Hydralazine

General

• Type: Vasodilator
• Dosage Forms: 10, 25, 50, 100; PO, IM, IV
• Common Trade Names: Apresoline

Adult Dosing

• hypertension: 10 - 50mg PO QID
• Hypertensive crisis: 10-20mg IM/IV q2-4h

Pediatric Dosing

• Hypertensive Crisis:

1. 1 mo - 12 years: 0.1 - 0.5mg/kg IM/IV q4-6h, max dose of 20mg
2. > 12 years old: 10 - 20mg IV q2-4h

Special Populations

• Pregnancy Rating: C
• Lactation: Probably Safe
• Renal Dosing
  • Adult: CrCl 10-50: give q8h, CrCl <10, give q8-16h
  • Pediatric: CrCl 10-50: give q8h, CrCl <10, give q8-16h
• Hepatic Dosing
  • Adult: not defined
  • Pediatric: not defined

Contraindications

• Allergy to class/drug
• mitral valvular rheumatic heart disease
• Caution if renal impairment

Adverse Reactions

Serious

• MI
• neutropenia
• lupus erythematosus (SLE)
• peripheral neuritis

Common

• headache
• tachycardia
• angina
• nausea/vomiting
• rash

Pharmacology

• Half-life: 3-7 hours
• Metabolism: liver
• Excretion: urine, feces
• Mechanism of Action: directly dilates peripheral vessels

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

	Indication	Dose	Context	Route	Population
Hypertensive emergency#Hydralazine Antihypertensive Adult	Hypertensive emergency	5-20 mg IV q4-6 hr	Antihypertensive	IV	Adult
Stroke (main)#Hydralazine BP control in acute stroke Adult	Stroke (main)	10-20 mg IV, repeat q4-6h	BP control in acute stroke	IV	Adult