Vasodilators for heart failure

Examples

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Brand Name	Chemical Name
Apresoline	hydralazine

Nitrates

Brand Name	Chemical Name
Sorbitrate	isosorbide dinitrate

Brand Name	Chemical Name
BiDil	isosorbide dinitrate and hydralazine hydrochloride

Brand Name	Chemical Name
ISMO	isosorbide mononitrate

Brand Name	Chemical Name
ISMO	nitroglycerin

How It Works

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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

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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

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When taken with other medicines to treat heart failure, vasodilators may have some effect in reducing premature death rates.¹

Side Effects

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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

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Vasodilator drugs seldom are used alone to treat heart failure.

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

References

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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

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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