Comparative Pharmacology
Head-to-head clinical analysis: HYDRALAZINE HYDROCHLORIDE versus IV PERSANTINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HYDRALAZINE HYDROCHLORIDE versus IV PERSANTINE.
HYDRALAZINE HYDROCHLORIDE vs IV PERSANTINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Vasodilation of arterioles by direct relaxation of vascular smooth muscle, likely involving interference with calcium movement.
Inhibits adenosine deaminase and phosphodiesterase, increasing intracellular cAMP and adenosine; causes coronary vasodilation and inhibits platelet aggregation.
Oral: Initiate with 10 mg 4 times daily for 2-4 days, then increase to 25 mg 4 times daily for the remainder of the week, then titrate to 50 mg 4 times daily. Maximum daily dose: 300 mg. Intravenous: 5-20 mg IV bolus, may repeat every 20-30 minutes as needed, or continuous IV infusion 0.5-10 mg/hour.
0.14 mg/kg/min intravenous infusion over 4 minutes for myocardial perfusion imaging.
None Documented
None Documented
The terminal elimination half-life of hydralazine is approximately 2–4 hours in patients with normal renal function, but it is prolonged in renal impairment (up to 7–16 hours). The antihypertensive effect often lasts longer than the half-life due to persistent binding to arteriolar receptors.
Terminal elimination half-life is approximately 10-12 hours in adults; may be prolonged in patients with hepatic impairment.
Hydralazine is primarily metabolized in the liver via N-acetylation (polymorphic) and hydroxylation. Less than 10% of the dose is excreted unchanged in urine. The major metabolites are hydralazine pyruvic acid hydrazone and other conjugates, which are excreted renally. Fecal elimination is negligible.
Primarily hepatic metabolism (glucuronidation) with enterohepatic recirculation; renal excretion of unchanged drug is minimal (<1%); biliary/fecal elimination accounts for approximately 90% of the dose.
Category A/B
Category C
Vasodilator
Vasodilator