Hydralazine Medication: Uses, Dosage, Side Effects & Warnings

Summary of Key Points

Hydralazine is a medication commonly used to treat high blood pressure (hypertension) and heart failure. It works by relaxing blood vessels, which helps the heart pump blood more efficiently. Hydralazine may also be prescribed for conditions such as pre-eclampsia and pulmonary hypertension. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist in managing your treatment.

Names of the Medication

US Brand Name: Apresoline (Hydralazine)

The generic name refers to the active ingredient in the medication. In this case, Hydralazine is the generic name, listed in parentheses.

Pharmacologic Category

Category: Vasodilators

Hydralazine Dosage

Hydralazine is prescribed for a variety of conditions. The dosage and frequency depend on the specific condition being treated. Always follow your doctor’s instructions and consult with one of our telemedicine providers before making any changes to your dose.

Hydralazine for Hypertension (High Blood Pressure)

Initial dose: 10 mg orally four times a day for the first 2-4 days. The dose may be increased to 25 mg four times a day for the remainder of the first week. Maintenance dose: 40-200 mg per day in divided doses.

Hydralazine for Heart Failure

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily. Hydralazine is often used in combination with other medications for heart failure.

Hydralazine for Pre-eclampsia

Initial dose: 5-10 mg intravenously every 20-30 minutes as needed to control blood pressure. This is typically administered in a hospital setting for pregnant women with dangerously high blood pressure.

Hydralazine for Pulmonary Hypertension

Initial dose: 10-25 mg orally three to four times daily. The dose may be adjusted based on your response and tolerance.

Hydralazine for Aortic Regurgitation

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily.

Hydralazine for Mitral Regurgitation

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily.

Hydralazine for Renal Artery Stenosis

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily.

Hydralazine for Scleroderma

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily.

Hydralazine for Raynaud’s Phenomenon

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily.

Hydralazine for Congestive Heart Failure

Initial dose: 10-25 mg orally three to four times daily. Maintenance dose: 50-100 mg three to four times daily. Hydralazine is often used alongside other medications for heart failure.

Dosage Forms and Strengths of Hydralazine

Oral tablet: 10 mg, 25 mg, 50 mg, 100 mg

Injectable solution: 20 mg/mL

Administration Instructions for Hydralazine

Hydralazine should be taken by mouth, with or without food. If you experience stomach discomfort, taking it with food may help. Injectable forms are typically administered in a hospital or clinical setting. It is crucial to take this medication exactly as prescribed by your healthcare provider. Do not skip doses or stop taking Hydralazine without consulting your doctor, as this may worsen your condition.

Hydralazine Side Effects and Adverse Reactions

Like all medications, Hydralazine can cause side effects. Some are more common than others, and not everyone will experience them. If you notice any severe or unusual symptoms, contact your healthcare provider immediately.

Common Side Effects: Headache, dizziness, nausea, vomiting, diarrhea, and loss of appetite. These side effects are usually mild and may improve as your body adjusts to the medication.

Less Common Side Effects: Rapid heart rate (tachycardia), chest pain, and fluid retention. If you experience these symptoms, consult your doctor as soon as possible.

Serious Side Effects: Lupus-like syndrome (joint pain, fever, rash), severe allergic reactions (swelling, difficulty breathing), and low blood pressure (hypotension). These require immediate medical attention.

Hydralazine Contraindications

A contraindication is a specific condition in which a medication should not be used because it may be harmful. For Hydralazine, there are several contraindications to be aware of before starting treatment. Discuss these with your healthcare provider, as Hydralazine may not be suitable if you have any of these conditions.

Coronary artery disease: Hydralazine can increase heart rate and workload, potentially worsening symptoms like chest pain (angina) in people with coronary artery disease.

Rheumatic heart disease affecting the mitral valve: This condition can cause the heart to work harder. Hydralazine may exacerbate the problem by increasing heart rate and blood flow, leading to complications.

Hypersensitivity to Hydralazine: If you have had an allergic reaction to Hydralazine in the past, you should not take this medication, as it could cause severe allergic reactions, including rash, swelling, or difficulty breathing.

