Adult Dosing

Hypertension

• Start with 10 mg PO qid x 2-4 days, titrate the dose to 25 mg qid x remainder of the first wk. Titrate the dose up to 50 mg qid for the second and subsequent wks
• Patients with low response to hydralazine: Use a lower dosage of hydralazine combined with a thiazide and/or reserpine or a beta-blocker
• Max: 300 mg/day

Pediatric Dosing

Hypertension

• Initial dose: 0.75 mg/kg/day in 4 divided doses, gradually increased over the next 3-4 wks to maximum 7.5 mg/kg or 200 mg daily

[Outline]

• Adult Dosing
• Pediatric Dosing

• Used alone or as an adjunct for the management of hypertension

• Hypersensitivity to any of the ingredients or class of the product
• Coronary artery disease
• Mitral valvular rheumatic heart disease

• N/A

Renal Dose Adjustment (Based on CrCl)

• 10-50 mL/min: Give q8 hrs
• <10 mL/min: Give q8-16 hrs (fast acetylator) or q12-24 hrs (slow acetylator)

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustment not defined, caution advised

• Hydralazine may cause a clinical picture similar to that of systemic lupus erythematosus including glomerulonephritis. Discontinue therapy unless the benefit-to-risk determination requires continued antihypertensive therapy with this drug
• Signs and symptoms usually reverse when drug is discontinued, but residua may be detected many years later. Prolonged treatment with steroids may be essential
• Anginal attacks and ECG changes indicative of myocardial ischemia may occur; exercise caution in patients with suspected coronary artery disease
• Hydralazine may be associated with accentuation of specific cardiovascular inadequacies. May reduce the pressor responses to epinephrine. Postural hypotension may occur in some patients
• Use with caution in patients with advanced renal damage
• Peripheral neuritis, paresthesia, numbness, and tingling may occur with this drug; if such symptoms develop, pyridoxine should be added to the regimen
• Monitor CBC, lupus erythematosus (LE) cell preparation, and antinuclear 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

• Cerebral vascular disease
• Renal impairment

Pregnancy Category:C

Breastfeeding: Hydralazine is an acceptable antihypertensive in nursing mothers and even in those nursing newborns. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 10 March 2011). Manufacturer advises caution.

• CNS: Headache, peripheral neuritis
• GI: Anorexia, nausea, vomiting, diarrhea
• CV: MI, palpitations, tachycardia, angina pectoris
• HEMA: Blood dyscrasias, neutropenia
• IMMU: Lupus erythematosus
• DERM: Rash, flushing

• Antihypertensive agent; exact mechanism of action unknown; directly relaxes vascular smooth muscle, reduces arterial BP and peripheral vascular resistance by exerting a peripheral vasodilating effect
• Extensively metabolized by liver; CYP450: Unknown
• Excreted in urine
• Half-life: 3-7 hrs

US Trade Name(s)

• Only generic available

US Availability

hydralazine (generic)

• TABS: 10, 25, 50, 100 mg

Canadian Trade Name(s)

• Novo-Hylazin
• Nu-Hydral

Canadian Availability

hydralazine (generic)

• TABS: 10, 25, 50 mg

Novo-Hylazin, Nu-Hydral

• TABS: 10, 25, 50 mg

UK Trade Name(s)

• Apresoline

UK Availability

hydralazine (generic)

• TABS: 25, 50 mg

Apresoline

• TABS: 25 mg

Australian Trade Name(s)

• Alphapress

Australian Availability

Alphapress

• TABS: 25, 50 mg

[Outline]

Cardiovascular

Vasodilators

Peripheral Vasodilators

Pricing data from www.DrugStore.com in U.S.A.

• HydrALAZINE HCl 100 MG TABS [Bottle] (CAMBER PHARMACEUTICALS)
  30 mg = $25.99
  90 mg = $66.97
• HydrALAZINE HCl 25 MG TABS [Bottle] (PAR)
  100 mg = $27.99
  200 mg = $52.98
• HydrALAZINE HCl 50 MG TABS [Bottle] (CAMBER PHARMACEUTICALS)
  30 mg = $20.99
  60 mg = $28.97

Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

• Apresoline 10 MG Oral Tablet (Ciba-Geigy Corporation)
• Apresoline 100 MG Oral Tablet (Ciba-Geigy Corporation)
• Apresoline 25 MG Oral Tablet (Ciba-Geigy Corporation)
• Apresoline 50 MG Oral Tablet (Ciba-Geigy Corporation)
• Hydralazine Hydrochloride 10 MG Oral Tablet (Barr Laboratories, Inc.)
• Hydralazine Hydrochloride 10 MG Oral Tablet (Glenmark Generics Inc., USA)
• Hydralazine Hydrochloride 10 MG Oral Tablet (Goldline Laboratories, Inc.)
• Hydralazine Hydrochloride 10 MG Oral Tablet (HETERO DRUGS LIMITED)
• Hydralazine Hydrochloride 10 MG Oral Tablet (Heritage Pharmaceuticals Inc.)
• Hydralazine Hydrochloride 10 MG Oral Tablet (InvaGen Pharmaceuticals, Inc.,)
• Hydralazine Hydrochloride 10 MG Oral Tablet (NCS HealthCare of KY, Inc dba Vangard Labs)
• Hydralazine Hydrochloride 10 MG Oral Tablet (Par Pharmaceutical, Inc.)
• Hydralazine Hydrochloride 100 MG Oral Tablet (Barr Laboratories, Inc.)
• Hydralazine Hydrochloride 100 MG Oral Tablet (Glenmark Generics Inc., USA)
• Hydralazine Hydrochloride 100 MG Oral Tablet (HETERO DRUGS LIMITED)
• Hydralazine Hydrochloride 100 MG Oral Tablet (Heritage Pharmaceuticals Inc.)
• Hydralazine Hydrochloride 100 MG Oral Tablet (InvaGen Pharmaceuticals, Inc.,)
• Hydralazine Hydrochloride 100 MG Oral Tablet (NCS HealthCare of KY, Inc dba Vangard Labs)
• Hydralazine Hydrochloride 100 MG Oral Tablet (Par Pharmaceutical, Inc.)
• Hydralazine Hydrochloride 25 MG Oral Tablet (Barr Laboratories, Inc.)
• Hydralazine Hydrochloride 25 MG Oral Tablet (Glenmark Generics Inc., USA)
• Hydralazine Hydrochloride 25 MG Oral Tablet (Goldline Laboratories, Inc.)
• Hydralazine Hydrochloride 25 MG Oral Tablet (HETERO DRUGS LIMITED)
• Hydralazine Hydrochloride 25 MG Oral Tablet (Heritage Pharmaceuticals Inc.)
• Hydralazine Hydrochloride 25 MG Oral Tablet (InvaGen Pharmaceuticals, Inc.,)
• Hydralazine Hydrochloride 25 MG Oral Tablet (McKesson Packaging Services Business Unit of McKesson Corporation)
• Hydralazine Hydrochloride 25 MG Oral Tablet (NCS HealthCare of KY, Inc dba Vangard Labs)
• Hydralazine Hydrochloride 25 MG Oral Tablet (Par Pharmaceutical, Inc.)
• Hydralazine Hydrochloride 50 MG Oral Tablet (Barr Laboratories, Inc.)
• Hydralazine Hydrochloride 50 MG Oral Tablet (Glenmark Generics Inc., USA)
• Hydralazine Hydrochloride 50 MG Oral Tablet (Goldline Laboratories, Inc.)
• Hydralazine Hydrochloride 50 MG Oral Tablet (HETERO DRUGS LIMITED)
• Hydralazine Hydrochloride 50 MG Oral Tablet (Heritage Pharmaceuticals Inc.)
• Hydralazine Hydrochloride 50 MG Oral Tablet (InvaGen Pharmaceuticals, Inc.,)
• Hydralazine Hydrochloride 50 MG Oral Tablet (McKesson Packaging Services Business Unit of McKesson Corporation)
• Hydralazine Hydrochloride 50 MG Oral Tablet (NCS HealthCare of KY, Inc dba Vangard Labs)
• Hydralazine Hydrochloride 50 MG Oral Tablet (Par Pharmaceutical, Inc.)