Skip to main content

Hydralazine and nitrates

  • If you cannot take ACE inhibitors or ARBs, you may need to take hydralazine and nitrates. When taken together, they relax your blood vessels and decrease how hard your heart has to work to pump blood.

    The most common products are:

    • hydralazine (Apresoline®)
    • isosorbide dinitrate (Isordil®)
    • isosorbide mononitrate (IMDUR®)
    • hydralazine/isosorbide dinitrate combination tablet (Bidil®)

    Tip

    Your doctor may add these medicines to treat your heart failure even if you are already taking an ACE or ARB.

    Side effects

    Possible side effects when taking these medicines together include: 

    • dizziness
    • headaches
    • flushing (warm, tingling, itchy skin)
    • nausea and vomiting

    When to call your health care provider while taking hydralazine

    Call your health care provider if you have any of the following while taking hydralazine:

    • dizziness
    • severe headache or headache that won't go away
    • skin blisters
    • joint or muscle pain
    • skin rash or itch
    • fever
    • sore throat

    Caution

    Do not use Viagra® (sildenfil) with nitrates because the combination will further decrease your blood pressure, which can lead to death.

    When to call your health care provider while taking nitrates

    Call your health care provider if you have any of the following while taking nitrates:

    • dry mouth
    • blurred vision
    • severe headache that won't go away
    • blushed color to your lips or fingernails
    • fast pulse

    Side effects that go away after using hydralazine include:

    • facial flushing or redness
    • headache
    • loss of appetite
    • nausea or vomiting
    • constipation

    Side effects that go away after using nitrates include:

    • dizziness or lightheadedness
    • headache
    • nausea or vomiting
    • flushing of your face or neck