Vasodilators for Heart Failure
Examples
Hydralazin
|
| hydralazine | |
| hydralazine and isosorbide dinitrate | BiDil |
Nitrates
|
| isosorbide dinitrate | Isordil |
| isosorbide mononitrate | ISMO |
| nitroglycerin | |
How It Works
Vasodilators work on different substances
in the body to help widen (dilate) blood vessels. It is easier for the heart to
pump blood if the blood vessels are widened.
Why It Is Used
Vasodilators are often combined with
other medicines to treat
heart failure. Hydralazine taken with a nitrate may be
used as an alternative to angiotensin-converting enzyme (ACE) inhibitors if ACE
inhibitors cannot be tolerated.
How Well It Works
For heart failure, hydralazine is
typically used along with a nitrate. But nitrates may be used alone, without
hydralazine, if you are taking it to relieve
angina symptoms.
If you take hydralazine
with a nitrate, you will also take other medicines for heart failure such as
ACE inhibitors and beta-blockers. This combination of medicines may help
relieve symptoms and lower the risk of early death. This benefit has been shown
in African Americans but has not been shown in other groups of people.1
Side Effects
The most common side effect is low blood
pressure, which may cause symptoms of dizziness, weakness, or fainting. People
who have low blood pressure when they start therapy will typically be started
with a low dose and may need close monitoring to avoid reducing blood pressure
too much.
Long-term use of these medicines is associated with
fluid retention (with hydralazine) and loss of effectiveness (development of
tolerance) with nitrates. For these reasons, their use may be limited.
Nitrates may cause headaches.
See Drug Reference for a full
list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Vasodilator drugs seldom are used
alone to treat heart failure.
If you are taking nitrates, do not
use erection-enhancing medicines such as sildenafil (Viagra), tadalafil
(Cialis), or vardenafil (Levitra). Do not take a nitrate and an
erection-enhancing medicine together, because you can have very low blood
pressure, which can lead to death.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
- Hunt SA, et al. (2009). 2009 focused update
incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management
of heart failure in adults. A report of the American College of Cardiology
Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation, 119(14): e391–e479.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Theresa O'Young, PharmD - Clinical Pharmacy |
|---|
| Last Revised | August 9, 2010 |
|---|
Last Revised:
August 9, 2010
Hunt SA, et al. (2009). 2009 focused update
incorporated into the ACC/AHA 2005 guidelines for the diagnosis and management
of heart failure in adults. A report of the American College of Cardiology
Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation, 119(14): e391–e479.
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