Hydralazine

The dose of hydralazine is based on the individual and depends on the condition being treated and the person's response to the medication. The starting dose of hydralazine tablets is 10 mg taken 4 times a day for the first 2 to 4 days. Depending on how well it is working for you and how well it is tolerated, your doctor will gradually increase the dose. The usual recommended maintenance dose of hydralazine to treat high blood pressure varies from 10 mg to 50 mg 4 times daily. The dose should not be increased over 100 mg per day without further testing by your doctor to determine your acetylator phenotype.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take Hydralazine exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Hydralazine at room temperature, protect it from heat and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause headaches; it may cause diarrhea; it may cause redness of the face; it may cause nausea and vomiting; it may cause palpitations (rapid and strong heart beat). Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

10 mg
Each orange, round, scored tablet, debossed with "H" on one side and "38" on the other side, contains 10 mg of hydralazine. Nonmedicinal ingredients: anhydrous lactose, microcrystalline cellulose, sodium starch glycolate, stearic acid, and FD&C Yellow No. 6.

25 mg
Each orange, round, unscored tablet, debossed with "H" on one side and "39" on the other side, contains 25 mg of hydralazine. Nonmedicinal ingredients: anhydrous lactose, microcrystalline cellulose, sodium starch glycolate, stearic acid, and FD&C Yellow No. 6.

50 mg
Each orange, round, unscored tablet, debossed with "H" on one side and "40" on the other side, contains 50 mg of hydralazine. Nonmedicinal ingredients: anhydrous lactose, microcrystalline cellulose, sodium starch glycolate, stearic acid, and FD&C Yellow No. 6.

Do not use hydralazine if you:

• are allergic to hydralazine or any ingredients of the medication
• have an untreated Aneurysm in the aorta (large artery leaving the heart)
• have certain heart conditions (e.g., aortic stenosis, mitral stenosis, constrictive pericarditis, cor pulmonale, or a very fast heartbeat combined with heart failure)
• have Coronary Artery Disease
• have Lupus (also called systemic lupus erythematosus or SLE)
• have mitral valve rheumatic heart disease

There may be an interaction between hydralazine and any of the following:

• Aldesleukin
• Aliskiren
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Enalapril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• antipsychotics (e.g., Aripiprazole. Chlorpromazine, Lurasidone, Paliperidone, Quetiapine)
• barbiturates (e.g., butalbital, pentobarbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• brimonidine
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• dexmethylphenidate
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Duloxetine
• Guanfacine
• levodopa
• Methylphenidate
• Minoxidil
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Rasagiline, Selegiline, Tranylcypromine)
• Morphine
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• non-steroidal anti-inflammatory medications (NSAIDs; e.g., Diclofenac, Ibuprofen, Naproxen)
• Obinutuzumab
• Pentoxifylline
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• quinine
• Rotigotine
• sacubitril
• sotalol
• Tizanidine
• tolcapone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Hydralazine. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Hydralazine.

Blood tests: Rarely, Hydralazine can decrease the number of neutrophils (a type of white blood cell that helps fight infection), red blood cells (which carry oxygen), and platelets (which help your blood to clot). Your doctor will do regular blood tests to monitor your blood cell levels while you are taking Hydralazine.

Kidney Disease: Decreased kidney function can cause Hydralazine to build up in the body, causing side effects. If you have decreased kidney function, discuss with your doctor how Hydralazine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Hydralazine, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Hydralazine to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how Hydralazine may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Hydralazine, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking Hydralazine.

Low blood pressure: Some people taking hydralazine may experience sudden blood pressure drops when getting up from a sitting or lying position. These blood pressure drops could lead to dizziness, lightheadedness, and falls. If you experience this problem, try getting up more slowly. If it persists or if you faint, contact your doctor.

Lupus: Hydralazine may cause lupus-like symptoms (e.g., joint pain, fever, generalized rash). If these symptoms develop, contact your doctor immediately.

Pregnancy: Hydralazine should only be used during pregnancy when the benefits outweigh the risks. If you become pregnant while taking Hydralazine, contact your doctor immediately.

Breast-feeding: Hydralazine passes into breast milk. If you are a breast-feeding mother and are taking hydralazine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Hydralazine have not been established for children.

Seniors: Seniors may be more sensitive to the blood-lowering effects of hydralazine. It should be used with more caution.

This medication is typically used 4 times a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. It must be used regularly and continuously to maintain its beneficial effects. Be sure to keep an adequate supply on hand. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food.