Drug to Drug Interactions

Hydralazine can interact with other medications, potentially increasing side effects or reducing the effectiveness of your treatment. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Hydralazine:

1. Beta-blockers: Medications like Metoprolol (Lopressor) or Atenolol (Tenormin) may interact with Hydralazine, possibly leading to a significant drop in blood pressure or heart rate.
2. Diuretics: Drugs such as Furosemide (Lasix) or Hydrochlorothiazide (Microzide) can enhance Hydralazine’s blood pressure-lowering effects, increasing the risk of hypotension (low blood pressure).
3. MAO inhibitors: Medications like Phenelzine (Nardil) or Tranylcypromine (Parnate) may interact with Hydralazine, potentially causing dangerously high blood pressure.
4. Other antihypertensive medications: Combining Hydralazine with drugs like Lisinopril (Zestril) or Amlodipine (Norvasc) may result in excessively low blood pressure.

Hydralazine in Pregnancy

Is it safe to take Hydralazine during pregnancy?

Hydralazine is sometimes prescribed to manage high blood pressure in pregnant women, particularly in cases of pre-eclampsia, a condition characterized by elevated blood pressure and potential organ damage. However, it should only be used when absolutely necessary and under the close supervision of a healthcare provider. If you are pregnant or planning to become pregnant, it’s essential to discuss the risks and benefits of Hydralazine with your doctor. They may recommend alternative treatments depending on your specific condition.

Hydralazine while Breastfeeding

Is it safe to take Hydralazine while breastfeeding?

Hydralazine passes into breast milk in small amounts. While it is generally considered safe during breastfeeding, it’s important to monitor your baby for any potential side effects, such as low blood pressure or changes in feeding patterns. Always consult your healthcare provider before starting or continuing Hydralazine while breastfeeding to ensure it is the best option for both you and your baby.

Estimated Cost of Hydralazine Medication

The cost of a 30-day supply of Hydralazine without insurance can vary depending on the pharmacy and your location. However, with a GoodRx coupon, the price for a 30-day supply of Hydralazine (10 mg tablets) typically ranges from $4 to $15. Be sure to check with your pharmacy for the most accurate pricing, and consider using a discount program like GoodRx to help reduce the cost of your prescription.

Possible Alternatives to Hydralazine

If Hydralazine is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule an appointment with one of our providers through telemedicine to discuss your options.

1. Hypertension: Alternatives include ACE inhibitors (e.g., Lisinopril), calcium channel blockers (e.g., Amlodipine), or lifestyle changes such as reducing salt intake, exercising regularly, and managing stress.
2. Heart failure: Medications like beta-blockers (e.g., Carvedilol) or diuretics (e.g., Furosemide) may be used. Lifestyle changes, such as reducing fluid intake and following a heart-healthy diet, can also be beneficial.
3. Pre-eclampsia: In addition to Hydralazine, medications like Labetalol or Nifedipine may be used to manage blood pressure during pregnancy. Close monitoring by your healthcare provider is essential.
4. Pulmonary hypertension: Alternatives include medications like Sildenafil (Revatio) or Bosentan (Tracleer). Oxygen therapy and lifestyle changes may also be recommended.
5. Aortic regurgitation: Treatment may involve other vasodilators or surgical interventions, depending on the severity of the condition. Regular monitoring by a cardiologist is important.
6. Mitral regurgitation: Similar to aortic regurgitation, treatment may involve medications or surgery. Lifestyle changes, such as reducing sodium intake, may help manage symptoms.
7. Renal artery stenosis: Treatment may include ACE inhibitors, ARBs (e.g., Losartan), or surgical procedures like angioplasty. Controlling blood pressure is crucial for managing this condition.
8. Scleroderma: Medications like calcium channel blockers (e.g., Nifedipine) or immunosuppressants may be used. Physical therapy and lifestyle changes can also help manage symptoms.
9. Raynaud’s phenomenon: Calcium channel blockers or vasodilators like Nitroglycerin may be used. Keeping hands and feet warm and reducing stress can also help manage symptoms.
10. Congestive heart failure: Other medications like ACE inhibitors, beta-blockers, or diuretics may be used. Lifestyle changes, such as reducing fluid and sodium intake, along with regular exercise, can improve symptoms.

Recent Updates on Hydralazine Research

Recent studies have explored the use of Hydralazine in combination with other medications, such as nitrates, to improve outcomes for heart failure patients, particularly in African American populations. This combination has been shown to reduce mortality and improve quality of life in some patients. Ongoing research is also investigating Hydralazine’s potential benefits in treating pulmonary hypertension and other cardiovascular conditions. Stay informed and consult your healthcare provider about any new developments in your treatment options.

James Kingsley

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