HYDRALAZINE & HYDROCHLOROTHIAZIDE

Brand & Generic Names

Apresazide
Aprozide
Hydra-zide

Basic Information

• Habit forming? No
• Prescription needed? Yes
• Available as generic? Yes
• Drug class: Antihypertensive, diuretic

Uses

• Controls, but doesn't cure, high blood pressure.
• Reduces fluid retention (edema).

Dosage & Usage Information

How to take:
Tablet or capsule--Swallow with liquid. If you can't swallow whole, crumble tablet or open capsule and take with liquid or food.

When to take:
At the same time each day.

If you forget a dose:
Take as soon as you remember up to 2 hours late. If more than 2 hours, wait for next scheduled dose (don't double this dose).

What drug does:
Forces sodium and water excretion, reducing body fluid.
Relaxes and expands blood vessel walls, lowering blood pressure.
Reduced body fluid and relaxed arteries lower blood pressure.

Time lapse before drug works:
Regular use for several weeks may be necessary to determine drug's effectiveness.

Don't take with:
Non-prescription drugs containing alcohol without consulting doctor.
Any other medicine without consulting your doctor or pharmacist.

Overdose

SYMPTOMS:
Cramps, drowsiness, weak pulse, rapid and weak heartbeat, fainting, extreme weakness, cold and sweaty skin, coma.

WHAT TO DO:

• Dial 911 (emergency) or O (operator) for an ambulance or medical help. Then give first aid immediately.
• If patient is unconscious and not breathing, give mouth-to- mouth breathing. If there is no heartbeat, use cardiac massage and mouth-to-mouth breathing (CPR). Don't try to make patient vomit. If you can't get help quickly, take patient to nearest emergency facility.
• See EMERGENCY Information.

Possible Adverse Reactions or Side Effects

Life-threatening:

Chest pain, irregular Discontinue. Seek and fast heartbeat, emergency treatment. weak pulse.

Common:

• Nausea, vomiting.
• Headache, diarrhea, appetite loss, frequent urination, dry mouth, thirst.

Infrequent:

• Rash; black, bloody or tarry stool; red or flushed face; sore throat, fever, mouth sores; constipation; lymph glands swelling; blurred vision; skin blisters; swelling in feet or legs.
• Dizziness; confusion; watery eyes; weight gain or loss; joint, muscle or chest pain; depression; anxiety; fever.

Rare:

• Weakness and faintness when arising from bed or chair, jaundice.
• Numbness or tingling in hands or feet, nasal congestion, impotence.

Warnings & Precautions

Don't take if:

• You are allergic to hydralazine, any thiazide diuretic drug or tartrazine dye.
• You have history of coronary-artery disease or rheumatic heart disease.

Before you start, consult your doctor:

• If you feel pain in chest, neck or arms on physical exertion.
• If you are allergic to any sulfa drug.
• If you have had lupus or a stroke.
• If you have gout, liver, pancreas or kidney disorder.
• If you will have surgery within 2 months, including dental surgery, requiring general or spinal anesthesia.

Over age 60:
Adverse reactions and side effects may be more frequent and severe than in younger persons, especially dizziness and excessive potassium loss.

Pregnancy:
Risk to unborn child outweighs drug benefits. Don't use.

Breast-feeding:
Drug passes into milk. Avoid drug or discontinue nursing until you finish medicine. Consult doctor for advice on maintaining milk supply.

Infants & children:
Not recommended.

Prolonged use:

• May cause lupus (arthritis-like illness).
• Possible psychosis.
• May cause numbness, tingling in hands or feet.
• Talk to your doctor about the need for follow-up medical examinations or laboratory studies to check blood pressure, complete blood counts (white blood cell count, platelet count, red blood cell count, hemoglobin, hematocrit), ANA titers*.

Skin & sunlight:
May cause rash or intensify sunburn in areas exposed to sun or sunlamp.

Driving, piloting or hazardous work:
Don't drive or pilot aircraft until you learn how medicine affects you. Don't work around dangerous machinery. Don't climb ladders or work in high places. Danger increases if you drink alcohol or take medicine affecting alertness and reflexes, such as antihistamines, tranquilizers, sedatives, pain medicine, narcotics and mind-altering drugs.

Discontinuing:
Don't discontinue without consulting doctor's advice until you complete prescribed dose, even though symptoms diminish or disappear.

Others:

• Vitamin B-6 diet supplement may be advisable. Consult doctor.
• Hot weather and fever may cause dehydration and drop in blood pressure. Dose may require temporary adjustment. Weigh daily and report any unexpected weight decreases to your doctor.
• May cause rise in uric acid, leading to gout.
• May cause blood-sugar rise in diabetics.

Possible Interaction with Other Drugs

GENERIC NAME	COMBINED EFFECT
------------------------	-----------------------
Acebutolol	Decreased antihypertensive effect
	of acebutolol.
Allopurinol	Decreased allopurinol effect.
Amphetamines*	Decreased hydralazine effect.
Antidepressants,	Dangerous drop in
tricyclic (TCA)*	blood pressure. Avoid combination
	unless under medical supervision.
Antihypertensives,	Increased antihypertensive
other*	effect.
Barbiturates*	Increased hydrochlorothiazide
	effect.
Carteolol	Decreased antihypertensive effect.
Cholestyramine	Decreased hydrochlorothiazide
	effect.
Cortisone drugs*	Excessive potassium loss that
	causes dangerous heart rhythms.
Diazoxide	Increased antihypertensive effect.
Didanosine	Increased risk of peripheral
	neuropathy.
Digitalis	Excessive potassium
preparations*	loss that causes dangerous heart
	rhythms.
Diuretics, oral*	Increased effect of both drugs.
	When monitored carefully,
	combination may be beneficial in
	controlling hypertension.
Indapamide	Increased diuretic effect.
Lithium	Increased effect of lithium.
MAO inhibitors*	Increased effect of drugs.
Nimodipine	Dangerous blood pressure drop.
Nitrates*	Excessive blood pressure drop.
Potassium	Decreased potassium
supplements*	effect.
Probenecid	Decreased probenecid effect.

Possible Interaction with Other Substances

INTERACTS WITH	COMBINED EFFECT
---------------	---------------
Alcohol:	May lower blood pressure
	excessively. Use extreme caution.
Beverages:	None expected.
Cocaine:	Dangerous blood pressure rise.
	Avoid.
Licorice.	Excessive potassium loss that
	causes dangerous heart rhythms.
Marijuana:	Weakness on standing. May increase
	blood pressure.
Tobacco:	Possible angina attacks.