ヒドララジン

使用用途

• Adjunctive therapy in treatment of heart failure
• Treatment of systemic hypertension (Fourth step drug)
• Systemic hypertension
• Adjunctive therapy in treatment of heart failure (afterload reducer)
• Adjunctive therapy in treatment of heart failure (long-term therapy)
• Adjunctive therapy in treatment of heart failure (not receiving ACE inhibitors)
• Acute, fulminant heart failure due to severe mitral regurgitation (not receiving ACE inhibitors)
• Adjunctive therapy in treatment of heart failure (receiving ACE inhibitors)
• Short-term treatment of CHF secondary to valve disease
• Treatment of systemic hypertension (Fifth step drug)
• Congestive heart failure / Systemic hypertension

投与方法

考えられる副作用

• Hypotension
• Weakness and lethargy
• Syncope (fainting)
• Reflex tachycardia
• Sodium and water retention
• GI distress (vomiting, diarrhea)
• Increased creatinine levels
• SLE-like syndrome (documented in humans, theoretical in animals)
• Lacrimation and conjunctivitis
• Peripheral neuritis
• Blood dyscrasias
• Urinary retention
• Constipation
• Severe hypotension
• Anorexia (especially in cats)
• Vomiting (especially in cats)

注意事項と禁忌

• Known hypersensitivity to hydralazine
• Coronary artery disease
• Hypovolemia
• Preexisting hypotension
• Hypovolaemia
• Hypotension
• Renal impairment
• Cerebral bleeding
• > **Dose Titration**: Doses must be titrated upwards carefully to avoid severe, life-threatening hypotension. * **Renal Disease**: Use with caution. Reduced renal blood flow can activate the RAAS and exacerbate renal injury; pretreatment with an ACE inhibitor and spironolactone is often advised. * **Intracerebral Bleeding**: Use with caution due to potential effects on cerebral blood flow. * **Autoimmune Disease**: Use cautiously in patients with preexisting autoimmune diseases, as an SLE-like syndrome has been documented in humans. * **Pregnancy**: FDA Category C (humans); Papich Class B (veterinary). Safe for use if used cautiously, but crosses the placenta. Excreted in milk but generally considered compatible with nursing.

薬物相互作用

• ACE-INHIBITORS: May cause additive hypotensive effect; usually used for therapeutic advantage
• BETA-BLOCKERS: May cause additive hypotensive effect; usually used for therapeutic advantage
• DIAZOXIDE: Potentially could cause profound hypotension
• DIURETICS: May cause additive hypotensive effect; usually used for therapeutic advantage
• FUROSEMIDE: Hydralazine may increase furosemide's renal effects
• MAO INHIBITORS: May cause additive hypotensive effect
• SYMPATHOMIMETICS (e.g., epinephrine): Hydralazine may cause decreased pressor effect and may cause additive tachycardia
• ACE inhibitors (e.g., enalapril, benazepril): Enhanced hypotensive effects
• Anaesthetics: Enhanced hypotensive effects
• Beta-blockers (e.g., propranolol): Enhanced hypotensive effects
• Calcium-channel blockers (e.g., diltiazem, verapamil): Enhanced hypotensive effects
• Corticosteroids: Enhanced hypotensive effects
• NSAIDs: Enhanced hypotensive effects
• Sympathomimetics (e.g., phenylpropanolamine): May cause tachycardia
• Adrenaline (Epinephrine): Reduced pressor response to adrenaline

よくある質問