Getting The Most From Your Treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress. You will need to have regular blood pressure measurements, and also some blood and urine tests from time to time.
- Your doctor will advise you on what lifestyle changes you can make to help your condition. These could include losing weight if you are overweight, taking regular physical activity, eating a healthy diet, cutting back on the amount of alcohol you drink, stopping smoking, and reducing the amount of salt in your meals and caffeine in your drinks. It is important that you follow any advice you are given.
- If you buy any medicines, check with a pharmacist that they are suitable for you to take. This is because some medicines can interfere with the way hydralazine works.
- Treatment with hydralazine is usually long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise by your doctor.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking hydralazine. This is because some anaesthetics can affect your blood pressure.
Enhancing Healthcare Team Outcomes
Hydralazine should not be considered a first-line agent for essential hypertension but can be considered in hypertension refractory to other first-line medications. The newer hypertensive medications are more efficacious with fewer adverse effects. The recommended dosing of three to four times daily makes hydralazine patient compliance a challenge. Patients tend to tolerate this medication better when the hydralazine is given with a beta-blocker and/or diuretic.
IV hydralazine has had increased off-label use for the treatment of hypertensive urgency or emergency. However, it should not be considered for first-line therapy due to tachyphylaxis, highly variable blood pressures, and adverse hypotension.
For African Americans with HFrEF, the combination of hydralazine and isosorbide dinitrate can be added to medication therapy if the patient is already receiving an ACE inhibitor, ARB, or ARNI and a beta-blocker. In clinical practice, this combination has been used in heart failure patients as a preload and afterload reducer, especially in patients who cannot tolerate beta-blockers and ACE-inhibitors or ARBs and would benefit from therapy reducing their systolic blood pressures.
While hydralazine is relatively safe, it is important to be aware of some of its adverse effects, which, although rare, include triggering lupus-like syndrome. This can usually be reversed upon discontinuation of the drug.
Special Instructions For Hydralazine
- Store the tablets at room temperature in a dry place.
- Take hydralazine with food. Food increases the amount of drug that gets in your body. If you cannot take this with food every time, then always take it without food. It is important to take this medicine the same way and at the same time each day, so your blood pressure is controlled with the same amount of medicine each day.
- This medicine may cause you to feel dizzy and lightheaded. Do not operate heavy equipment or drive a motor vehicle until you see how this medicine will affect you. To avoid feeling dizzy or having fainting spells do not sit up or stand up too quickly.
- You or your nurse should check your blood pressure and heart rate regularly while you are taking hydralazine. Your doctor will tell you what to do if your blood pressure level is low or high. Your dose of hydralazine may change based on your blood pressure level. If your blood pressure is above _____________ or below__________, call your doctor right away. If your heart rate is _____________, call your doctor right away.
- Hydralazine may affect the way some medicines work. Some medicines may also affect the way hydralazine works. These medicines include:
- Other blood pressure medicines
- Medicines for colds and coughs
- Ibuprofen and other anti-inflammatory medicines
- Medicines for depression
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Overviews Of The Classes Of Blood Pressure Medications
Summaries of some of the major types of commonly prescribed cardiovascular medications are provided here.
- For your information and reference, we have included generic names as well as major trade names to help you identify what you may be taking. However, this information does not signify a recommendation or endorsement from the American Heart Association.
- If your prescription medication isnt on this list, remember that your healthcare provider and pharmacist are your best sources of information.
- It’s important to discuss all of the drugs you take with your doctor and understand their desired effects and possible side effects.
- Never stop taking a medication and never change your dose or frequency without first consulting your doctor.
Side Effects Of Hydralazine
Hydralazine tends to increase heart rate and may cause fluid retention through its action on the kidneys.These effects are usually countered by giving hydralazine along with other medicines like beta-blockers and diuretics, though this is not always possible in pregnant patients. Some common side effects of hydralazine include:
Rarely, hydralazine may cause a serious disease known as drug-induced systemic lupus erythematosus, which causes the immune system to attack normal cells. This condition almost always resolves once the hydralazine is stopped.
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Problems With Heart Conduction
A low pulse rate can sometimes be an indicator of a problem with the hearts electrical conduction pathway.
