Apreszine 25/Apreszine 50

Hydralazine HCl

Adjunct to other antihypertensive agents in moderate to severe HTN. Apreszine 50 Supplement in combination w/ long-acting nitrates in moderate to severe chronic congestive cardiac failure in patients whom optimal doses of conventional therapy have proved insufficient.

Adult Apreszine 25 Initially 25 mg bid for the 1st 2-4 days. Increase to 25 mg qid for balance of the 1st wk. Dosage titration: 50 mg qid from 2nd wk. Maintenance dose: Adjust dose to lowest effective level. Up to 300 mg daily in resistant patients. Apreszine 50 HTN Initially 25 mg bid. May gradually increase to max of 200 mg daily. Chronic CHF Dose titration: Initially 25 mg tid or qid, increasing every 2nd day to ave maintenance dose of 50-75 mg qid after progressive titration.

May be taken with or without food.

Hypersensitivity to hydralazine HCl or dihydralazine. Idiopathic SLE & related diseases; severe tachycardia; dissecting aortic aneurysm; high output cardiac failure (eg, hyrotoxicosis); cor pulmonale; myocardial insufficiency due to mechanical obstruction (eg, presence of mitral or aortic stenosis or constrictive pericarditis). Apreszine 25 CAD; mitral valvular rheumatic heart disease. Apreszine 50 Porphyria.

Lactation. Apreszine 25 Discontinue therapy if blood dyscrasias (eg, Hb & RBC count reduction, leucopenia, agranulocytosis, purpura) occur. Drug-induced lupus-like syndrome including glomerulonephritis in patients receiving higher doses. Postural hypotension. Patients w/ CVA & suspected CAD, producing myocardial stimulation causing angina attacks & ECG changes of myocardial ischemia. Increased pulmonary artery pressure in patients w/ mitral valvular disease. Initiate pyridoxine therapy w/ onset of peripheral neuritis (eg, paresthesia, numbness, tingling). Advanced renal impairment. Not to be used during pregnancy. Apreszine 50 W/draw gradually if symptoms of SLE-like syndrome develop; immediately if overt clinical signs or symptoms of SLE-like syndrome eg, microhaematuria &/or proteinuria along w/ +ve ANF titres develop; if skin rash, febrile reaction & change in blood count occur. Not to be given in patients who have survived MI until post-infarction stabilization has been achieved. Peripheral neuritis in the form of paraesthesia. Fall in BP. May provoke SLE-like syndrome w/ prolonged treatment (usually >6 mth) w/ >100 mg daily dose. Monitor patients for early detection of postural hypotension or tachycardia when initiating therapy in heart failure. Start β-blocker few days prior to commencing hydralazine treatment. Check patient's acetylator status prior to increasing daily dose to >100 mg. Determine antinuclear factors & conduct urine analysis at approx 6 mth intervals during long-term treatment. Patients w/ CAD & cerebrovascular disease. Not to be taken by patients w/ rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption. May impair ability to drive or operate machinery. Hepatic or renal impairment. Avoid during 1st & 2nd trimesters of pregnancy but may be used later in pregnancy if mother or foetus is at risk. Not recommended in childn. Elderly.

Headache; nausea, vomiting, diarrhea; palpitations, tachycardia, angina pectoris/symptoms. Apreszine 25 Anorexia. Apreszine 50 Dizziness; hypotension, flushing; nasal congestion; GI disturbances; arthralgia, myalgia, joint swelling, SLE-like syndrome (sometimes resulting in fatal outcome).

Apreszine 25 May increase levels/effects of amifostine, 2nd generation antipsychotics, bromperidol, duloxetine, hypotension associated agents, levodopa, nitroprusside, pholcodine. Increased levels/effects w/ alfuzosin, barbiturates, benperidol, brigatinib, topical brimonidine, dapoxetine, diazoxide, herbs (hypotensive properties), lormetazepam, molsidomine, naftopidil, nicergoline, nicorandil, obinutuzumab, pentoxifylline, phosphodiesterase-5 inhibitors, prostacyclin analogues, quinagolide. Decreased levels/effects w/ amphetamines, brigatinib, bromperidol, herbs (hypertensive properties), methylphenidate, NSAIDs, yohimbine. Apreszine 50 Enhanced hypotensive effects w/ other antihypertensives (diuretics, ACE inhibitors, Ca channel blockers, vasodilators), anaesth, TCAs, major tranquillisers, nitrates or drugs exerting central depressant actions (including alcohol). Marked hypotension w/ diazoxide. Antagonised effects w/ NSAIDs (especially indometacin), corticosteroids, carbenoxolone, oestrogens & combined OCs. May increase bioavailability of β-blockers (eg, propranolol) which are subject to significant 1st-pass metabolism. Concomitant use w/ MAOIs.

Other Antihypertensives

C02DB02 - hydralazine ; Belongs to the class of hydrazinophthalazine derivatives. Used in the treatment of hypertension.

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