Before taking this medication, tell your doctor if you
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have low blood pressure;
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have had a stroke, a transient ischemic attack (TIA, or mini-stroke), or a serious head injury;
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have anemia;
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have an allergy to nitrates;
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have closed-angle glaucoma;
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suffer from migraines;
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have systemic lupus erythematosus;
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have high levels of cholesterol or triglycerides (types of fat) in your blood;
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have pulmonary hypertension;
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have kidney disease; or
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have liver disease.
You may not be able to take hydralazine and isosorbide dinitrate, or you may require a dosage adjustment or special monitoring during therapy.
Hydralazine and isosorbide dinitrate is in the FDA pregnancy category C. This means that it is not known whether hydralazine and isosorbide dinitrate will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant.
It is also not known whether hydralazine or isosorbide dinitrate pass into breast milk. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.
If you are over 60 years of age, you may be more likely to experience dizziness from hydralazine. You may require a lower dose or special monitoring during therapy.
Take hydralazine and isosorbide dinitrate exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.
Take each dose with a full glass of water.
Do not stop taking hydralazine and isosorbide dinitrate suddenly. Talk to your doctor before you stop taking the drug completely.
Store this medication at room temperature away from moisture and heat.
Take the missed dose as soon as you remember. If your next regularly scheduled dose is within
2 hours, skip the dose you missed and take only the next dose.
If you experience any of the following serious side effects, stop taking hydralazine and isosorbide dinitrate and seek emergency medical attention:
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an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
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blurred vision and dry mouth;
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irregular heartbeat; or
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blood in your urine or stools;
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numbness, tingling, pain, or weakness of your arms or legs;
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fainting.
Other, less serious side effects may be more likely to occur. If you experience any of the following side effects, continue to take isosorbide and talk to your doctor:
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headache or dizziness;
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flushing (redness of the face, neck and chest);
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nausea or vomiting;
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fast heartbeat;
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swollen ankles; or
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weakness.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
You may develop a headache because of this medicine, but do not stop taking it. Take aspirin or acetaminophen to treat the headache. Ask your doctor which is best for you. This side effect usually goes away with continued hydralazine and isosorbide dinitrate treatment.
Do not stop taking hydralazine and isosorbide dinitrate suddenly. Talk to your doctor before you stop taking the drug completely.
Do not drink alcohol while taking this medication.
Use caution when driving, operating machinery, or performing other hazardous activities. Hydralazine and isosorbide dinitrate may cause dizziness. If you experience dizziness, avoid these activities.
Use caution when driving, operating machinery, or performing other hazardous activities. Hydralazine and isosorbide dinitrate may cause dizziness. If you experience dizziness, avoid these activities. Also, stand up slowly from a lying or sitting position.
Avoid alcohol. Alcohol also widens your blood vessels, and it can cause very low blood pressure, dizziness, and drowsiness. If you consume alcohol, you could endanger yourself or others.
Do not stop taking hydralazine and isosorbide dinitrate suddenly. Talk to your doctor before you stop taking the drug completely.
Before taking hydralazine and isosorbide dinitrate, tell your doctor if you are taking any of the following medicines:
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dihydroergotamine (D.H.E. 45); or
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any other heart medicines, especially those used to treat high blood pressure or irregular heartbeats.
You may require a dosage adjustment or special monitoring during your treatment if you are taking any of the medicines listed above.
Drugs other than those listed here may also interact with hydralazine and isosorbide dinitrate or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.
Seek emergency medical attention.
Symptoms of an hydralazine and isosorbide dinitrate overdose include a severe throbbing headache, difficult or slow breathing, muscle cramps, nausea, vomiting, diarrhea, fever, dizziness, fainting, an irregular or slow heart beat, changes in vision, confusion, flushing, and seizures.
