HYDRALAZINE HYDROCHLORIDE

Indications & Dose:

Hypertension, CHF, afterload reduction in severeaortic insufficiency and after valve replacement,eclampsia

• BY MOUTH

Adult

PO 25mg twice daily , increased to usual max; 50mg twice daily Heart failure (initial in the hospital)25mg 3-4 times daily, increased every 2 days if necessary ; usualmaintainance dose 50-70mg 4 times daily.

• BY INJECTION


• By slow i.v injection , hypertension with renacomplications and hypertension crises 5-10mgmdiluted with 10ml sodium chloride 0.9%, may berepeated after 20-30 minutes


• By i.v infusion hypertension with renalcomplications and hypertension crises 200-300microgram/ minute , maintanance usually 50-150mg/m.inute

Child

• BY MOUTH


• PO 0.75-1 mg/kg/day divided bid-qd, increase over3-4 wk to 7.5 mg/kg/day divided bid-qid if necessardo not exceed 200 mg/day;IM/IV 0.1-0.2 mg/kg/dose q4-6h, do not exceed 20 mg/dose

Contraindications:

CAD,mitral valvular rheumatic heart disease

Side Effects:

CNS: Anxiety, depression, dizziness, headache,peripheral neutritis, psychotic reaction, tremor

~CV: Angina, flushing, hypotension, palpitations, reflex tachycardia

EENT: Nasal congestion

GI: Anorexia, constipation, diarrhea, hepatitis,nausea, paralytic ileus, vomiting, pancreatitis

GU: Frequency, glucosuria, polyuremia incresed creatinine

BUN

HEME: Agranulocytosis, aplastic anemia, hemolytic anemia, neutropenia,   thrombocytopenia,eosinophilia, leukopenia

MS: Arthralgia, muscle cramps

RESP: Dyspnea

SKIN: Pruritus, rash, urticar ia

MISC: Lupus-like syndrome (arthralgia, dermatoses,fever; splenmegaly, glomerulonephritis)

Cautions:

Precautions:

Advanced renal disease, children,pulmonary hypertension.

Interaction:

Drugs 

• Diazoxide: Severe hypotension 


•  NSAIDs: Inhibited antihypertensive response to hydralazine

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C; commonly used in pregnant women;excreted into breast milk; compatible with breast feeding

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: