Hydralazine 1mg/5ml oral solution
Requires a prescription from a doctor or prescriber
Hypertension and heart failure
Official documents, adverse reaction reporting, and safety monitoring
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Official medicine documents
Safety monitoring data
Yellow Card reports
The MHRA Yellow Card scheme collects reports of suspected side effects from healthcare professionals and patients. View the Drug Analysis Profile (iDAP) for real-world adverse reaction data.
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Suspected adverse reactions reported for Hydralazine
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Submit a Yellow Card report to the MHRA
Data from the MHRA Yellow Card scheme. A reported reaction does not necessarily mean the medicine caused it. Contains public sector information licensed under the Open Government Licence v3.0.
EudraVigilance
The European Medicines Agency (EMA) collects suspected adverse reaction reports from across the EU/EEA through the EudraVigilance system. Search for safety data on this medicine.
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Suspected adverse reactions reported for Hydralazine
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EudraVigilance data is published by the European Medicines Agency (EMA). A suspected adverse reaction is not necessarily caused by the medicine.
1 branded products available
WHO defined daily dose (DDD)
100 mg
Not a recommended dose. The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults. It is a statistical measure used for research and comparison purposes only.
Source: WHO Collaborating Centre for Drug Statistics Methodology, distributed via NHS dm+d BNF mapping files. Contains public sector information licensed under the Open Government Licence v3.0.
Therapeutically similar medicines
Similarity based on WHO Anatomical Therapeutic Chemical (ATC) classification and NHS BNF section grouping. Source data: NHS dm+d via TRUD (OGL v3.0), WHO ATC/DDD Index.
NHS prescribing volume and spending trends
Clinical guidelines and formulary information
British National Formulary
Hydralazine
Source: British National Formulary, NICE. Joint Formulary Committee. Contains public sector information licensed under the Open Government Licence v3.0.
NICE clinical guidance(4)
Dapagliflozin for treating chronic heart failure with reduced ejection fraction (TA679)
Chronic heart failure in adults: diagnosis and management (NG106)
Hypertension in pregnancy: diagnosis and management (NG133)
Chronic heart failure in adults (QS9)
Source: National Institute for Health and Care Excellence (NICE). Contains public sector information licensed under the Open Government Licence v3.0.
Check stock at pharmacies and supply information
Pharmacy stock checkers
Search for this medicine at major UK pharmacy chains. These links open the retailer's own website — results depend on their current online catalogue.
Supply & product information
Official product databases and supply status monitoring
Pharmacy links redirect to the retailer's own search and do not represent real-time stock levels. emc (electronic medicines compendium) is operated by Datapharm Ltd. Shortage information sourced from NHS Specialist Pharmacy Service (SPS), sps.nhs.uk.
Codes for healthcare professionals and prescribing systems
These codes are used by healthcare IT systems and prescribers to identify this medicine.
NHS UK identifiers
Browse tools
SNOMED CT and dm+d codes from NHS TRUD (Technology Reference data Update Distribution), licensed under the Open Government Licence v3.0. BNF codes from NHS Business Services Authority (NHSBSA). ATC codes from the WHO Collaborating Centre for Drug Statistics Methodology (whocc.no).
Active and completed clinical studies from ClinicalTrials.gov
Source: ClinicalTrials.gov, a database of the U.S. National Library of Medicine (NLM), National Institutes of Health (NIH). Data accessed via ClinicalTrials.gov API v2. Trial information is provided for research purposes and does not constitute medical advice.
Pharmacology and chemical data from DrugBank
Key facts
Drug status
Approved
Major interactions
7 found
Half-life
2.2-7.8h
Mechanism
Hydralazine may interfere with calcium transport in vascular smooth muscle by an…
Food interactions
1 warning
Human targets
3 targets
Data: DrugBank · CC BY-NC 4.0
Pharmacokinetics at a glance
Absorption
0.3mg/k
[A186835]…
Half-life
2.2-7.8h
Protein binding
87%
[A186304]
Volume of distribution
0.79L/kg
[A186817]
Metabolism
[A186310]…
Elimination
10%
[A186817]
Clearance
55%
[A186817]…
Pharmacokinetic data: DrugBank · CC BY-NC 4.0
Hydralazine hydrochloride was FDA approved on 15 January 1953.[L8779]
[L8782]
A combination product with isosorbide dinitrate is indicated as an adjunct therapy in the treatment of heart failure.
