Hydralazine side effects are frequent and mainly due to vasodilatation.
1. The most common hydralazine side effects are facial flushing, conjunctival injection, throbbing headache, dizziness, palpitation, nasal stuffiness, fluid retention, edema, CHF.
2. Angina and MI may be precipitated in patients with coronary artery disease are Hydralazine side effects that can be life threatening.
3. Postural hypotension is not prominent because of little action on veins: venous return and c.o. are not reduced.
4. Paresthesias, tremor, muscle cramps, rarely peripheralneuritis are also lesser common hydralazine side effects.
5. Lupus erythematosus or rheumatoid arthritis likesymptoms develop on prolonged use of doses above 100 mg/day. It is more common in women and in slow acetylators. It is slowly reversible on stopping treatment.
Hydralazine can be used in patients with renal involvement, but is contraindicated in older patients and in those with ischemic heart disease. It is one of the preferred antihypertensives during pregnancy because of decades of experience and record of safety. It can also be used parenterally in hypertensive emergencies.
The arteriolar dilator action of hydralazine can be employed in the management of CHF.