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Apresoline (hydralazine) Disease Interactions

There are 5 disease interactions with Apresoline (hydralazine):

Major

Hydralazine (Includes Apresoline) ↔ Bone Marrow Suppression

Severe Potential Hazard, Low plausibility

Applies to: Bone Marrow Depression/Low Blood Counts

Hydralazine may rarely cause blood dyscrasias at recommended dosages. Reduction in hemoglobin, red cell count, agranulocytosis, leukopenia, and purpura have been reported. Therapy with hydralazine should be administered cautiously in patients with these preexisting conditions and if such abnormalities develop during the course of therapy, treatment should be discontinued. Monitoring blood counts should be considered for those patients at higher risk.

References

  1. "Product Information. Apresoline (hydralazine)." Ciba Pharmaceuticals, Summit, NJ.
  2. Widerlov E, Karlman I, Storsater J "Hydralazine-induced neonatal thrombocytopenia." N Engl J Med 303 (1980): 1235
  3. Freestone S, Ramsay LE "Transient monoclonal gammopathy in hydralazine-induced lupus erythematosus." Br Med J 285 (1982): 1536-7
  4. Koch-Weser J "Hydralazine." N Engl J Med 295 (1976): 320-3
  5. Harrison BD, Laidlaw ST, Reilly JT "Fatal aplastic anaemia associated with lisinopril." Lancet 346 (1995): 247-8
  6. Macleod WN "Anaemia in the hydrallazine-induced lupus syndrome." Scott Med J 28 (1983): 181-2
  7. Orenstein AA, Yakulis V, Eipe J, Costea N "Immune hemolysis due to hydralazine." Ann Intern Med 86 (1977): 450-1
View all 7 references
Major

Hydralazine (Includes Apresoline) ↔ Coronary Artery Disease

Severe Potential Hazard, High plausibility

Applies to: Ischemic Heart Disease

The use of hydralazine is contraindicated in patients with coronary artery disease. Reflex tachycardia may commonly occur. Palpitations and chest pain have also been reported. Myocardial infarction has been associated with the use of hydralazine.

References

  1. Laslett LJ, DeMaria AN, Amsterdam EA, Mason DT "Hydralazine-induced tachycardia and sodium retention in heart failure: hemodynamic and symptomatic correlation by prazosin therapy." Arch Intern Med 138 (1978): 819-20
  2. Packer M, Meller J, Medina N, et al "Provocation of myocardial ischemic events during initiation of vasodilator therapy for severe chronic heart failure." Am J Cardiol 48 (1981): 939-46
  3. Koch-Weser J "Hydralazine." N Engl J Med 295 (1976): 320-3
Major

Hydralazine (Includes Apresoline) ↔ Lupus Erythematosus

Severe Potential Hazard, High plausibility

Applies to: Lupus Erythematosus

The use of hydralazine has been associated with the development of lupus erythematosus and lupus-like syndromes, as well as exacerbation of the disease. Hydralazine therapy should be withdrawn in patients experiencing worsening of preexisting lupus. Monitoring complete blood counts, and antinuclear antibody titers before and during prolonged therapy is recommended.

