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hydralazine

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Brand names: Apresoline

Vasodilator Rx

Hydralazine is a drug that lowers blood pressure by relaxing blood vessels. It can be used alone or with other medications.

Drug Pricing (NADAC)

Generic Price

$0.03/unit

Generic Available

Yes (21 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Hydralazine is used to treat high blood pressure (hypertension).

Common side effects

Headache, Loss of appetite, Nausea

Key warnings

Taking high doses of hydralazine can cause a drug-induced lupus erythematosus (L.

How It Works

Hydralazine works by relaxing the muscles in your blood vessels. This allows blood to flow more easily. As a result, your blood pressure goes down.

How to Take It

Start with a low dose and increase it slowly as directed by your doctor. You will likely start with 10 mg four times a day for 2-4 days. Then, your doctor may increase the dose to 25 mg four times a day for the rest of the first week. In the second week, the dose may increase to 50 mg four times a day. Take this medicine exactly as prescribed by your doctor.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. It is not known if hydralazine will harm an unborn baby. Talk to your doctor about the risks and benefits of taking hydralazine during pregnancy or while breastfeeding.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store hydralazine tablets at room temperature (68° to 77°F) in a tightly closed, light-resistant container, and keep out of reach of children.

Side Effects (from patient reports)

Based on 17,575 FDA adverse event reports.

Long-term kidney disease
2,819
Sudden kidney damage
2,616
Kidney failure
2,097
Final stage of kidney failure
1,585
Tiredness
1,541
Difficulty breathing
1,535
Diarrhea
1,406
Nausea
1,334
The drug is not working
1,326
Death
1,316

FDA Adverse Event Report Analysis

Detailed analysis of 28,498 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1995–2025.

Total Reports

28,498

Death-Related Reports

3,510

Hospitalization Reports

12,190

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 14,054 (54%)
Male 11,762 (45%)

Age Distribution

0–17 325
18–44 1,742
45–64 6,121
65–74 5,477
75+ 5,829

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 CHRONIC KIDNEY DISEASE 2,819
2 ACUTE KIDNEY INJURY 2,616
3 RENAL FAILURE 2,097
4 END STAGE RENAL DISEASE 1,585
5 FATIGUE 1,542
6 DYSPNOEA 1,535
7 DIARRHOEA 1,407
8 NAUSEA 1,337
9 DRUG INEFFECTIVE 1,326
10 DEATH 1,316
11 HYPERTENSION 1,312
12 OFF LABEL USE 1,168
13 ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY POSITIVE VASCULITIS 1,005
14 ASTHENIA 973
15 DIZZINESS 958

Reactions in Death Reports

DEATH 1,309
CHRONIC KIDNEY DISEASE 530
ACUTE KIDNEY INJURY 449
RENAL FAILURE 409
END STAGE RENAL DISEASE 403
COMPLETED SUICIDE 255
CARDIAC ARREST 182
CARDIAC FAILURE CONGESTIVE 160
NEPHROGENIC ANAEMIA 157
PNEUMONIA 144

Reactions in Hospitalization Reports

ACUTE KIDNEY INJURY 1,201
DYSPNOEA 895
RENAL FAILURE 836
HYPERTENSION 767
CHRONIC KIDNEY DISEASE 753
PNEUMONIA 708
CARDIAC FAILURE CONGESTIVE 704
ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY POSITIVE VASCULITIS 671
FATIGUE 599
NAUSEA 595

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Taking high doses of hydralazine can cause a drug-induced lupus erythematosus (L.E.) cell syndrome. Your doctor will monitor your dose to avoid this.

Known Drug Interactions

Although not studied with alosetron, inhibition of N-acetyltransferase may have clinically relevant consequences for drugs such as isoniazid, procainamide, and hydralazine.

Mechanism: Alosetron may interfere with the way your body processes hydralazine, potentially leading to higher drug levels.

