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CARDIOVASCULAR SYSTEM › ANTIHYPERTENSIVES › ARTERIOLAR SMOOTH MUSCLE, AGENTS ACTING ON › Hydrazinophthalazine derivatives
cadralazine
C02DB04
Adult Dosing
- Initial dose: 2 mg to 4 mg orally once or twice daily
- Maintenance dose: 2 mg to 8 mg daily, adjusted based on blood pressure response
- Maximum daily dose: 12 mg per day
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been established
Indications
- Hypertension (essential and secondary)
Mechanism of Action
- Direct-acting peripheral vasodilator that relaxes vascular smooth muscle, predominantly affecting arterioles
- Reduces total peripheral resistance and lowers blood pressure with reflex sympathetic activation
Contraindications
- Hypersensitivity to cadralazine or structurally related hydralazine derivatives
- Pre-existing tachycardia
- High-output heart failure
- Coronary artery disease and recent myocardial infarction
- Dissecting aortic aneurysm
Adverse Reactions
- Headache
- Tachycardia and palpitations
- Flushing and warmth
- Dizziness and orthostatic hypotension
- Gastrointestinal disturbances (nausea, vomiting)
- Drug-induced lupus-like syndrome with long-term high-dose therapy
Drug Interactions
- Antihypertensive agents, diuretics, and vasodilators: May cause additive hypotensive effects
- Beta-blockers: Often co-administered to mitigate reflex tachycardia
- Monoamine oxidase inhibitors (MAOIs): May enhance hypotensive response
Curated Content: Needs Vetting Before Put to Clinical Use