What is Hydralazine; Isosorbide Dinitrate, ISDN tablets?

HYDRALAZINE; ISOSORBIDE DINITRATE, ISDN (BiDil) is a combination of two drugs used to treat heart failure in patients self-identified as black. Hydralazine; isosorbide dinitrate works by relaxing blood vessels, increasing the blood oxygen supply to your heart. Heart failure happens when the heart muscles are too weak to pump enough blood through out the body. This medicine is not a cure for heart failure, however it is important that you take this medication regularly.

What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions: anemia blood vessel disease chest pain glaucoma heart disease or history of heart attacks kidney disease liver disease low blood pressure overactive thyroid recent head injury, stroke, or bleeding in the brain system lupus erythematosus (SLE) an unusual reaction to hydralazine, isosorbide dinitrate, other medicines, foods, dyes, or preservatives pregnant or trying to get pregnant breast-feeding

How should this medicine be used?

Take hydralazine; isosorbide dinitrate tablets by mouth. Follow the directions on the prescription label. Swallow the tablets with a drink of water. It is best if you take your medication at the same time every day. You may take this medicine with or without food. Do not take your medicine more often than directed. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. Elderly patients over 65 years old may have a stronger reaction to this medicine and may need smaller doses.

What if I miss a dose?

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

What drug(s) may interact with Hydralazine; Isosorbide Dinitrate, ISDN?

Do not take hydralazine; isosorbide dinitrate with any of the following: sildenafil (Viagra) tadalafil (Cialis) vardenafil (Levitra) Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil) should not be taken with this medication to avoid severe side effects including very low blood pressure and other complications. This medicine may also interact with the following medications: alcohol antiinflammatory rugs (NSAIDs, such as ibuprofen) female hormones including contraceptive or birth control pills hawthorn, crataegus laevigata medicine for high blood pressure medicines for colds and breathing difficulties medicines for Parkinson's disease containing Levodopa, such as Atamet, Parcopa, Sinemet and Sinemet CR, Stalevo, and Larodopa monoamine oxidase inhibitors (Azilect, Eldepryl, Emsam, Marplan, Nardil, Parnate, Zelapar) nitroglycerin water pills weight loss medication containing Ephedra, Ma Huang zalcitabine, ddC Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking Hydralazine; Isosorbide Dinitrate, ISDN?
Check your heart rate and blood pressure regularly while you are taking hydralazine; isosorbide dinitrate. Ask your prescriber or health care professional what your heart rate and blood pressure should be and when you should contact him or her. Tell your prescriber or health care professional if you feel your medicine is no longer having any effect. You may get dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how isosorbide dinitrate affects you. To reduce the risk os dizzy or fainting spells, do not sit or stand up quickly, especially if you are an older patient. Alcohol can make you more dizzy, and increase flushing and rapid heartbeats. Avoid alcoholic drinks. Do not treat yourself for coughs, colds, headache, or pain while you are receiving hydralazine, without asking your prescriber or health care professional for advice.

What side effects may I notice from receiving Hydralazine; Isosorbide Dinitrate, ISDN?

Side effects that you should report to your prescriber or health care professional as soon as possible: bluish discoloration of lips, fingernails, or palms of hands chest pain or irregular heart beat (palpitations) difficulty urinating dizziness or fainting excessive sweating feeling of extreme pressure in the head fever, chills, sore throat, muscle cramps low blood pressure numbness, pain, and tingling in the hands and feet shortness of breath skin rash including welts around the lips and mouth sudden weight gain swelling of the legs or feet unusual tiredness or weakness Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): flushing of the face or neck headache lightheadedness, especially when changing from a seated or lying position nasal congestion nausea, vomiting, or upset stomach

How does coronary artery disease develop?

Arteries that supply blood and oxygen to the heart muscles are called coronary arteries. Coronary artery disease (CAD) occurs when cholesterol plaque (a hard, thick substance comprised of varying amounts of cholesterol, calcium, muscle cells, and connective tissue, which accumulates locally in the artery walls) builds up in the walls of these arteries, a process called arteriosclerosis. Over time, arteriosclerosis causes significant narrowing of one or more coronary arteries. When coronary arteries narrow more than 50% to 70%, the blood supply beyond the plaque becomes inadequate to meet the increased oxygen demand of the heart muscle during exercise. Lack of oxygen (ischemia) in the heart muscle causes chest pain (angina) in most people. However, some 25% of those with significant coronary artery narrowing experience no chest pain at all despite documented ischemia, or may only develop episodic shortness of breath instead of chest pain. These people are said to have "silent angina" and have the same risk of heart attack as those with angina. When arteries are narrowed in excess of 90% to 99%, people often have angina at rest (unstable angina). When a blood clot (thrombus) forms on the plaque, the artery may become completely blocked, causing death of a part of the heart muscles (heart attack, or myocardial infarction). The arteriosclerotic process can be accelerated by smoking, high blood pressure,elevated cholesterol levels, and diabetes. Individuals are also at higher risk for arteriosclerosis if they are older (greater than 45 years for men and 55 years for women) or if they have a positive family history of coronary heart disease.

What is a Percutaneous Coronary Intervention (PCI)?

PCI is a treatment procedure that unblocks narrowed coronary arteries without performing surgery. During this procedure, your cardiologist determines the best treatment for your condition. Treatment will vary from patient to patient.

PCI may include one or more of the following treatments: Balloon catheter angioplasty: During this procedure, the cardiologist inserts a cardiac catheter with a small balloon around it into the coronary artery. The cardiologist then places the balloon in the narrowed area of the artery and expands it with liquid. This pushes the plaque (blockage) to the sides of the artery where it remains. This technique reduces the narrowing in the artery and restores the normal size of the artery. The cardiologist removes the balloon catheter at the end of the procedure. Stent: The cardiologist places a small, hollow metal (mesh) tube called a "stent" in the artery to keep it open following a balloon angioplasty. The stent prevents constriction or closing of the artery during and after the procedure. Drug-eluting stents are now used. These stents are coated with medication that helps prevent narrowing of the artery.