What is BiDil?

Q: I have read about BiDil, a drug that was approved for heart failure for African-American women. What is it? I am on Coreg but I have had some reaction to it. Should I try BiDil?

A: BiDil is a combination of two commonly used drugs. The first, an anti-hypertensive called hydralazine hydrochloride, relaxes the arteries and decreases the work of the heart. The second is the anti-anginal agent isosorbide dinitrate. This drug relaxes the veins as well as the arteries.

BiDil was used for the treatment of heart failure in the African-American Heart Failure Trial. Despite the fact that the mechanism of how the two drugs work together is not fully known, there is strong evidence that the combination is extremely effective in improving survival and functional status in African-American patients with heart failure.

BiDil is approved for use in conjunction with standard therapy for heart failure. Coreg is a beta-blocker and is used in the treatment of patients with mild to severe heart failure. If you are not tolerating Coreg, you should discuss alternative mediations, including BiDil, with your physician.

Jennifer H. Mieres, M.D., is director of nuclear cardiology and associate professor of clinical medicine at New York University. She's also a spokeswoman for the American Heart Association.