- Severe hypotension (low blood pressure).
- Recent use of phosphodiesterase inhibitors (like sildenafil or tadalafil), as this can lead to a dangerous drop in blood pressure.
Advice From The Pharmacist
- Take BiDil exactly as prescribed by your healthcare provider, usually three times a day.
- It is important to monitor your blood pressure regularly while on this medication to avoid hypotension (very low blood pressure).
- Dizziness or lightheadedness may occur when standing up too quickly. Take your time when moving from sitting or lying down to standing.
- Let your healthcare provider know if you are using any medications for erectile dysfunction (like Viagra), as these drugs should not be taken with BiDil.
Side Effects of BiDil
Common Side Effects
- Headache
- Dizziness
- Weakness
- Nausea
Uncommon/Severe Side Effects
- Severe hypotension (dangerously low blood pressure)
- Rapid or irregular heartbeat
- Lupus-like syndrome (with hydralazine, characterized by joint pain, fever, and rash)
Risks and Warnings of BiDil
- Hypotension: BiDil can cause a significant drop in blood pressure, especially when combined with other vasodilators or medications like sildenafil or tadalafil.
- Lupus-like syndrome: Hydralazine, one of the active ingredients in BiDil, can cause a lupus-like syndrome, with symptoms like joint pain, fever, and rash. Inform your doctor if you experience these symptoms.
- Headaches: Isosorbide dinitrate is known to cause headaches, especially when starting the medication. Over time, the body often adjusts to this side effect.
Interactions with BiDil
Common Drug Interactions
- Phosphodiesterase inhibitors (PDE5 inhibitors): Medications like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can cause severe drops in blood pressure when used with BiDil.
- Antihypertensive medications: Taking BiDil with other blood pressure-lowering medications can increase the risk of hypotension.
- NSAIDs: Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, may reduce the effectiveness of BiDil in controlling heart failure symptoms.
Alternatives to BiDil
- ACE inhibitors (such as enalapril or lisinopril): These are often the first-line treatment for heart failure and work by relaxing blood vessels and reducing the heart’s workload.
- ARBs (angiotensin II receptor blockers): Such as losartan and valsartan, these medications are alternatives to ACE inhibitors for heart failure management.
- Beta-blockers: Medications like carvedilol or metoprolol are commonly used to improve heart function in heart failure patients.
