hydralazine (Apresoline) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Tablets: 10, 25, 50, 100 mg; Solution for injection: 20 mg/ml

STORAGE: Tablets and injection solution may be stored at room temperature between 20 C to 25 C (68 F to 77 F).

DOSING:

Hypertension in adult patients:

  • Start treatment at a low dose and increase gradually based on individual patient response. The usual recommended starting regimen is 10 mg orally four times daily for the first 2 to 4 days, increase to 25 mg four times daily for the remainder of the first week.
  • For the second and subsequent weeks, increase dosage to 50 mg four times daily (increase dose by 10-25 mg/dose gradually every 2-5 days).
  • The maximum daily dose used in clinical studies is 300 mg.

Congestive heart failure:

  • The initial dose for treating heart failure is 10 to 25 mg orally 3 to 4 times daily.
  • The usual dose is 225 to 300 mg daily in 3 to 4 divided doses.

For pediatric hypertensive emergencies, the dose is 0.5 mg/Kg IV every 4 hours.

DRUG INTERACTIONS:

Sympathomimetics such as:

  • cocaine,
  • dobutamine (Dobutrex),
  • dopamine (Intropin),
  • norepinephrine (Levophed),
  • epinephrine (Adrenalin),
  • metaraminol (Aramine),
  • methoxamine,
  • phenylephrine, (NeoSynephrine, Neofrin)
  • phenylpropanolamine,
  • ephedra (Ma Huang), and
  • ephedrine may decrease the effectiveness of hydralazine.

Co-administration of these agents may block the anti-hypertensive benefits of hydralazine treatment.

PREGNANCY: Hydralazine should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Hydralazine is classified as FDA pregnancy risk category C (Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks). It is used for treating high blood pressure during pregnancy.

NURSING MOTHERS: Hydralazine is excreted in breast milk. Hydralazine should be used cautiously in females who are breastfeeding if treatment is necessary.

REFERENCE: FDA Prescribing Information.


Medically Reviewed by a Doctor on 12/3/2014


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