Hydralazine

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Nov 06, 2023

Warnings

Hydralazine Risks, Warnings, and Complications

Hydralazine can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other medications for high blood pressure if you are at an increased risk of adverse reactions from this drug.

LUPUS-LIKE SYMPTOMS: There are reports of hydralazine causing symptoms similar to systemic lupus erythematosus (SLE or lupus), such as fever, joint pain, muscle pain, and a rash on the cheeks. These symptoms usually go away after you stop taking the medicine, but they may persist for some time. Tell your doctor immediately if you develop any such symptoms. Your provider will likely switch you to another antihypertensive medication.
ANGINAL ATTACKS AND ECG CHANGES: Hydralazine can cause angina attacks (chest pain) and ECG changes similar to a heart attack. This medicine may not be the best choice for people with a history of heart attack, coronary artery disease, heart valve problems, or stroke. Before starting hydralazine, tell your doctor if you have a history of heart problems.
BLOOD DYSCRASIAS: Reductions in hemoglobin, red blood cell count, and white blood cell count have been reported in people taking hydralazine. This is a rare side effect. Tell your doctor if you develop symptoms such as dizziness, unusual or severe tiredness, or frequent infections. Keep all your laboratory appointments while on hydralazine. Your provider may want to check a complete blood count periodically.
NERVE PROBLEMS: Hydralazine can affect the nerves and cause numbness, burning, or tingling sensations in your hands or feet. Tell your doctor if you have these symptoms. Your provider may recommend taking pyridoxine (vitamin B6) supplements.

Precautions Before Starting Hydralazine

Tell your doctor if you have ever had an allergic reaction to hydralazine, any of the active or inactive ingredients in hydralazine tablets, aspirin, tartrazine (a yellow dye found in certain foods and medications), or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible drug interactions between hydralazine and your other medicines.

Give your doctor a complete medical history. Hydralazine may not be right for people with a medical condition such as coronary heart disease, valvular heart disease, liver disease, or kidney disease.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breast feeding. It is not known if this medication passes into breast milk.

Precautions During Use of Hydralazine

Keep all your medical and lab appointments while on hydralazine. Your doctor will adjust your dose based on your response to the medicine.

Talk to your doctor about drinking alcohol while on hydralazine. Alcohol can make some of the side effects of this medicine worse.

Tell your doctor if you become pregnant while on hydralazine.

Tell your healthcare providers you are on hydralazine before any surgery, including dental procedures.

Hydralazine Drug Interactions

Concomitant use of certain medicines can affect how hydralazine works. Possible interactions with other drugs can increase the risk of severe adverse events. The following medications can have interactions with hydralazine:

Nonsteroidal anti-inflammatory drugs such as indomethacin (Indocin, Tivorbex)
Beta blockers such as propranolol (Innopran XL, Inderal LA, in Inderide) and metoprolol (Lopressor, Toprol-XL, in Dutoprol)
Diazoxide injection
Antidepressants called MAO inhibitors

The above list may not include all the potential drug interactions of hydralazine. Give your doctor or pharmacist a complete list of your medications. This includes prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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