Hydralazine/Hydrochlorothiazide

DEA Class; Rx

Common Brand Names; Hydra-Zide

• Thiazide Combos

Hydralazine/hydrochlorothiazide is a fixed-combination tablet that combines a vasodilator, hydralazine and a thiazide diuretic, hydrochlorothiazide

Hydralazine, a direct vasodilator, dilates arterioles with little effect on veins; decreases systemic resistance

Hydrochlorothiazide, a thiazide diuretic, inhibits Na reabsorption in distal renal tubules resulting in increased excretion of Na+ and water, also K+ and H+ ions

Indicated for the treatment of hypertension.

Anuria

Hypersensitivity to either component or sulfonamides

Coronary artery disease

Dissecting aortic aneurysm

Mitral valve rheumatic heart disease

Hydralazine (Common)

• Palpitations
• Hypotension
• Tachycardia
• Headache
• Peripheral neuropathy
• Anorexia
• Diarrhea
• Nausea/vomiting
• Dyspnea
• Nasal congestion
• Agranulocytosis
• Eosinophilia
• Leukopenia
• Hemolytic anemia
• Thrombocytopenia

Hydrochlorothiazide

• AnorexiaEpigastric distress
• Hypotension
• Orthostatic hypotension
• Photosensitivity
• Anaphylaxis
• Anemia
• Confusion
• Erythema multiforme
• Stevens-Johnson syndrome
• Exfoliative dermatitis including toxic epidermal necrolysis
• Hypomagnesemia
• Dizziness
• Headache
• Hyperuricemia

This fixed-combination drug is not indicated for initial therapy of hypertension; requires therapy titrated to the individual patient before fixed-combination drug therapy initiated

May induce SLE-type syndrome (usually at doses >200 mg/day); instruct patients to report joint/chest pain or fever; consider discontinuation if occurs

DM, fluid or electrolyte imbalance, hyperuricemia or gout, liver disease, renal disease

May aggravate digitalis toxicity

Sensitivity reactions may occur with or without history of allergy or asthma

CVA, severe renal impairment, volume depletion, preexisting hypotension, concurrency with other hypotensive agents

Discontinue slowly to avoid rapid rise in BP

Risk of male sexual dysfunction

Acute transient myopia and acute angle-closure glaucoma has been reported, particularly with history of sulfonamide or penicillin allergy (hydrochlorothiazide is a sulfonamide)

Pregnancy Category: C

Lactation: enters breast milk; compatible