From the Guidelines
Hydrazine is not recommended for the management of elevated blood pressure (hypertension) due to its toxicity and potential for severe side effects. According to the 2024 ESC guidelines for the management of elevated blood pressure and hypertension 1, hydralazine (not hydrazine) may be considered as a last resort in resistant hypertension, but only after other treatment options have been exhausted. The guidelines recommend using FDA-approved antihypertensive medications such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers, diuretics, or beta-blockers as first-line treatments.
Key points to consider:
- Hydrazine is a highly toxic industrial chemical and not approved for medical use in treating hypertension
- FDA-approved antihypertensive medications have established safety profiles and proven efficacy in lowering blood pressure
- The 2024 ESC guidelines recommend combination therapy with two or more of the major drug classes (ACE inhibitors, ARBs, dihydropyridine CCBs, and thiazide or thiazide-like diuretics) as first-line treatment for hypertension 1
- Hydralazine may be considered in resistant hypertension, but with caution and under close monitoring due to its potential side effects
It is essential to consult with a healthcare professional for proper diagnosis and treatment recommendations tailored to specific health needs. The use of hydrazine for medical purposes would be extremely dangerous and is not supported by any clinical evidence 1.
From the Research
Hydrazine Dosing for Elevated Blood Pressure
- The recommended dosing for hydrazine in the management of elevated blood pressure is not established, as it is not a recommended treatment for hypertension 2.
- Hydralazine, a direct-acting vasodilator, has been used for the treatment of hypertension since the 1950s, but its use has largely been replaced by newer antihypertensive drugs with more acceptable tolerability profiles 2.
- There is insufficient evidence to conclude on the effects of hydralazine versus placebo on mortality, morbidity, withdrawals due to adverse effects, serious adverse events, or systolic and diastolic blood pressure 2.
- Hydralazine may reduce blood pressure when compared to placebo in patients with primary hypertension, however this data is based on before and after studies, not randomized controlled trials (RCTs) 2.
- The first-choice treatment for hypertension in nondiabetic adults without cardiovascular or renal disease should be chlortalidone, or hydrochlorothiazide if chlortalidone is not available 3.
- In cases of hypertensive emergencies, parenteral drugs such as sodium nitroprusside, intravenous nitroglycerin, and esmolol may be used, but hydralazine is not typically recommended as a first-line treatment 4.
- For patients unable to take oral medications, intravenous antihypertensive agents such as hydralazine, methyldopate, enalaprilat, and nicardipine may be considered, but the choice of therapy should be based on individual patient needs and diseases 5.