Teaser: Does the formulation of oral nitrate therapy matter when used for patients with heart failure with reduced ejection fraction (HFrEF)? Should fixed-dose hydralazine (HYD)/isosorbide dinitrate (ISDN) (BiDil®) be used in those with HFrEF or can the medications be prescribed separately? In clinical practice the individual components HYD and ISDN are often prescribed as a result of cost concerns with the brand name, fixed-dose combination product. Additionally, clinicians often substitute extended-release isosorbide mononitrate (ISMN) for ISDN given its less frequent administration schedule. In this post we will discuss whether these formulations can be used interchangeably in those with HFrEF.
