Vasodilators for heart failure

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Examples

Brand Name Chemical Name
Apresazide [contains a diuretic], Apresoline hydralazine
Isordil, Sorbitrate isosorbide dinitrate
BiDil isosorbide dinitrate and hydralazine hydrochloride
Imdur, ISMO isosorbide mononitrate
nitroglycerin

Nitrates

Brand Name Chemical Name
Apresazide [contains a diuretic], Apresoline hydralazine
Isordil, Sorbitrate isosorbide dinitrate
BiDil isosorbide dinitrate and hydralazine hydrochloride
Imdur, ISMO isosorbide mononitrate
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. Certain vasodilators may be used as an alternative to angiotensin-converting enzyme (ACE) inhibitors if ACE inhibitors cannot be tolerated.

How Well It Works

When taken with other medicines to treat heart failure, vasodilators may have some effect in reducing premature death rates.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 generally 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.

People who are taking nitrates should never use sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) because of the risk of developing very low blood pressure, which can lead to death.

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.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Lejemtel TH, et al. (2004). Diagnosis and management of heart failure. In V Fuster et al., eds., Hurst's The Heart, 11th ed., vol. 1, pp. 723–762. New York: McGraw-Hill.

Credits

Author Robin Parks, MS
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman
Associate Editor Terrina Vail
Primary Medical Reviewer Caroline S. Rhoads, MD
- Internal Medicine
Specialist Medical Reviewer Stephen Fort, MD, MRCP, FRCPC
- Interventional Cardiology
Last Updated September 1, 2006
Last Updated: 09/01/2006

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