1 vial

$5.18

1 tablet 25mg

54 cents

  • Afterload reduction / peripheral vasodilation

IV:
20mg vial of powder
Reconstitute with 1ml of water for injection
For direct injection, inject as either reconstituted solution or further dilute with a small volume of normal saline. Give over 1-2 minutes
For IV infusion reconstitute 100mg and add to 100ml of compatible IV fluid
Compatible with the following IV fluids:
Normal saline Hartmanns
Note 5% dextrose should not be used as glucose rapidly causes hydralazine to be broken down.
Prepare solutions immediately before use and discard after 24 hours. Hydralazine undergoes colour changes in most infusion fluids; however, these changes generally do not indicate loss of potency.
Store at room temperature.

PO:
Rarely indicated in ICU


ADULT DOSE

IV:
5mg IV stat, then up to 20mg per hour by infusion.

PAEDIATRIC DOSE

IV:
0.1-0.2mg/kg stat, then 4-6mcg/kg/min

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY
Start with a small dose and adjust in accordance with response

Although the precise mechanism of action of hydralazine is not fully understood, the major effects are on the cardiovascular system. Hydralazine apparently lowers blood pressure by exerting a peripheral vasodilating effect through a direct relaxation of vascular smooth muscle

CONTRAINDICATIONS:

  • Hypersensitivity to hydralazine


WARNINGS
In a few patients hydralazine may produce a clinical picture simulating systemic lupus erythematosus including glomerulonephritis. In such patients hydralazine should be discontinued unless the benefit-to-risk determination requires continued antihypertensive therapy with this drug.


PRECAUTIONS
General
Myocardial stimulation produced by hydralazine can cause anginal attacks and ECG changes of myocardial ischaemia. The drug has been implicated in the production of myocardial infarction. It must, therefore, be used with caution in patients with suspected coronary artery disease
Peripheral neuritis, evidenced by paraesthesia, numbness, and tingling, has been observed.

Laboratory Tests
No tests in addition to routine ICU tests are required

Drug/Laboratory Test Interactions
None known

Concomitant administration with other antihypertensives increases the risk of hypotension

Body as a Whole:
Rash, urticaria, pruritus, fever, chills
Cardiovascular System:
Hypotension, paradoxical pressor response, oedema, palpitations, tachycardia, angina pectoris
Respiratory System:
Dyspnea.
Gastrointestinal System:
Constipation, paralytic ileus, anorexia, vomiting, diarrhoea,
Haematological System:
Blood dyscrasias, consisting of reduction in haemoglobin and red cell count, leukopaenia, agranulocytosis, purpura; lymphadenopathy; splenomegaly.
Neurological System:
Headache, peripheral neuritis, evidenced by paraesthesia, numbness, and tingling; dizziness; tremors; muscle cramps; psychotic reactions characterised by depression, disorientation, or anxiety.

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