[L8785]
Known interactions with other medications. Always consult a healthcare professional.
Showing 50 of 1265 interactions
[L8782]
Patients experiencing an overdose may present with hypotension, tachycardia, headache, flushing, myocardial ischemia, myocardial infarction, cardiac arrhythmia, and shock.
[L8782]
Overdose can be treated through emptying the gastric contents and administering activated charcoal, though these treatments may cause further arrhythmias and shock.
[L8782]
Supportive and symptomatic treatment should be administered.
[L8782]
Hydralazine also competes with protocollagen prolyl hydroxylase (CPH) for free iron.[A13596] This competition inhibits CPH mediated hydroxylation of HIF-1α, preventing the degradation of HIF-1α.[A13596] Induction of HIF-1α and VEGF promote proliferation of endothelial cells and angiogenesis.[A13596]
How the body processes this drug — absorption, distribution, metabolism, and elimination
[A186835]
An intravenous dose of 0.3mg/kg leads to an AUC of 17.5-29.4µM\*min and a 1mg/kg oral dose leads to an AUC of 4.0-30.4µM\*min.
[A186838]
The Cmax of oral hydralazine is 0.12-1.31µM depending on the acetylator status of patients.
[A186838]
[A186310][L8782]
The half life in heart failure patients is 57-241 minutes with an average of 105 minutes and in hypertensive patients is 200 minutes for rapid acetylators and 297 minutes for slow acetylators.
[A186817]
Hydralazine is subject to polymorphic acetylation;[A244480] slow acetylators generally have higher plasma levels of hydralazine and require lower doses to maintain control of pressure. However, other factors, such as acetylation being a minor metabolic pathway for hydralazine, will contribute to differences in elimination rates.
[A186304]
[A186817]
[A186310]
There are 5 identified metabolic pathways for hydralazine.
[A186301][A186754][A186316][A186310][A186319][A186769]
Hydralazine can be metabolized to phthalazine or α-ketoglutarate hydrazone.
[A186301][A186310]
These metabolites can be further converted to phthalazinone or hydralazine can be metabolized directly to phthalazinone.
[A186301][A186310]
Hydralazine can undergo a reversible converstion to the active hydralazine acetone hydrazone.
[A186319][A186769]
Hydralazine is spontaneously converted to the active pyruvic acid hydrazone or the pyruvic acid hydrazone tricyclic dehydration product, and these metabolites can convert back and forth between these 2 forms.
[A186301][A186316]
Hydralazine can be converted to hydrazinophthalazinone, which is further converted to the active acetylhydrazinophthalazinone.
[A186301][A186310]
The final metabolic process hydralazine can undergo is the conversion to an unnamed hydralazine metabolite, which is further metabolized to 3-methyl-s-triazolophthalazine (MTP).
[A186301]
MTP can be metabolized to 9-hydroxy-methyltriazolophthalazine or 3-hydroxy-methyltriazolophthalazine; the latter is converted to triazolophthalazine.
[A186301]
[A186817]
[A186817]
The average clearance in congestive heart failure patients is 1.77±0.48L/kg/h,[A186817] while hypertensive patients have an average clearance of 42.7±8.9mL/min/kg.
[A186838]
Proteins and enzymes this drug interacts with in the body
PMID:19588076 PMID:24304424 PMID:9653080
Has a preference for the primary monoamines methylamine and benzylamine .
PMID:19588076 PMID:9653080
Could also act on 2-phenylethylamine but much less efficiently .
PMID:19588076
At endothelial cells surface can also function as a cell adhesion protein that participates in lymphocyte extravasation and recirculation by mediating the binding of lymphocytes to peripheral lymph node vascular endothelial cells in an L-selectin-independent fashion PMID:9254657 PMID:9653080
PMID:11292861 PMID:11566883 PMID:15465032 PMID:16973622 PMID:17610843 PMID:18658046 PMID:20624928 PMID:22009797 PMID:30125331 PMID:9887100
Under hypoxic conditions, activates the transcription of over 40 genes, including erythropoietin, glucose transporters, glycolytic enzymes, vascular endothelial growth factor, HILPDA, and other genes whose protein products increase oxygen delivery or facilitate metabolic adaptation to hypoxia .
