Hydralazine (drug interactions)
Hydralazine is a medication primarily used to dilate blood vessels, making it beneficial in treating conditions such as hypertension, diuretic resistance, and edema. However, it is essential to be aware of its potential drug interactions which can impact patient safety and treatment efficacy. Notably, hydralazine can lead to a deficiency in vitamin B6, prompting some healthcare providers to recommend B6 supplementation to alleviate associated side effects like numbness and tingling. Additionally, there is some evidence that hydralazine may affect the body’s production of Coenzyme Q10, suggesting that CoQ10 supplements could be beneficial for some patients.
The herb Coleus forskohlii is theorized to interact with hydralazine, potentially leading to unpredictable effects. Furthermore, there are significant interactions with other substances, including muscle relaxers like tizanidine, which can cause dangerously low blood pressure. Patients on monoamine oxidase inhibitors (MAOIs) should also exercise caution when considering hydralazine. Other interactions include increased effects of ACE inhibitors and calcium channel blockers, as well as potential severe reactions with alcohol. Given these considerations, individuals taking hydralazine should consult their healthcare providers to navigate these interactions safely.
Hydralazine (drug interactions)
DEFINITION: Medication that causes dilation of the walls of blood vessels and is sometimes used to treat hypertension, diuretic resistance, and edema.
INTERACTIONS: Coenzyme Q10, Coleus forskohlii, vitamin B6
TRADE NAME: Apresoline
Vitamin B6
Effect: Supplementation Likely Helpful
Hydralazine is known to deplete the blood of vitamin B6, causing a deficiency. Taking vitamin B6 supplements, particularly the 4-methanol form called Pyridoxine, may prevent or reverse the side effects of the medication. Physicians sometimes prescribe vitamin B6 supplements with hydralazine to treat numbness, tingling, and burning sensations that sometimes occur as a result of the medication.
Coenzyme Q10 (CoQ10)
Effect: Supplementation Possibly Helpful
There is some evidence that hydralazine might impair the body’s ability to manufacture the substance CoQ10. This suggests (but does not prove) that taking CoQ10 supplements may produce a beneficial effect.
Coleus forskohlii
Effect: Theoretical Interaction
The herb Coleus forskohlii relaxes blood vessels and might have unpredictable effects if combined with hydralazine.
Other Interactions
Hydralazine has several other drug interactions of which patients should be aware. The supplements melatonin, zinc, calcium, and ephedra also interact with hydralazine. One major drug interaction occurs with the muscle relaxer tizanidine, which could cause an unsafe drop in blood pressure when taken with hydralazine. Patients taking monoamine oxidase inhibitors (MAOI) for depression while receiving diazoxide injections should also not take hydralazine. Patients with some medical issues, such as coronary artery diseases, renal dysfunction, or cerebral vasculopathy, should also avoid taking hydralazine. Hydralazine increases the effect of angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, and vasodilators. Patients taking hydralazine should also avoid alcohol, as severe reactions may occur.
Bibliography
Brunton, Laurence L., et al., editors. Goodman and Gilman’s the Pharmacological Basis of Therapeutics. 14th ed., McGraw-Hill Medical, 2023.
Crooks, Frank, and Ryan Raman. “Hydralazine Side Effects, Dosage, Uses & More.” Healthline, 7 Feb. 2018, www.healthline.com/health/drugs/hydralazine-oral-tablet#interactions. Accessed 21 Aug. 2023
Garrison, Kelli. "Hydralazine - Uses, Side Effects, and More." WebMD, 3 June 2024, www.webmd.com/drugs/2/drug-8662/hydralazine-oral/details. Accessed 20 Sept. 2024.
“Hydralazine Interactions Checker.” Drugs.com, 2023, www.drugs.com/drug-interactions/hydralazine.html. Accessed 21 Aug. 2023.
Kishi, H., et al. “Bioenergetics in Clinical Medicine: Inhibition of Coenzyme Q10 Enzymes by Clinically Used Anti-Hypertensive Drugs.” Research Communications in Chemical Pathology and Pharmacology, vol. 12, no. 3, 1975, pp. 533-40.
Preston, Claire L. Stockley’s Drug Interactions. 12th ed., Pharmaceutical Press, 2021.
Tucker, Katherine, et al. Modern Nutrition in Health and Disease. 12th ed., Jones & Bartlett Learning, 2024.