Does Apresoline (hydralazine) cause side effects?
Apresoline (hydralazine) is an antihypertensive medication used to treat high blood pressure (hypertension), alone or in-combination with other anti-hypertensive medications. It is also used for treating hypertensive crisis and congestive heart failure.
Apresoline is a peripheral arterial vasodilator and causes relaxation of blood vessels which carry blood away from the heart and towards the organs and tissues. The exact mechanism of how Apresoline causes arterial smooth muscle relaxation is not yet understood. Apresoline affects calcium movement within blood vessels. Calcium is required for muscle contraction and therefore disturbances in calcium movement may cause smooth muscle relaxation in the blood vessels.
Apresoline is selective for arterioles (small arteries), and the overall effects of treatment include a decrease in arterial blood pressure, and peripheral vascular resistance. In addition to treating high blood pressure, Apresoline has shown to be beneficial for the treatment of congestive heart failure (CHF).
Although ACE inhibitors are preferred for the treatment of CHF, Apresoline in combination with isosorbide dinitrate is an alternative for patients who cannot tolerate ACE inhibitors. Parenteral or injectable hydralazine is used to treat hypertensive emergencies (severally high blood pressure) during pregnancy.
Common side effects of Apresoline include
- headache,
- loss of appetite,
- nausea,
- vomiting,
- diarrhea,
- palpitations,
- rapid heartbeat, and
- chest pain (angina pectoris).
Serious side effects of Apresoline include
- constipation,
- paralytic ileus,
- low blood pressure,
- edema,
- paradoxical pressor response,
- shortness of breath,
- peripheral neuritis,
- numbness,
- tingling,
- tremors,
- muscle cramps,
- psychotic reactions,
- difficulty urinating,
- blood disorders,
- hypersensitivity reactions,
- nasal congestion,
- flushing,
- abnormal tear production, and
- conjunctivitis.
Drug interactions of Apresoline include sympathomimetics such as cocaine, dobutamine, dopamine, norepinephrine, epinephrine, metaraminol, methoxamine, phenylephrine, phenylpropanolamine, ephedra, and ephedrine because they may decrease the effectiveness of Apresoline.
Apresoline should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. It is used for treating high blood pressure during pregnancy. Apresoline is excreted in breast milk. Apresoline should be used cautiously in females who are breastfeeding if treatment is necessary.
What are the important side effects of Apresoline (hydralazine)?
Common side effects of hydralazine are:
- headache,
- anorexia,
- nausea,
- vomiting,
- diarrhea,
- palpitations,
- tachycardia (rapid heartbeat), and
- angina pectoris (chest pain).
Other less commonly reported side effects include:
- constipation,
- paralytic ileus,
- low blood pressure,
- edema,
- paradoxical pressor response,
- dyspnea (shortness of breath),
- peripheral neuritis,
- numbness,
- tingling,
- tremors,
- muscle cramps,
- psychotic reactions,
- difficulty urinating,
- blood disorders,
- hypersensitivity type reactions,
- nasal congestion,
- flushing,
- abnormal tear production (lacrimation) , and
- conjunctivitis.
Apresoline (hydralazine) side effects list for healthcare professionals
Adverse reactions with Apresoline (hydralazine) are usually reversible when dosage is reduced. However, in some cases it may be necessary to discontinue the drug.
The following adverse reactions have been observed, but there has not been enough systematic collection of data to support an estimate of their frequency.
Common
Less Frequent
- Digestive: constipation, paralytic ileus.
- Cardiovascular: hypotension, paradoxical pressor response, edema.
- Respiratory: dyspnea.
- Neurologic: peripheral neuritis evidenced by paresthesia, numbness, and tingling, dizziness: tremors; muscle cramps; psychotic reactions characterized by depression, disorientation, or anxiety.
- Genitourinary: difficulty in urination.
- Hematologic: blood dyscrasias, consisting of reduction in hemoglobin and red cell count, leukopenia, agranulocytosis, purpura, lymphadenopathy; splenomegaly.
- Hypersensitive Reactions: rash, urticaria, pruritus, fever, chills, arthralgia, eosinophilia, and, rarely, hepatitis.
- Other: nasal congestion, flushing, lacrimation, conjunctivitis.
What drugs interact with Apresoline (hydralazine)?
- MAO inhibitors should be used with caution in patients receiving hydralazine.
- When other potent parenteral antihypertensive drugs, such as diazoxide, are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure.
- Profound hypotensive episodes may occur when diazoxide injection and Apresoline (hydralazine) are used concomitantly.
Summary
Apresoline (hydralazine) is an antihypertensive medication used to treat high blood pressure (hypertension), alone or in-combination with other anti-hypertensive medications. It is also used for treating hypertensive crisis and congestive heart failure. Common side effects of Apresoline include headache, loss of appetite, nausea, vomiting, diarrhea, palpitations, rapid heartbeat, and chest pain (angina pectoris). Apresoline should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Apresoline should be used cautiously in females who are breastfeeding if treatment is necessary.
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High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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Congestive Heart Failure (CHF)
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
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Things to Know About High Blood Pressure Treatment
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Hypertension-Induced Chronic Kidney Disease
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What Is High Blood Pressure (Hypertension)?
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High Blood Pressure Symptoms
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Medications & Supplements

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Professional side effects and drug interactions sections courtesy of the U.S. Food and Drug Administration.