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dihydralazine and diuretics, combinations with other drugs

C02LG51

Forms & Strengths

Dihydralazine 10-20mg with hydrochlorothiazide 25-50mg
Dihydralazine 20-40mg with chlorothiazide 50-100mg
Dihydralazine 25-50mg with amiloride 2.5-5mg
Tablets
Capsules

Adult Dosing

1-2 tablets per day
Initial dose: 1 tablet (dihydralazine 10-20mg with hydrochlorothiazide 25-50mg) once daily
Maintenance dose: 1-2 tablets (dihydralazine 20-40mg with chlorothiazide 50-100mg) per day
Adjust dose according to blood pressure response

Pediatric Dosing

Not recommended for children under 12 years of age
Half the adult dose for children 12-18 years of age
Use with caution in pediatric patients
Dose adjustment based on clinical response

Indications

Treatment of hypertension
Mild-to-moderate essential hypertension
Hypertension in patients with renal impairment
Management of hypertension in pregnancy

Mechanism of Action

Dihydralazine: direct arteriolar vasodilation
Hydrochlorothiazide/chlorothiazide: inhibition of sodium reabsorption in the distal convoluted tubule
Amiloride: inhibition of sodium reabsorption in the collecting duct
Synergistic effect of combination therapy

Contraindications

Severe renal impairment
Hypersensitivity to dihydralazine, hydrochlorothiazide, chlorothiazide, or amiloride
Anuria
Lactation

Adverse Reactions

Dizziness
Lightheadedness
Headache
Nausea and vomiting
Hypotension
Hyperkalemia (with amiloride)
Hypokalemia (with hydrochlorothiazide/chlorothiazide)

Drug Interactions

Other antihypertensive agents: increased hypotensive effect
Non-steroidal anti-inflammatory agents: reduced antihypertensive effect
Digitalis: increased risk of digitalis toxicity
Lithium: increased lithium levels
MAOIs: increased risk of hypertensive crisis

Curated Content: Needs Vetting Before Put to Clinical Use