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Hydralazine - Interactions and Warnings

Three case reports are presented to emphasize the potentially hazardous complications resulting from the administration of diazoxide to patients concurrently being treated with other vasodilator and catecholamine-depleting agents.
- S Afr Med J 1981 Mar 28;59(14):496-7 -- Adverse effects of a combination of diazoxide and hydrallazine therapy. -- Davey M, Moodley J, Soutter P.

Hydralazine can cause inhibition of CoQ10-enzymes which are indispensable in the bioenergetics of cardiac function. A pre-existing deficiency of coenzyme Q10 in the myocardium of hypertensive patients could be augmented by subsequent treatment with propranolol, possibly to the "life-threatening" state described by others.
- Res Commun Chem Pathol Pharmacol 1975 Nov;12(3):533-40 -- Bioenergetics in clinical medicine. III. Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive drugs. -- Kishi H, Kishi T, Folkers K.

The mechanism by which the antihypertensive vasodilator hydralazine relaxes vascular smooth muscle is unknown. The drug interacts with pyridoxal and can produce B6 deficiency; it also inhibits a number of enzymes requiring pyridoxal as a cofactor, but there is no apparent relation between its enzymatic and blood pressure effects. Hydralazine hypotension in anesthetized rats was also reduced by pyridoxal pretreatment. These results suggest that at least part of hydralazine-induced hypotension may be related to interaction with pyridoxal, possibly through interference with an effect of the vitamer on calcium and/or sodium transport into vascular smooth muscle.
- J Cardiovasc Pharmacol 1990 Jan;15(1):150-6 -- Interaction with pyridoxal as a possible mechanism of hydralazine hypotension. -- Vidrio H.

Consult with your physician before using any herbs or herbal products especially those which may have an effect on the blood or heart.

last update: November 2008

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