References

  1. Shapiro KS, Pinn VW, Harrington JT, Levey AS "Immune complex glomerulonephritis in hydralazine-induced SLE." Am J Kidney Dis 3 (1984): 270-4
  2. Pirmohamed M "Hydralazine-induced lupus: yet another autoantibody! triplex-DNA stabilization by hydralazine and the presence of anti-(triplex DNA) antibodies in patients treated with hydralazine - comment." Hum Exp Toxicol 15 (1996): 361-2
  3. Naparstek Y, Kopolovic J, Tur-Kaspa R, Rubinger D "Focal glumerulonephritis in the course of hydralazine-induced lupus syndrome." Arthritis Rheum 27 (1984): 822-5
  4. Freestone S, Ramsay LE "Transient monoclonal gammopathy in hydralazine-induced lupus erythematosus." Br Med J 285 (1982): 1536-7
  5. Cush JJ, Goldings EA "Southwestern internal medicine conference: drug-induced lupus: clinical spectrum and pathogenesis." Am J Med Sci 290 (1985): 36-45
  6. Darwaza A, Lamey P-J, Connell JM "Hydrallazine-induced Sjogren's syndrome." Int J Oral Maxillofac Surg 17 (1988): 92-3
  7. Carey RM, Coleman M, Feder A "Pericardial tamponade: a major presenting manifestation of hydralazine-induced lupus syndrome." Am J Med 54 (1973): 84-7
  8. Innes A, Rennie JA, Cato GR "Drug-induced lupus caused by very-low-dose hydralazine." Br J Rheumatol 25 (1986): 225-31
  9. Timbrell JA, Facchini V, Harland SJ, Mansilla-Tinoco R "Hydralazine-induced lupus: is there a toxic metabolic pathway?" Eur J Clin Pharmacol 27 (1984): 555-9
  10. Sturman SG, Kumararatne D, Beevers DG "Fatal hydralazine-induced systemic lupus erythematosus." Lancet 12/03/88 (1988): 1304
  11. Hahn BH, Sharp GC, Irvin WS, et al "Immune responses to hydralazine and nuclear antigens in hydralazine-induced lupus erythematosus." Ann Intern Med 76 (1972): 365-74
  12. Weinstein J "Hypocomplementemia in hydralazine-associated systemic lupus erythematosus." Am J Med 65 (1978): 553-6
  13. "Product Information. Apresoline (hydralazine)." Ciba Pharmaceuticals, Summit, NJ.
  14. Lunde PK, Frislid K, Hansteen V "Disease and acetylation polymorphism." Clin Pharmacokinet 2 (1977): 182-97
  15. Perry HM "Late toxicity to hydralazine resembling systemic lupus erythematosus or rheumatoid arthritis." Am J Med 54 (1973): 58-72
  16. Fleming MG, Bergfeld WF, Tomecki KJ, et al "Bullous systemic lupus erythematosus." Int J Dermatol 28 (1989): 321-6
  17. Blumenkrantz N, Christiansen AH, Ullman S, Asboe-Hansen G "Hydralazine-induced lupoid syndrome." Acta Med Scand 195 (1974): 443-9
  18. Cameron HA, Ramsay LE "The lupus syndrome induced by hydralazine: a common complication with low dose treatment." Br Med J 289 (1984): 410-12
  19. Macleod WN "Anaemia in the hydrallazine-induced lupus syndrome." Scott Med J 28 (1983): 181-2
  20. Ihle BU, Whitworth JA, Dowling JP, Kincaid-Smith P "Hydralazine and lupus nephritis." Clin Nephrol 22 (1984): 230-8
  21. Ramsey-Goldman R, Franz T, Solano FX, Medsger TA "Hydralazine induced lupus and sweet's syndrome: report and review of the literature." J Rheumatol 17 (1990): 682-4
View all 21 references
Major

Hydralazine (Includes Apresoline) ↔ Valvular Heart Disease

Severe Potential Hazard, High plausibility

Applies to: Valvular Heart Disease

The use of hydralazine is contraindicated in patients with mitral valvular rheumatic heart disease.

References

  1. "Product Information. Apresoline (hydralazine)." Ciba Pharmaceuticals, Summit, NJ.
Moderate

Hydralazine (Includes Apresoline) ↔ Renal Dysfunction

Moderate Potential Hazard, Moderate plausibility

Applies to: Glomerulonephritis, Renal Dysfunction

The use of hydralazine has been associated with the development of glomerulonephritis. Hydralazine should be used with caution in patients with advanced renal damage and these patients may require a lower dose. Renal function should be monitored and supported as required.

Apresoline (hydralazine) drug Interactions

There are 491 drug interactions with Apresoline (hydralazine)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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