Trade Names:Apresoline- Tablets 25 mg- Tablets 50 mg- Tablets 100 mg- Injection 20 mg/mLApo-Hydralazine (Canada)
Directly relaxes vascular smooth muscle to cause peripheral vasodilation, decreasing arterial BP and peripheral vascular resistance.
Hydralazine is rapidly absorbed. T max is 1 to 2 h and bioavailability is 30% to 50%.
Hydralazine is 87% protein bound.
Hydralazine is subject to polymorphic acetylation and undergoes extensive hepatic metabolism.
Hydralazine is excreted in urine mainly in the form of metabolites. The t ½ is 3 to 7 h.
Onset is 10 to 20 min (parenteral).
Duration is 6 to 12 h (oral) and 2 to 4 h (parenteral).
Slow acetylators generally have higher plasma levels of hydralazine and require lower doses to maintain control of BP.
Treatment of essential hypertension (oral form). Treatment of severe essential hypertension (parenteral form).
Reduction of overload in treatment of CHF, severe aortic insufficiency, and after valve replacement.
Coronary artery disease; mitral valvular rheumatic heart disease.
PO Begin with 10 mg 4 times daily for 2 to 4 days; then 25 mg 4 times daily for 3 to 5 days; then 50 mg 4 times daily (max, 300 mg/day). IV/IM 20 to 40 mg repeated as needed.Children
PO 0.75 mg/kg/day in 4 divided doses initially; increase gradually over 3 to 4 wk to max 7.5 mg/kg/day or 200 mg/day. IV/IM 0.1 to 0.2 mg/kg/dose every 4 to 6 h as needed.
Store at room temperature.
May increase effect of hydralazine or effect of beta-blockers.NSAIDs
Effects of hydralazine may be decreased.
None well documented.
Palpitations; tachycardia; angina pectoris; edema.
Headache; peripheral neuritis with paresthesias, numbness and tingling; dizziness; tremors; depression; disorientation; anxiety.
Anorexia; nausea; vomiting; diarrhea; constipation.
Blood dyscrasias; decreased hemoglobin; decreased RBC; leukopenia; agranulocytosis.
Hypersensitivity (eg, rash, urticaria, pruritus, fever, chills, arthralgia, eosinophilia); systemic lupus erythematosus.
Category C .
Excreted in breast milk.
Safety and efficacy have not been established by controlled clinical trials, but there is experience with its use.
Use drug with caution in patients with advanced renal damage.
Some of these products contain tartrazine, which can cause allergic-type reactions in susceptible individuals, especially those who have aspirin hypersensitivity.
Drug may produce clinical picture similar to that with systemic lupus erythematosus (eg, arthralgia, dermatoses, fever, splenomegaly), including glomerulonephritis, when more than 50 mg/day is given for long periods. Symptoms usually reverse when drug is discontinued, but treatment may be required.
Hypotension, tachycardia, headache, flushing, MI, myocardial ischemia, cardiac arrhythmias, profound shock.
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