Last reviewed 2026-04-22 · How we verify

Isosorbide Dinitrate + Hydralazine

Isosorbide dinitrate provides nitric oxide to relax blood vessels, while hydralazine directly relaxes vascular smooth muscle, together reducing cardiac preload and afterload to improve heart function.

Isosorbide dinitrate provides nitric oxide to relax blood vessels, while hydralazine directly relaxes vascular smooth muscle, together reducing cardiac preload and afterload to improve heart function. Used for Heart failure with reduced ejection fraction, particularly in African American patients, Angina pectoris.

At a glance

Mechanism of action

Isosorbide dinitrate is a nitrate that releases nitric oxide, causing vasodilation and reducing venous return (preload). Hydralazine is an arteriolar vasodilator that reduces peripheral vascular resistance (afterload). This combination is particularly effective in heart failure by reducing the workload on the heart while improving coronary perfusion.

Approved indications

• Heart failure with reduced ejection fraction, particularly in African American patients
• Angina pectoris

Common side effects

• Headache
• Dizziness
• Hypotension
• Palpitations
• Lupus-like syndrome (hydralazine)
• Tachycardia

Key clinical trials

• Baroreflex Activation Therapy for Heart Failure (NA)
• DANHEART (H-HeFT and Met-HeFT) (PHASE4)
• Verification of the Efficacy and Safety of the BAROSTIM NEO System in the Treatment of Drug Resistant Hypertension (NA)
• Hypertensive Heart Failure Treatment in SSA (PHASE4)
• Diuretics vs. Afterload Reduction for Treatment of HeartLogic Alerts (PHASE4)
• Genomic Response Analysis of Heart Failure Therapy in African Americans
• Vasodilator Therapy for Heart Failure and Preserved Ejection Fraction (PHASE2)
• Safety and Cardiovascular Efficacy of Hydralazine and Isosorbide Dinitrate in Dialysis-Dependent ESRD (PHASE4)

Primary sources

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