HYDRALAZINE

 (Apresoline)

Standard Prescription

hydralazine__mg PO Q__H (__mg/kg/24hr)
hydralazine__mg IV x 1 loading dose (__mg/kg/dose)
hydralazine__mcg/kg/min continuous IV infusion

Dosages

Hypertension:
Oral:
Initial: 0.25 mg/kg/dose given TID-QID. Maximum 10 mg/dose
Maintenance: titrate over 3-4 weeks to maximum of 7.5 mg/kg/day or 200 mg per day, whichever is less.

For use in acute hypertension, consider faster titration every 1-3 days

Hypertensive Crisis:
0.1-0.2 mg/kg/dose IM/IV Q6-8H  Maximum: 20 mg/dose

Mechanism of Action

Antihypertensive, Vasodilator

Forms Supplied

tablet: 10 mg, 25 mg,
injection: 20 mg/mL (1 mL ampule)
oral liquid (BCCH): 4 mg/mL

Comments

Maximum effects with PO doses not achieved until after 3-4 days.

IV hydralazine should be given slowly, at a rate not exceeding 5mg/min.

Associated with development of lupus-like syndrome (usually reversible) particularly in patients who are slow acetylators, have renal impairment or who are taking large doses (> 200 mg/day) for long periods.

May be given with a beta blocker and a diuretic to minimize reflex tachycardia and fluid retention.

References

29, 32, 44, 60

Last Edited

2022-07-03 02:42:02