Isosorbide dinitrate–hydralazine

A combination of isosorbide dinitrate (a nitrate) and hydralazine (a vasodilator), FDA-approved for heart failure as an add-on to standard therapy in self-identified Black patients.

psilodex.org/m/isosorbide-dinitrate-hydralazine · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: ~4 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado Condition rules (3)

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Isosorbide dinitrate–hydralazine”, v2026.10.05. psilodex.org/m/isosorbide-dinitrate-hydralazine

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

Sources [1]

FDA-approved for

Heart failure, as an adjunct to standard therapy in self-identified Black patients

Sources [1]

Other safety

The label contraindicates PDE-5 inhibitors (such as sildenafil or tadalafil) and riociguat, which can cause severe hypotension. Hydralazine can cause a drug-induced lupus syndrome.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Psilocybin raises heart rate and blood pressure for hours, raising the heart's oxygen demand, which may matter with heart failure. Also, it lowers blood pressure.

Detail This combination is a nitrate plus a vasodilator used for heart failure. Psilocybin raises heart rate and blood pressure for several hours, increasing the heart's oxygen demand, which may matter with heart failure. Also, its label warns of symptomatic hypotension (low blood pressure), especially on standing. Hydralazine can cause tachycardia (fast heart rate) and worsen myocardial ischemia (reduced blood flow to the heart). Sources [1]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: Hydralazine ~4 h; isosorbide dinitrate ~2 h (active 5-mononitrate ~5 h) (FDA label, checked 2026-10-04)

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

2 listed · counted on reports

Lowers blood pressure or causes orthostasis: Lowers blood pressure, or causes a drop on standing (orthostasis) that can bring dizziness or fainting. Sources [1]
Raises blood pressure or heart rate: Raises blood pressure or heart rate. Psilocybin raises both for several hours, so the effects can add. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not namedCondition rules (3)

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

Screening items in state rules

This medication is usually taken for a condition. State rules screen for some conditions directly, so the medication is a prompt to ask about them. Confirm with the participant; never assume a condition from the medication.

Heart failure (only indication)
- CO 2.5(A)(2) · Clinical Facilitator licensees
- CO 6.16(F)(2)(a) · Facilitators without a clinical facilitator license
- CO 6.16(F)(1) · All licensees

05 Sources

BIDIL (isosorbide dinitrate and hydralazine HCl) tablets (Azurity; NDA020727) · FDA label (DailyMed) — revised 2025-11-30 | "treatment of heart failure as an adjunct to standard therapy in self-identified black patients" | Lowers blood pressure or causes orthostasis: "Symptomatic hypotension, particularly with upright posture, may occur with even small doses of BiDil." | Raises blood pressure or heart rate: "Hydralazine hydrochloride can cause tachycardia and hypotension potentially leading to myocardial ischemia and angina" | "The half-lives were about 4 hours for hydralazine and about 2 hours for isosorbide dinitrate."; 5-mononitrate "overall half-life of about 5 hours" | contraindicated with PDE-5 inhibitors: "Concomitant use can cause severe hypotension, syncope, or myocardial ischemia"

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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