The heart has an electrical system that travels in a distinct pattern to make the heart beat with a regular rhythm. If there is damage, scarring, or overstretching of the heart, the electrical system may not work as effectively. This can cause a low pulse rate.
Chronic high blood pressure can contribute to damage to the electrical system that, in turn, leads to a low pulse rate. Other causes of damage include smoking, a history of heavy drug or alcohol use, or aging of the heart.
Warnings For Certain Groups
For people with heart problems: Use this drug with caution if you have heart problems. Hydralazine may cause a heart attack, especially if you already have heart issues. Be sure to tell your doctor about your heart condition before taking hydralazine.
For pregnant women: Hydralazine is a category C pregnancy drug. That means two things:
Tell your doctor if youre pregnant or plan to become pregnant. Hydralazine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
For women who are breastfeeding: Small amounts of hydralazine may pass into breast milk. However, this drug doesnt typically cause side effects in a child who is breastfed. If you breastfeed your baby, talk to your doctor about the safety of this drug.
For seniors: Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If youre a senior, you may need a lower dose or a different schedule.
For children: This drug hasnt been studied in children younger than 18 years, but it has been used in children.
All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:
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What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store at room temperature and away from excess heat and moisture .
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Other Drugs Like Hydralazine
Hydralazine is formally known as a direct-acting vasodilator, which means that it works directly on the blood vessels themselves to cause relaxation. While there are many different types of vasodilators used in medicine today, none share the chemical or clinical properties of hydralazine. Hydralazine is the only drug of its kind currently used in the United States and is not a member of a larger, clinically relevant class of compounds. Though typically dispensed as a generic drug, hydralazine may sometimes still be found at the brand name drug Apresoline.
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What Are The Dangers Of High Blood Pressure
You may have heard high blood pressure be described as the silent killer, and this is a pretty accurate description. It is very dangerous to have high blood pressure, even though it doesnt usually cause you any symptoms. Having high blood pressure over time can significantly increase your risk of having a heart attack or a stroke. This is why it is important to check your blood pressure, even when you are feeling well.
Modelling Of Hypoxic Ventilatory Responses
In order to allow for the autocorrelation that exists between measurements of ventilation on successive breaths, a model of the noise processes was fitted to the data in parallel with the fitting of the model of the ventilatory response to hypoxia . The model parameters were estimated by fitting the models to the data using a standard subroutine to minimize the sum of squares of the residuals .
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Adjusting Your Exercise Goals
Adjusting your exercise goals based on this change in heart rate is fairly straightforward. If youve had an exercise stress test while on beta blockers, the results will provide hard numbers describing your actual exercise capacity. These numbers should be your guide when planning your exercise goals.
If you havent had a stress test, you can still approximate your targets using either your resting heart rate or perceived activity as a guide.
Can Hydralazine Cause Problems
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with hydralazine. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer’s printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer’s information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
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Is Hydralazine Hcl A Diuretic
Hydralazine is called a vasodilator. It works by relaxing blood vessels so blood can flow through the body more easily. Hydrochlorothiazide is a “water pill” . It works by increasing the amount of urine that you make.
Similarly, what class of drug is hydralazine? Hydralazine is in a class of medications called vasodilators. It works by relaxing the blood vessels so that blood can flow more easily through the body. High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body.
Similarly, when should you not take hydralazine?
What are the side effects of the drug hydralazine?
The more common side effects that can occur with hydralazine include:
How Should This Medicine Be Used
Hydralazine comes as a tablet to take by mouth. It usually is taken two to four a day. Take hydralazine at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydralazine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Hydralazine controls high blood pressure but does not cure it. Continue to take hydralazine even if you feel well. Do not stop taking hydralazine without talking to your doctor.
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How Beta Blockers Lower Blood Pressure
Beta blockers work by blocking the effect of epinephrine on the tissuesspecifically, by blocking the beta receptors that bind epinephrine. Among other things, blocking the beta receptors slows the heart rate, reduces the force of contraction of the heart muscle, reduces the amount of oxygen the heart muscle needs to do its work, reduces stress on the vascular system, and tends to lower the blood pressure.
Brand names for beta-blockers include include Inderal , Lopressor ,Tenormin , and Sectral .
