UNIPRES
Clinical safety rating: caution
Comprehensive clinical and safety monograph for UNIPRES (UNIPRES).
Unipres is a combination of hydralazine (vasodilator) and hydrochlorothiazide (thiazide diuretic). Hydralazine directly relaxes arteriolar smooth muscle, reducing peripheral resistance and afterload. Hydrochlorothiazide inhibits sodium reabsorption in distal convoluted tubule, reducing plasma volume and preload.
| Metabolism | Hydralazine is metabolized via N-acetylation (NAT2 polymorphism) and CYP450 (CYP3A4, CYP2D6, less). Hydrochlorothiazide is not extensively metabolized; eliminated mostly unchanged via renal excretion. |
| Excretion | Renal excretion accounts for 95% of elimination (80% unchanged, 15% as inactive metabolites); biliary/fecal excretion accounts for 5%. |
| Half-life | Terminal elimination half-life is 2.5–3 hours in healthy adults; prolonged to 5–8 hours in severe renal impairment (CrCl <30 mL/min). |
| Protein binding | 85–90% bound to albumin and alpha-1-acid glycoprotein. |
| Volume of Distribution | 0.5–0.7 L/kg, indicating moderate tissue distribution. |
| Bioavailability | Oral: 75–85% (first-pass effect minimal). |
| Onset of Action | Oral: 30–60 minutes; intravenous: 5–10 minutes. |
| Duration of Action | Oral: 6–8 hours; intravenous: 4–6 hours. Clinical note: duration may extend with renal impairment. |
UNIPRES (amlodipine/benazepril) is not a recognized drug. Please consult a complete drug reference.
| Dosage form | TABLET |
| Renal impairment | Not applicable. |
| Liver impairment | Not applicable. |
| Pediatric use | Not applicable. |
| Geriatric use | Not applicable. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for UNIPRES (UNIPRES).
| Breastfeeding | Excreted in breast milk; M/P ratio not determined. Avoid breastfeeding due to potential adverse effects in infant. |
| Teratogenic Risk | First trimester: Avoid due to risk of neural tube defects (NRTIs). Second/third trimester: Use if benefit outweighs risk; associated with lactic acidosis in pregnant women. |
| Fetal Monitoring | Monitor LFTs, serum lactate, and fetal growth ultrasound. Assess for signs of hepatic steatosis. |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
["Hypersensitivity to hydralazine, hydrochlorothiazide, or sulfonamides","Anuria","Acute myocardial infarction (relative)","Systemic lupus erythematosus (relative for hydralazine)"]
| Precautions | ["Can cause drug-induced lupus erythematosus (hydralazine)","May worsen renal function in renal impairment","Monitor electrolytes (hypokalemia, hyponatremia from thiazide)","May precipitate gout (thiazide increases uric acid)","May cause orthostatic hypotension","Use cautiously in patients with CAD (reflex tachycardia)","May require dose adjustment in hepatic impairment"] |
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| Fertility Effects | No direct effects on fertility reported in humans. |