- Management of hypertension
Note: Avoid use for initial therapy for hypertension
See Supplemental Patient Information
- Hydralazine component is associated with a clinical picture simulating systemic lupus erythematosus including glomerulonephritis. Discontinue therapy unless the benefit-to-risk determined requires continued antihypertensive therapy with this drug. Prolong treatment with steroids may be essential
- Thiazide component is associated with precipitation of azotemia. Cumulative effects of the drug have occurred in patients with impaired renal function. Precipitation of hepatic coma have occurred with minor alterations of fluid and electrolyte imbalance in patients with impaired hepatic function or progressive liver disease
- Thiazide component is associated with addition or potentiation of the action of other antihypertensive drugs
- Sensitivity reactions have occurred in patients having history of allergy or bronchial asthma
- Possibility of exacerbation or activation of systemic lupus erythematosus exists
- Anginal attacks and ECG changes indicative of myocardial ischemia may occur
- Hydralazine component is associated with accentuation of specific cardiovascular inadequacies. Reduces the pressor responses to epinephrine. Postural hypotension have occurred in patients
- Peripheral neuritis, evidenced by paresthesia, numbness, and tingling has occurred
- Observe patients for clinical signs of fluid or electrolyte imbalance, namely hyponatremia, hypochloremic alkalosis, and hypokalemia
- Hypokalemia have occurred especially in cases of brisk diuresis or severe cirrhosis
- Dilutional hyponatremia have occurred in edematous patients in hot weather; maintain water restriction, rather than administration of salt, except in rare occasions when the hyponatremia is fatal
- Avoid hypokalemia or treat it by the use of potassium supplements or foods with a high potassium content
- Hyperuricemia or precipitation of frank gout have occurred in certain patients
- Latent diabetes nay be manifested
- Consider suspension or discontinuation of diuretic therapy on evidence of progressive renal impairment
- Prolong therapy is associated with changes in the parathyroid gland with hypercalcemia and hypophosphatemia
- Hypomagnesemia is associated with thiazide component
- Monitor Cr at baseline
- Monitor CBC, Antinuclear Antibody test (ANA) at baseline, then periodically on prolonged therapy
- Monitor electrolytes at baseline, then periodically
Cautions: Use cautiously in
- Severe renal impairment
- Hepatic impairment
- Progressive hepatic disease
- Cardiovascular disease
- Arrhythmias
- Suspected CAD
- Post-sympathectomy
- Diabetes mellitus
- Volume depleted patients
- Cerebrovascular disease
- Seizure disorder
- Electrolyte abnormalities
- History of pancreatitis
- SLE
- History of gout
- Pregnancy 3rd trimester
- Gestational hypertension
- Geriatrics
Supplemental Patient Information
- Inform patients of possible side effects and advise them to take the medication regularly and continuously as directed
Pregnancy Category:C
Breastfeeding: Hydrochlorothiazide doses of 50 mg/day or less are acceptable during lactation. Intense diuresis with large doses may decrease breastmilk production. Hydralazine is an acceptable antihypertensive in nursing mothers and even in nursing newborns. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 9 February 2011). Unknown whether hydralazine is excreted in human milk. Thiazides are excreted in breast milk. Has a potential for serious adverse reactions in nursing infants. Discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
US Trade Name(s)
US Availability
Hydra-zide (hydralazine/hydrochlorothiazide)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
UK Availability
Australian Trade Name(s)
Australian Availability