PMID:11292861 PMID:11566883 PMID:15465032 PMID:16973622 PMID:17610843 PMID:20624928 PMID:22009797 PMID:30125331 PMID:9887100
Plays an essential role in embryonic vascularization, tumor angiogenesis and pathophysiology of ischemic disease .
PMID:22009797
Heterodimerizes with ARNT; heterodimer binds to core DNA sequence 5'-TACGTG-3' within the hypoxia response element (HRE) of target gene promoters (By similarity). Activation requires recruitment of transcriptional coactivators such as CREBBP and EP300 .
PMID:16543236 PMID:9887100
Activity is enhanced by interaction with NCOA1 and/or NCOA2 .
PMID:10594042
Interaction with redox regulatory protein APEX1 seems to activate CTAD and potentiates activation by NCOA1 and CREBBP .
PMID:10202154 PMID:10594042
Involved in the axonal distribution and transport of mitochondria in neurons during hypoxia PMID:19528298
Enzymes involved in drug metabolism — important for understanding drug interactions
Proteins that carry this drug through the body
PMID:19021548
Major calcium and magnesium transporter in plasma, binds approximately 45% of circulating calcium and magnesium in plasma (By similarity).
Potentially has more than two calcium-binding sites and might additionally bind calcium in a non-specific manner (By similarity). The shared binding site between zinc and calcium at residue Asp-273 suggests a crosstalk between zinc and calcium transport in the blood (By similarity). The rank order of affinity is zinc > calcium > magnesium (By similarity).
Binds to the bacterial siderophore enterobactin and inhibits enterobactin-mediated iron uptake of E.coli from ferric transferrin, and may thereby limit the utilization of iron and growth of enteric bacteria such as E.coli .
PMID:6234017
Does not prevent iron uptake by the bacterial siderophore aerobactin PMID:6234017
ATC C02DB02
ATC C02LG02
Chemical identifiers
CAS, UNII, InChI Key and database cross-references
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Chemical identifiers
CAS, UNII, InChI Key and database cross-references
Linked compound data from DrugBank Open Data (CC BY-NC 4.0)
Hydralazine
Additional database identifiers
Drugs Product Database (DPD)
6436
ChemSpider
3511
BindingDB
81461
PDB
HLZ
ZINC
ZINC000012360535
HUGO Gene Nomenclature Committee (HGNC)
HGNC:550
GenAtlas
AOC3
GeneCards
AOC3
GenBank Gene Database
U39447
GenBank Protein Database
1399032
Guide to Pharmacology
2767
UniProt Accession
AOC3_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:4910
GenAtlas
HIF1A
GeneCards
HIF1A
GenBank Gene Database
U22431
UniProt Accession
HIF1A_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:8546
GenAtlas
P4HA1
GeneCards
P4HA1
GenBank Gene Database
M24486
GenBank Protein Database
190786
UniProt Accession
P4HA1_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:2637
GenAtlas
CYP3A4
GeneCards
CYP3A4
GenBank Gene Database
M18907
Guide to Pharmacology
1337
UniProt Accession
CP3A4_HUMAN
HUGO Gene Nomenclature Committee (HGNC)
HGNC:399
GenAtlas
ALB
GeneCards
ALB
GenBank Gene Database
V00494
GenBank Protein Database
28590
UniProt Accession
ALBU_HUMAN
International reference pricing
Reference pricing from DrugBank. Prices are indicative and may not reflect current UK costs.
Source: DrugBank. Used under CC BY-NC 4.0 academic licence for non-commercial purposes.
Patent information
All patents expired, 2 expired
Source: DrugBank · CC BY-NC 4.0. Patent data sourced from national patent offices. Expiry dates may not reflect extensions, regulatory exclusivity periods, or legal challenges.
DrugBank citations
If you use DrugBank data in your research, please cite the following publications: