BiDil® is now approved for the treatment of heart failure in self-identified African-Americans. The approval was based partly on results from the African-American Heart Failure Trial (A-HeFT).
Patients receiving BiDil® experienced a 43% reduction in death and a 39% decrease in hospitalization for heart failure, compared with rates for placebo, and decreased symptoms of heart failure.
The product contains two older drugs, neither of which has been approved for heart failure—hydralazine (Apresoline®, Novartis) and drug isosorbide dinitrate (e.g., Sorbitrate®, AstraZeneca).
As an anti-hypertensive agent, hydral-azine relaxes the arteries, and decreases the work of the heart. The anti-anginal agent, isosorbide dinitrate, relaxes the veins and arteries. Isosorbide seems to work by releasing nitric oxide at the blood vessel wall, but its effect usually wears off after half a day. Hydralazine may prevent this loss of effect. How the two drugs work together is not yet clear.