Classes
DEA Class; Rx
Common Brand Names; Hydra-Zide
- Thiazide Combos
Description
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
Indications
Indicated for the treatment of hypertension.
Contraindications
Anuria
Hypersensitivity to either component or sulfonamides
Coronary artery disease
Dissecting aortic aneurysm
Mitral valve rheumatic heart disease
Adverse Effects
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
Warnings
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 and Lactation
Pregnancy Category: C
Lactation: enters breast milk; compatible
Maximum Dosage
Hypertension
Not for initial therapy
Usual dose: 25 mg/25 mg PO q12hr
Maximum: 100 mg/50 mg PO q12hr
Dosage strength determined by individual titration
Pediatric
<18 years: Safety/efficacy not established
How supplied
Hydralazine/Hydrochlorothiazide
capsule
- 25mg/25mg
- 50mg/50mg
- 100mg/50mg