When should I schedule hydralazine (Apresoline)?

From the Guidelines

Hydralazine should be scheduled two to three times a day, with a usual dose range of 100-200 mg, as it is associated with sodium and water retention and reflex tachycardia, and should be used with a diuretic and beta blocker 1.

Key Considerations

• The dosage may vary from those listed in the FDA-approved labeling, and it's essential to consider the patient's specific condition and medical history when determining the schedule and dose of hydralazine.
• Hydralazine is associated with drug-induced lupus-like syndrome at higher doses, and patients should be monitored closely for any signs of this condition.
• The use of hydralazine requires careful consideration of its potential side effects and interactions with other medications, and patients should be educated on the importance of adhering to their prescribed treatment plan.

Important Factors to Consider

• The patient's blood pressure should be closely monitored when initiating or adjusting hydralazine therapy, as it can cause significant changes in blood pressure.
• Hydralazine should be used with caution in patients with certain medical conditions, such as heart failure or ischemic heart disease, and patients should be closely monitored for any signs of worsening condition.
• The use of hydralazine in combination with other medications, such as diuretics and beta blockers, can increase the risk of side effects, and patients should be closely monitored for any signs of adverse reactions.

Recommendations for Use

• Hydralazine should be used under the guidance of a healthcare professional, and patients should be closely monitored for any signs of side effects or adverse reactions.
• Patients should be educated on the importance of adhering to their prescribed treatment plan and attending follow-up appointments to monitor their condition and adjust their treatment plan as needed.
• Hydralazine should be used in conjunction with lifestyle modifications, such as dietary changes and exercise, to help manage blood pressure and reduce the risk of cardiovascular disease.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested: in adults, 50 to 100 mg four times daily. The dosage schedule for hydralazine (Apresoline) is:

• Adults: 50 to 100 mg four times daily
• Children under 6 years: 50 mg daily in divided doses
• Children over 6 years: 50 to 100 mg daily in divided doses 2

From the Research

Scheduling Hydralazine (Apresoline)

There are no research papers to assist in answering this question, as the provided studies do not mention the scheduling of hydralazine (Apresoline). The studies primarily focus on:

• The role of monoamine oxidase inhibitors in depression treatment guidelines 3, 4, 5
• The discovery of antidepressants and their development 4
• Consensus guidelines for care of patients exposed to hydrazine and hydrazine derivatives 6
• Treating depression with atypical features 7 None of these studies provide information on the scheduling of hydralazine (Apresoline), so it is not possible to provide a recommended schedule based on the available evidence.