How To Use Dihydralazine
Take this medication by mouth with or without food as directed by your doctor. The dosage is based on your medical condition and response to treatment. Your doctor may start You with a low dose and gradually increase Your dose. Follow the doctors instructions carefully.
Use this medication regularly to get the most optimal. You need to remember, taking the medication at the same time every day. It is important to continue to take this medicine even if you feel well. Most people with high blood pressure do not feel sick. It can take up to several weeks before you get the full benefit of this drug.
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Hydralazine Not A First Line Of Treatment
While this medication has been around for decades, its no longer a first choice for therapy, says J. Herbert Patterson, PharmD, professor and interim chair of the pharmacotherapy and experimental therapeutics division at UNC Eshelman School of Pharmacy in Chapel Hill, North Carolina. Newer drugs are just as effective if not more so, can be given once or twice a day, and are generally better tolerated, Patterson says.
Typically, hydralazine has to be given 3 to 4 times a day, so sticking to a dosing plan can be difficult, he adds. Your doctor may still suggest hydralazine along with another medication. The combination of hydralazine and a diuretic will lower blood pressure more effectively than either drug alone, Patterson says.
Are Hydralazine And Clonidine Safe To Take While Pregnant Or Breastfeeding
- Hydralazine should be used in pregnancy only if the potential benefit justifies the potential risk to the fetus. Hydralazine is classified as FDA pregnancy risk category C . It is used for treating high blood pressure during pregnancy.
- Hydralazine is excreted in breast milk. Hydralazine should be used cautiously in females who are breastfeeding if treatment is necessary.
- There are no adequate studies of this drug in during pregnancy
- It is excreted into breast milk and potentially could cause adverse effects in the infant.
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How Beta Blockers Affect Your Target Heart Rate
If you have high blood pressure, treatment often requires medication with a beta blocker, a common type of blood pressure medication that lowers your resting heart rate. Exercising regularly, another important component of managing high blood pressure, also lowers your resting heart rate. Hence, if you take a beta blocker, you will need to make some adjustments when calculating your target heart rate while doing aerobic exercise.
Angiotensin Ii Receptor Blockers
These drugs block the effects of angiotensin, a chemical that causes the arteries to become narrow. Angiotensin needs a receptor- like a chemical “slot” to fit into or bind with- in order to constrict the blood vessel. ARBs block the receptors so the angiotensin fails to constrict the blood vessel. This means blood vessels stay open and blood pressure is reduced.
Some noted possible side effects of Angiotensin II receptor blockers:
- May cause occasional dizziness.
- ARBs should not be used during pregnancy.Medications that act directly on the renin-angiotensin system can cause injury or even death to a developing fetus. When pregnancy is detected, consult your healthcare professional as soon as possible.
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Medicines For Heart Failure
Most people with heart failure are treated with medication. Often you’ll need to take 2 or 3 different medicines.
Some of the main medicines for heart failure include:
- ACE inhibitors
- hydralazine with nitrate
You may need to try a few different medicines before you find a combination that controls your symptoms but doesn’t cause unpleasant side effects.
Calculating Your Target Heart Rate
Your maximum heart ratethe upper limit of what your cardiovascular system can handle during physical activitycan be estimated by subtracting your age from 220. So, if you’re 35 years old, your estimated maximum heart rate is around 185 beats per minute .
It is recommended that you exercise within 55 percent to 85 percent of your maximum heart rate for at least 20 to 30 minutes to get the best results from aerobic exercise. In the example of the 35-year-old above, the target heart rate zone would be from 102 to 157 bpm.
Beta blockers can slow down your heart rate, but its effect is different for everyone . To use your resting heart rate as your guide, figure out the decrease in your heart rate as a result of the beta blocker. You will need to know what your resting heart rate was before you started taking the beta blocker.
For example, if your resting heart rate is 70 bpm without a beta blocker and 50 bpm with a beta blocker, thats a difference of 20. When calculating your target heart rate, subtract this number from the result. Thats your beta blocked target heart rate and is equivalent to what your target heart rate would be without the beta blocker. Again using the 35-year-old as an example, in this case the target heart rate zone would be reduced to between 82 and 137 bpm.
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