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HYDRALAZINE injectable _ MSF Medical Guidelines

HYDRALAZINE injectable _ MSF Medical Guidelines

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Zoya Mai
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25 views

HYDRALAZINE injectable _ MSF Medical Guidelines

HYDRALAZINE injectable _ MSF Medical Guidelines

Uploaded by

Zoya Mai
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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HYDRALAZINE injectable

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Therapeutic action

Indications

Forms and strengths, route of administration

Dosage

Duration

Contra-indications, adverse effects, precautions

Remarks

Storage

Prescription under medical supervision

Therapeutic action
Antihypertensive vasodilatator

Indications
Hypertension in pregnancy, in case of severe symptoms or when oral treatment is not possible

Forms and strengths, route of administration


Powder for injection, in 20 mg vial, to be dissolved in 1 ml of water for injection, for IV infusion or
slow diluted IV injection

Dosage
Dosage should be adjusted according to blood pressure (BP). The goal is to reduce the blood
pressure to 140/90 mmHg. Diastolic BP must not fall below 90 mmHg.

By IV infusion
Dilute 100 mg (5 vials of reconstituted hydralazine solution) in 500 ml of 0.9% sodium chloride or
Ringer lactate, to obtain a solution containing 200 micrograms/ml.
Initial dose: 200 to 300 micrograms/minute
Maintenance dose: 50 to 150 micrograms/minute
Administer by increasing the rate up to 20 drops/minute (max. 30 drops/minute), check BP every 5
minutes.
As soon as hypertension is controlled, decrease progressively the rate (15 drops/minute, then 10,
then 5) until stopping infusion. An abrupt discontinuation may provoke a hypertensive crisis.

By slow diluted IV injection


Dilute 20 mg (1 vial of reconstituted hydralazine solution in 1 ml of water for injection) in 9 ml of
0.9% sodium chloride, to obtain 10 ml of solution containing 2 mg/ml.
Administer 5 mg (2.5 ml of the diluted solution) over 2 to 4 minutes. Check BP for 20 minutes. If BP
remains uncontrolled, repeat injection. Continue repeating if necessary, waiting 20 minutes
between each injection (max. 20 mg total dose).

Duration
According to clinical response.
Change to oral treatment as soon possible with labetalol or methyldopa.

Contra-indications, adverse effects, precautions


Administer with caution to patients with heart failure, coronary insufficiency, recent myocardial
infarction, severe tachycardia, history of stroke.
May cause:
hypotension, tachycardia, headache, gastrointestinal disturbances;
abrupt fall in maternal blood pressure with placental hypoperfusion and foetal death when
administered too rapidly by IV injection or in case of overdose.
Reduce doses in patients with renal or hepatic impairment.
Do not exceed recommended dosage and administration rate. During administration, monitor
maternal BP and heart rate, as well as foetal heart rate.
In the event of hypotension, administer Ringer lactate to maintain diastolic BP ≥ 90 mmHg.
Breast-feeding: no contra-indication

Remarks
For administration, only use sodium chloride 0.9% or Ringer lactate (incompatibility with glucose
and other solutions).
Do not mix with other drugs in the same syringe or infusion bottle.

Storage
– Below 25 °C
Reconstituted solution must be used immediately.

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