Drug & supplement interaction

Wine + Isosorbide Dinitrate, Hydralazine

Isosorbide Dinitrate, Hydralazine brand name: BiDil.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Isosorbide Dinitrate, Hydralazine falls into 2 drug categories that Wine can interact with; the most serious is rated moderate. Concomitant use may increase the risk of acute hypotension.

Read the full interaction report
SeverityModerate
LikelihoodProbable
Interactions2
EvidenceC
What do Severity, Likelihood & Evidence mean?
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Interaction report

Wine and Isosorbide Dinitrate, Hydralazine

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Wine interacts with whole categories of medication. Isosorbide Dinitrate, Hydralazine falls into 2 of those categories, so it can interact with Wine in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

VASODILATORS

1 of 2

Why this applies to Isosorbide Dinitrate, Hydralazine

Isosorbide Dinitrate, Hydralazine falls under VASODILATORS — the group Wine interacts with.

Concomitant use may increase the risk of acute hypotension.
Acute alcohol intoxication can increase the risk of hypotension and additive effects with vasodilators.
Severity Moderate Likelihood Probable Evidence C

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

BiDil combines two blood vessel relaxers: isosorbide dinitrate and hydralazine. Both work by widening your blood vessels to ease the heart's workload, which naturally lowers your blood pressure. Wine does something similar, since alcohol relaxes blood vessels too. Put them together and the effects can stack up, dropping your pressure more than expected.

The practical worry is too-low blood pressure. You might feel dizzy, lightheaded, or get a pounding headache, and standing up quickly could make you feel faint or even cause a fall. This is most likely with larger amounts of alcohol, while an occasional small glass is less of a concern. Still, it is worth checking with your doctor or pharmacist about what is safe for you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
Moderate

ANTIHYPERTENSIVE DRUGS

2 of 2

Isosorbide Dinitrate, Hydralazine also falls under ANTIHYPERTENSIVE DRUGS.

Theoretically, concomitant use may interfere with blood pressure control.
Clinical research suggests that consumption of alcohol can increase both systolic and diastolic blood pressure. However, acute alcohol intoxication can also increase the risk of hypotension and additive effects with antihypertensive drugs.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

BiDil combines two blood pressure medicines, isosorbide dinitrate and hydralazine, and both work by relaxing and widening your blood vessels. Drinking wine adds a wrinkle here. A drink or two can cause your vessels to dilate too, and when you stack that on top of BiDil, your blood pressure can drop more than expected. That can leave you feeling lightheaded, dizzy, or faint, especially when you stand up quickly.

On the flip side, regular heavier drinking over time tends to raise blood pressure, which can work against what BiDil is trying to do. The evidence here is moderate, not alarming. You don't need to panic over an occasional glass, but please talk with your pharmacist or doctor about what's safe for you.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Fraser AG. Pharmacokinetic interactions between alcohol and other drugs. Clin Pharmacokinet 1997;33:79-90. PubMed
  2. Zilkens, R. R., Burke, V., Hodgson, J. M., Barden, A., Beilin, L. J., and Puddey, I. B. Red wine and beer elevate blood pressure in normotensive men. Hypertension 2005;45(5):874-879. PubMed
  3. Potter, J. F., Watson, R. D., Skan, W., and Beevers, D. G. The pressor and metabolic effects of alcohol in normotensive subjects. Hypertension 1986;8(7):625-631. PubMed
  4. Puddey, I. B., Beilin, L. J., Vandongen, R., Rouse, I. L., and Rogers, P. Evidence for a direct effect of alcohol consumption on blood pressure in normotensive men. A randomized controlled trial. Hypertension 1985;7(5):707-713. PubMed
  5. Puddey, I. B., Beilin, L. J., Vandongen, R., and Rouse, I. L. A randomized controlled trial of the effect of alcohol consumption on blood pressure. Clin Exp Pharmacol Physiol 1985;12(3):257-261. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Wine Also Interacts With Other Medications

Wine has 656 major, 269 moderate known drug interactions in our database — the Isosorbide Dinitrate, Hydralazine one above is among them. If you take anything else, check it against the full list below.

Major 656 Moderate 269 No known interaction 1,905 (incl. Isosorbide Dinitrate, Hydralazine)
Taking anything else?

Check Another of Your Medications Against Wine

Covers the 2,830 medications we’ve checked against Wine. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Isosorbide Dinitrate, Hydralazine

This page covers Wine only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Isosorbide Dinitrate, Hydralazine page lists 137 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Coleus (major) and Hawthorn (major).

By severity: 6 major · 110 moderate · 21 minor.

From our pharmacist’s overview on the Isosorbide Dinitrate, Hydralazine page

“BiDil pairs isosorbide dinitrate with hydralazine to relax blood vessels in failing hearts, which is why the 137 supplements on this list deserve genuine care. Nearly all act on blood pressure, either stacking with the drug and dropping it too far or pushing back and undoing the treatment.”

Reviewed by 2 · Jul 18, 2026

Open the Isosorbide Dinitrate, Hydralazine interaction page

One more smart check

Taking Wine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 8 real supplement products containing Wine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Wine. Your product may carry other ingredients that interact with Isosorbide Dinitrate, Hydralazine too, on top of Wine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Wine and Isosorbide Dinitrate, Hydralazine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Wine
Top half

#411 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Isosorbide Dinitrate, Hydralazine
Top half

#1,060 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Wine

What is Wine?

  • Social and relaxation use
  • Heart health (popular belief)
  • Antioxidant intake
  • Aiding digestion (traditional use)
  • Culinary flavoring

Wine is an alcoholic beverage made from fermented grapes and is not a true dietary supplement or medicine. Despite popular claims about heart benefits, the alcohol it contains carries real health risks, and no amount of drinking can be recommended to improve health. If you drink, do so in moderation, and avoid alcohol entirely during pregnancy or if you have certain medical conditions.

Read the full Wine monograph & all interactions
Keep checking

Other Drugs & Wine

Browse every other medication we’ve checked against Wine — both the ones with a known interaction and the ones without. Select any drug for the full detail.

656Major
269Moderate
0Minor
1,904No known interaction
656 Major 269 Moderate 1,904 No interaction
Major

656 interactions

Showing 60 of 656 major interactions — see all 656 on the Wine page.

Moderate

269 interactions

Showing 60 of 269 moderate interactions — see all 269 on the Wine page.

No interaction 1,904 drugs checked — show the list

We also checked Wine against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,904 medications checked with no known interaction — see the full Wine list.

See the full Wine interactions page
See every supplement checked against Isosorbide Dinitrate, Hydralazine, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Wine monograph › Uses, safety, and every drug interaction in one place Isosorbide Dinitrate, Hydralazine supplement interactions › Every supplement checked against Isosorbide Dinitrate, Hydralazine, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Wine and Isosorbide Dinitrate, Hydralazine Together: Common Questions

Can you take Wine with Isosorbide Dinitrate, Hydralazine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 2 interactions listed for Wine and Isosorbide Dinitrate, Hydralazine?
Isosorbide Dinitrate, Hydralazine belongs to more than one drug category, and Wine interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Wine and Isosorbide Dinitrate, Hydralazine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Isosorbide Dinitrate, Hydralazine and Wine?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.