Adult Dosing
Hypersensitive crisis
- 10-20 mg IM/IV q2-4 hrs then switch to PO
Moderate to Severe Hypertension
- 10-40 mg IM/IV q4-6 hrs then switch to PO
Pediatric Dosing
Hypertensive crisis
- 1 month-12 yrs: 0.1-0.5 mg/kg IM/IV q4-6 hrs; Max: 20 mg/dose
- >12 yrs: 10-20 mg IV q2-4 hrs then switch to PO ASAP
Renal Dose Adjustment (Based on CrCl)
- >50 mL: Give q8 hrs
- 10-50 mL/min: Give q8 hrs
- < 10mL/min: Give q8-16 hrs
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustment not defined, caution advised
- 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
- Symptoms usually reverse when drug is discontinued, but treatment may be required. Prolong treatment with steroids may be essential
- Anginal attacks and ECG changes indicative of myocardial ischemia may occur, caution in patient with suspected coronary artery disease
- Hydralazine component is associated with accentuation of specific cardiovascular inadequacies. Reduces the pressor responses to epinephrine. Postural hypotension have occurred in patients
- Use with caution in patient with advance renal damage
- Peripheral neuritis, paresthesia, numbness, and tingling have occurred with drug, if such symptoms develop pyridoxine should be added in the regimen
- Monitor CBC, lupus erythematosus (LE) cell preparation, and anti nuclear antibody titer levels before and during long-term therapy at regular intervals. Do not discontinue abruptly as rebound hypertension may occur
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Cerebral vascular disease
- Cardiovascular disease
- Advance renal damage
Pregnancy Category:C
Breastfeeding: 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 11 March 2011). Manufacturer advises cautioned.