What to do: Talk to your doctor about monitoring your blood pressure and watching for any new symptoms.

Other Cardiovascular Agents Enalapril maleate has been used concomitantly with beta adrenergic-blocking agents, methyldopa, nitrates, calcium-blocking agents, hydralazine, prazosin and digoxin without evidence of clinically significant adverse interactions.

Mechanism: These two blood pressure medicines work in different ways to relax your blood vessels and have not been shown to cause harmful interactions when used together.

What to do: These drugs are generally safe to take together, but you should still watch for signs of very low blood pressure like dizziness.

Pindolol has been used with a variety of antihypertensive agents, including hydrochlorothiazide, hydralazine, and guanethidine without unexpected adverse interactions.

Mechanism: These two blood pressure medicines can be used together safely. They do not have any harmful interactions when taken at the same time.

What to do: You can take these medications together as prescribed. Your doctor will monitor your blood pressure to ensure the treatment is working.

Common Questions

Can I stop taking hydralazine if I feel better?
No, do not stop taking hydralazine without talking to your doctor. Your blood pressure may increase if you stop suddenly.
Will hydralazine cure my high blood pressure?
Hydralazine helps control high blood pressure, but it is usually not a cure. You will likely need to take it long-term.
Can I drink alcohol while taking hydralazine?
Talk to your doctor about drinking alcohol while taking hydralazine. Alcohol can lower your blood pressure and may increase the effects of hydralazine.
What should I do if I feel dizzy after taking hydralazine?
If you feel dizzy, sit or lie down until the dizziness passes. Avoid sudden changes in posture.
Does hydralazine interact with other medications?
Yes, hydralazine can interact with other medications. Tell your doctor about all the medicines you take, including prescription and over-the-counter drugs, vitamins, and herbal supplements.
Can hydralazine cause weight gain?
Edema (swelling) is a less frequent side effect. Talk to your doctor if you experience unexplained weight gain.
How long does it take for hydralazine to start working?
Hydralazine starts working quickly to lower blood pressure, but it may take a few weeks to see the full effect.
Can I take hydralazine if I have kidney problems?
Talk to your doctor if you have kidney problems. Your doctor may need to adjust your dose.
Is it safe to drive while taking hydralazine?
Hydralazine can cause dizziness. Be careful driving or operating machinery until you know how hydralazine affects you.
What are the symptoms of L.E. cell syndrome?
Symptoms of L.E. cell syndrome include joint pain, fever, chest pain, and skin rash. Tell your doctor if you develop these symptoms.
What are the common side effects of hydralazine?
The most commonly reported side effects of hydralazine include Headache, Loss of appetite, Nausea, Vomiting, Diarrhea. Based on 17,575 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does hydralazine interact with other medications?
Yes, hydralazine has 3 known drug interactions. Notable interactions include alosetron, enalapril, pindolol. Always inform your doctor about all medications you are taking.
What drug class is hydralazine?
hydralazine belongs to the Vasodilator drug class. It requires a prescription (Rx). Hydralazine is used to treat high blood pressure (hypertension).
Is hydralazine safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. It is not known if hydralazine will harm an unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.
Has hydralazine been recalled?
There is 1 recall associated with hydralazine products. CGMP Deviations: Firm went out of business and could no longer continue stability studies. Check the recalls section below for full details and affected products.

Active Recalls

Class II April 26, 2023

CGMP Deviations: Firm went out of business and could no longer continue stability studies.

Akorn, Inc.

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What the FDA Data Shows for hydralazine

The FDA label for hydralazine (sold under brand names such as Apresoline) classifies it as a prescription-only medication in the Vasodilator class. Hydralazine is used to treat high blood pressure (hypertension). Official labeling lists 7 commonly reported side effects, including Headache, Loss of appetite, Nausea.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 17,575 voluntary reports. The database also lists 3 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $0.03.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history (currently 1 recall record on file), and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: July 1, 2025

All federal data sources used on this page