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Hydralazine/ hydrochlorothiazide

Generic Name: hydralazine/hydrochlorothiazide (hye-DRAL-a-zeen/hye-droe-klor-oh-THYE-a-zide)
Brand Name: Generic only. No brands available.

Hydralazine/hydrochlorothiazide should not be used for the initial treatment of high blood pressure. Your doctor should periodically reevaluate your blood pressure treatment.


Hydralazine/ hydrochlorothiazide is used for:

Treating high blood pressure. It may also be used for other conditions as determined by your doctor.

Hydralazine/hydrochlorothiazide is a combination vasodilator and thiazide diuretic. Exactly how hydralazine/hydrochlorothiazide works to treat high blood pressure is unknown. The vasodilator relaxes and dilates (opens) the blood vessels in the body, allowing blood to flow through the vessels more easily. The diuretic helps the kidneys eliminate fluid from the body.

Do NOT use hydralazine/ hydrochlorothiazide if:

  • you are allergic to any ingredient in hydralazine/hydrochlorothiazide or to any other sulfonamide medicine (eg, sulfamethoxazole, glyburide, acetazolamide)
  • you are unable to urinate
  • you have problems with the blood vessels of your heart (coronary artery disease) or certain heart valve problems (mitral valvular rheumatic heart disease)
  • you are taking dofetilide or ketanserin

Contact your doctor or health care provider right away if any of these apply to you.

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Before using hydralazine/ hydrochlorothiazide:

Some medical conditions may interact with hydralazine/hydrochlorothiazide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have gout, liver problems, lupus, kidney problems, diabetes, asthma, parathyroid problems, or high blood cholesterol or lipid levels
  • if you have blood problems (eg, porphyria), blood vessel problems, heart problems, low blood pressure, or low levels of vitamin B6 in your blood
  • if you have low blood sodium, chloride, potassium, or magnesium levels; or high blood calcium levels
  • if you have a history of stroke

Some MEDICINES MAY INTERACT with hydralazine/hydrochlorothiazide. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Cholestyramine, colestipol, or nonsteroidal anti-inflammatory medicines (NSAIDs) (eg, ibuprofen) because they may decrease hydralazine/hydrochlorothiazide's effectiveness
  • Barbiturates (eg, phenobarbital), corticosteroids (eg, prednisone), medicines that may affect your blood vessels, medicines that treat high blood pressure (eg, diazoxide), narcotic pain medicines (eg, codeine, fentanyl, morphine), or other vasodilators (eg, isosorbide, nitroglycerin) because they may increase the risk of hydralazine/hydrochlorothiazide's side effects. Check with your doctor or pharmacist if you have questions about which medicines may affect your blood vessels.
  • Methyldopa or monoamine oxidase (MAO) inhibitors (eg, phenelzine) because the risk of serious side effects may be increased
  • Beta-blockers (eg, propranolol) or nondepolarizing muscle relaxants (eg, tubocurarine) because the risk of their side effects may increased by hydralazine/hydrochlorothiazide
  • Lithium because the risk of toxicity may be increased by hydralazine/hydrochlorothiazide
  • Digoxin, dofetilide, or ketanserin because the risk of irregular heartbeat may be increased by hydralazine/hydrochlorothiazide
  • Diabetes medicines (eg, glipizide, metformin), insulin, or pressor amines (eg, epinephrine, norepinephrine) because their effectiveness may be decreased by hydralazine/hydrochlorothiazide

This may not be a complete list of all interactions that may occur. Ask your health care provider if hydralazine/hydrochlorothiazide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use hydralazine/ hydrochlorothiazide:

Use hydralazine/hydrochlorothiazide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Take hydralazine/hydrochlorothiazide by mouth with or without food.
  • Hydralazine/hydrochlorothiazide may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.
  • Take hydralazine/hydrochlorothiazide on a regular schedule to get the most benefit from it. Taking hydralazine/hydrochlorothiazide at the same time each day will help you remember to take it.
  • Continue to use hydralazine/hydrochlorothiazide even if you feel well. Do not miss any doses.
  • If you miss a dose of hydralazine/hydrochlorothiazide, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use hydralazine/hydrochlorothiazide.

Important safety information:

  • Hydralazine/hydrochlorothiazide may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using hydralazine/hydrochlorothiazide; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Tell your doctor or dentist that you take hydralazine/hydrochlorothiazide before you receive any medical or dental care, emergency care, or surgery.
  • Hydralazine/hydrochlorothiazide may raise your blood sugar. High blood sugar may make you feel confused, drowsy, or thirsty. It can also make you flush, breathe faster, or have a fruit-like breath odor. If these symptoms occur, tell your doctor right away.
  • Your doctor may have also prescribed a potassium supplement for you. If so, follow the dosing carefully. Do not start taking additional potassium on your own or change your diet to include more potassium without first checking with your doctor.
  • Hydralazine/hydrochlorothiazide may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to hydralazine/hydrochlorothiazide. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.
  • Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.
  • Lab tests, including kidney function, blood pressure, complete blood cell counts, and blood electrolyte levels, may be performed while you use hydralazine/hydrochlorothiazide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Use hydralazine/hydrochlorothiazide with caution in the ELDERLY; they may be more sensitive to its effects.
  • Hydralazine/hydrochlorothiazide should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using hydralazine/hydrochlorothiazide while pregnant. Hydralazine/hydrochlorothiazide is found in breast milk. Do not breast-feed while taking hydralazine/hydrochlorothiazide.

Possible side effects of hydralazine/ hydrochlorothiazide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Blurred vision; diarrhea; dizziness; drowsiness; headache; light-headedness especially when sitting up or standing; loss of appetite; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; decrease in sexual ability; decreased or difficult urination; depression; drowsiness; fainting; fast or irregular heartbeat; fever, chills, or persistent sore throat; mental or mood changes; muscle pain or cramps; numbness of an arm or leg; numbness or tingling of the skin; painful, stiff joints; red, swollen, blistered, or peeling skin; restlessness; seizures; severe or persistent headache or dizziness; sharp stomach pain; stomach tenderness; sweating; unusual bruising or bleeding; unusual thirst; unusual or persistent tiredness or weakness; unusually dry mouth; vision changes; yellowing of the eyes or skin.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include chest pain; dry mouth; excessive urination followed by a decrease in amount of urine; flushing; muscle cramps; severe headache; shock; weak, fast, or irregular heartbeat.

Proper storage of hydralazine/hydrochlorothiazide:

Store hydralazine/hydrochlorothiazide at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep hydralazine/hydrochlorothiazide out of the reach of children and away from pets.

General information:

  • If you have any questions about hydralazine/hydrochlorothiazide, please talk with your doctor, pharmacist, or other health care provider.
  • Hydralazine/hydrochlorothiazide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take hydralazine/hydrochlorothiazide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about hydralazine/hydrochlorothiazide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to hydralazine/hydrochlorothiazide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using hydralazine/hydrochlorothiazide.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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