Hydralazine tablet precautions: Difference between revisions
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==PRECAUTIONS== | |||
===General=== | |||
Myocardial stimulation produced by hydralazine can cause [[anginal ]]attacks and ECG changes of [[myocardial ischemia]]. 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. | |||
The “hyperdynamic” circulation caused by hydralazine may accentuate specific cardiovascular inadequacies. For example, hydralazine may increase pulmonary artery pressure in patients with mitral valvular disease. The drug may reduce the pressor responses to epinephrine.[[ Postural hypotension]] may result from hydralazine but is less common than with ganglionic blocking agents. It should be used with caution in patients with cerebral vascular accidents. | |||
<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = HYDRALAZINE HYDROCHLORIDE TABLET [PLIVA INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ddbbdb09-3202-42d7-bbb0-08331dde2f54 | publisher = | date = | accessdate = 10 March 2014 }}</ref> | In hypertensive patients with normal kidneys who are treated with hydralazine, there is evidence of increased renal blood flow and a maintenance of [[glomerular filtration rate]]. In some instances where control values were below normal, improved renal function has been noted after administration of hydralazine. However, as with any [[antihypertensive ]]agent, hydralazine should be used with caution in patients with advanced renal damage. | ||
[[Peripheral neuritis]], evidenced by [[paresthesia]], numbness, and tingling, has been observed. Published evidence suggests an antipyridoxine effect, and that [[pyridoxine ]]should be added to the regimen if symptoms develop. | |||
===Information for Patients=== | |||
Patients should be informed of possible side effects and advised to take the medication regularly and continuously as directed. | |||
===Laboratory Tests=== | |||
Complete blood counts and antinuclear antibody titer determinations are indicated before and periodically during prolonged therapy with hydralazine even though the patient is asymptomatic. These studies are also indicated if the patient develops [[arthralgia]], [[fever]], [[chest pain]], continued malaise, or other unexplained signs or symptoms. | |||
A positive[[ antinuclear antibody]] titer requires that the physician carefully weigh the implications of the test results against the benefits to be derived from antihypertensive therapy with hydralazine. | |||
Blood dyscrasias, consisting of reduction in hemoglobin and red cell count, [[leukopenia]], [[agranulocytosis]], and [[purpura]], have been reported. If such abnormalities develop, therapy should be discontinued. | |||
===Drug/Drug Interactions=== | |||
[[MAO inhibitors]] should be used with caution in patients receiving hydralazine. | |||
When other potent parenteral antihypertensive drugs, such as [[diazoxide]], are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure. Profound hypotensive episodes may occur when [[diazoxide ]]injection and hydralazine are used concomitantly. | |||
===Drug/Food Interactions=== | |||
Administration of hydralazine with food results in higher plasma levels.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = HYDRALAZINE HYDROCHLORIDE TABLET [PLIVA INC.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=ddbbdb09-3202-42d7-bbb0-08331dde2f54 | publisher = | date = | accessdate = 10 March 2014 }}</ref> | |||
==References== | ==References== | ||
Revision as of 19:54, 10 March 2014
| Hydralazine |
|---|
| HYDRALAZINE tablet® FDA Package Insert |
| Indications and Usage |
| Dosage and Administration |
| Contraindications |
| Warnings |
| Precautions |
| Adverse Reactions |
| Drug Interactions |
| Use in Specific Populations |
| Overdosage |
| Description |
| Clinical Pharmacology |
| Nonclinical Toxicology |
| How Supplied/Storage and Handling |
| Labels and Packages |
| HYDRALAZINE injection® FDA Package Insert |
| Indications and Usage |
| Dosage and Administration |
| Contraindications |
| Warnings |
| Precautions |
| Adverse Reactions |
| Drug Interactions |
| Use in Specific Populations |
| Overdosage |
| Description |
| Clinical Pharmacology |
| Nonclinical Toxicology |
| How Supplied/Storage and Handling |
| Labels and Packages |
| Clinical Trials on Hydralazine |
| ClinicalTrials.gov |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]
PRECAUTIONS
General
Myocardial stimulation produced by hydralazine can cause anginal attacks and ECG changes of myocardial ischemia. 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.
The “hyperdynamic” circulation caused by hydralazine may accentuate specific cardiovascular inadequacies. For example, hydralazine may increase pulmonary artery pressure in patients with mitral valvular disease. The drug may reduce the pressor responses to epinephrine.Postural hypotension may result from hydralazine but is less common than with ganglionic blocking agents. It should be used with caution in patients with cerebral vascular accidents.
In hypertensive patients with normal kidneys who are treated with hydralazine, there is evidence of increased renal blood flow and a maintenance of glomerular filtration rate. In some instances where control values were below normal, improved renal function has been noted after administration of hydralazine. However, as with any antihypertensive agent, hydralazine should be used with caution in patients with advanced renal damage.
Peripheral neuritis, evidenced by paresthesia, numbness, and tingling, has been observed. Published evidence suggests an antipyridoxine effect, and that pyridoxine should be added to the regimen if symptoms develop.
Information for Patients
Patients should be informed of possible side effects and advised to take the medication regularly and continuously as directed.
Laboratory Tests
Complete blood counts and antinuclear antibody titer determinations are indicated before and periodically during prolonged therapy with hydralazine even though the patient is asymptomatic. These studies are also indicated if the patient develops arthralgia, fever, chest pain, continued malaise, or other unexplained signs or symptoms.
A positiveantinuclear antibody titer requires that the physician carefully weigh the implications of the test results against the benefits to be derived from antihypertensive therapy with hydralazine.
Blood dyscrasias, consisting of reduction in hemoglobin and red cell count, leukopenia, agranulocytosis, and purpura, have been reported. If such abnormalities develop, therapy should be discontinued.
Drug/Drug Interactions
MAO inhibitors should be used with caution in patients receiving hydralazine.
When other potent parenteral antihypertensive drugs, such as diazoxide, are used in combination with hydralazine, patients should be continuously observed for several hours for any excessive fall in blood pressure. Profound hypotensive episodes may occur when diazoxide injection and hydralazine are used concomitantly.
Drug/Food Interactions
Administration of hydralazine with food results in higher plasma levels.[1]
References
- ↑ "HYDRALAZINE HYDROCHLORIDE TABLET [PLIVA INC.]". Retrieved 10 March 2014.