Direct Vasodilator·Cardiovascular - Vasodilators

hydrALAZINE

Moderate-to-severe hypertension, pre-eclampsia, HFrEF (in combination with nitrates)

PBSVASODILATORApresoline25 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

200 mg/day

Half-life

1-2 h

Caution: Lupus-like

RARE

Caution: Tachycardia

REFLEX

Cautions

Avoid / Cautions

Ischaemic heart disease (monotherapy will cause reflex tachycardia and trigger an MI), aortic aneurysm, SLE. Pregnancy Category C, but widely used and safe for pre-eclampsia.

Where it stands

Rapid Summary

Overview

Direct-acting smooth muscle relaxant acting purely on arterioles. Powerful but triggers a massive reflex sympathetic response (tachycardia).

Clinical Focus

Almost never used as monotherapy; must be paired with a beta-blocker to prevent reflex tachycardia and a diuretic to prevent fluid retention.

Bottom Line

Hydralazine is a direct vasodilator safe in pregnancy and useful in heart failure (with nitrate), but causes reflex tachycardia and can trigger drug-induced lupus with chronic use.

Formulation & Access

Brand Names

Apresoline

Oral Routes

Tablets (25 mg, 50 mg).

Parenteral

Ampoule (20 mg powder for reconstitution).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Moderate-to-severe hypertension, pre-eclampsia, HFrEF (in combination with nitrates).

Clinical Place

Third or fourth-line agent for resistant hypertension. Major role in severe pre-eclampsia.

Quick reference

Class & Role

Direct Vasodilator — Direct-acting smooth muscle relaxant acting purely on arterioles.

Route / Formulation

Tablets (25 mg, 50 mg). (Apresoline)

Usual Dose & Max

PO 25 mg BD. Titrate to Max 100 mg BD (200 mg/day).

Key Indication Doses

Hypertension (Chronic): PO 25 mg BD. Titrate to Max 100 mg BD (200 mg/day). Hypertensive Emergency: IV 5-10 mg slowly over 20 mins. Repeat every 20-30 mins PRN. Pre-eclampsia: IV 5 mg boluses, titrated to response.

Best Uses

Hydralazine is a direct vasodilator safe in pregnancy and useful in heart failure (with nitrate), but causes reflex tachycardia and can trigger drug-induced lupus with chronic use.

Key Risks

Cardiovascular: Reflex tachycardia, fluid retention, worsening angina. Immunological: Drug-induced systemic lupus erythematosus (DILE) at high doses >200mg. Neurological: Headache, flushing (due to vasodilation).

Key Interactions

Additive hypotension with other vasodilators and anaesthetics. BENEFICIAL — Beta-blockers (blunt reflex tachycardia) and Diuretics (blunt fluid retention).

Monitoring

Continuous BP and HR monitoring if giving IV. Monitor FBC and ANA antibodies if using high doses long-term due to lupus risk.

Clinical Pearl

Hydralazine metabolism depends on a patient's genetic acetylator status. 'Slow acetylators' accumulate the drug and are at high risk of drug-induced lupus.

Access

Apresoline25 mg tablet

Brand: Apresoline
Formulation: Tablets (25 mg, 50 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Direct Vasodilator·Cardiovascular - Vasodilators

hydrALAZINE

Moderate-to-severe hypertension, pre-eclampsia, HFrEF (in combination with nitrates)

PBSVASODILATORApresoline25 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

200 mg/day

Half-life

1-2 h

Caution: Lupus-like

RARE

Caution: Tachycardia

REFLEX

Cautions

Avoid / Cautions

Ischaemic heart disease (monotherapy will cause reflex tachycardia and trigger an MI), aortic aneurysm, SLE. Pregnancy Category C, but widely used and safe for pre-eclampsia.

Where it stands

Rapid Summary

Overview

Direct-acting smooth muscle relaxant acting purely on arterioles. Powerful but triggers a massive reflex sympathetic response (tachycardia).

Clinical Focus

Almost never used as monotherapy; must be paired with a beta-blocker to prevent reflex tachycardia and a diuretic to prevent fluid retention.

Bottom Line

Hydralazine is a direct vasodilator safe in pregnancy and useful in heart failure (with nitrate), but causes reflex tachycardia and can trigger drug-induced lupus with chronic use.

Formulation & Access

Brand Names

Apresoline

Oral Routes

Tablets (25 mg, 50 mg).

Parenteral

Ampoule (20 mg powder for reconstitution).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Moderate-to-severe hypertension, pre-eclampsia, HFrEF (in combination with nitrates).

Clinical Place

Third or fourth-line agent for resistant hypertension. Major role in severe pre-eclampsia.

Quick reference

Class & Role

Direct Vasodilator — Direct-acting smooth muscle relaxant acting purely on arterioles.

Route / Formulation

Tablets (25 mg, 50 mg). (Apresoline)

Usual Dose & Max

PO 25 mg BD. Titrate to Max 100 mg BD (200 mg/day).

Key Indication Doses

Best Uses

Hydralazine is a direct vasodilator safe in pregnancy and useful in heart failure (with nitrate), but causes reflex tachycardia and can trigger drug-induced lupus with chronic use.

Key Risks

Key Interactions

Additive hypotension with other vasodilators and anaesthetics. BENEFICIAL — Beta-blockers (blunt reflex tachycardia) and Diuretics (blunt fluid retention).

Monitoring

Continuous BP and HR monitoring if giving IV. Monitor FBC and ANA antibodies if using high doses long-term due to lupus risk.

Clinical Pearl

Hydralazine metabolism depends on a patient's genetic acetylator status. 'Slow acetylators' accumulate the drug and are at high risk of drug-induced lupus.

Access

Apresoline25 mg tablet

Brand: Apresoline
Formulation: Tablets (25 mg, 50 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.