Hydralazine NSAIDs

Drugs that are commonly associated with vasculitis are ACE inhibitors, amiodarone, ampicillin, cimetidine, coumadin, furosemide, hydantoins, hydralazine, NSAIDs, pyrazolons, quinidine, sulfonamides, thiazides, and thiouracils. 

NSAiDs ACE inhibitors + NSAIDs Alpha blockers + NSAiDs Angiotensin II receptor antagonists + Aspirin or NSAiDs Beta blockers + Aspirin or NSAiDs Calcium-channel blockers + Aspirin or NSAiDs Guanethidine + NSAiDs Hydralazine + NSAiDs Thiazide and related diuretics + NSAiDs... 

Drugs that may affect beta blockers include aluminum salts, barbiturates, calcium salts, cholestyramine, cimetidine, colestipol, diphenhydramine, hydroxychloroquine, NSAIDs, penicillins (ampicillin), rifampin, salicylates, SSRIs, sulfinpyrazole, calcium blockers, oral contraceptives, flecainide, haloperidol, hydralazine, loop diuretics,... 

Isosorbide Dinitrate Hydralazine (BiDil) [Antianginal, Antihypertensive/Vasodilator, Nitrate] Uses HF in African Amer-icans improve survival functional status, prolong time between hospitalizations Action Relaxes vascular smooth muscle peripheral vasodilator Dose Initially 1 tab tid PO (if not tol ated reduce to 1/2 tab tid), titrate >3-5 d as tolerated Max 2 tabs tid Caution [C, /-] recent MI, syncope, hypovolemia, hypotension, hep impair Contra For children, concomitant use w/ PDE5 inhibitors (sildenafil) Disp Tabs SE HA, dizziness, orthostatic hypotension, sinusitis, GI distress, tach, paresthesia, amblyopia Interactions t Risk of severe hypotension W/ antihypertensives, ASA, CCBs, MAOIs, phenothiazides, sildenafil, tadalafil, vardenafil, EtOH X pressor response Wf i -1- effects W7 NSAIDs EMS Use ASA, antihypertensives and CCBs w/ caution, may t hypotension concurrent Viagra-type drug use can lead to profound hypotension concurrent EtOH use can t effects OD May cause N/V, profound hypotension, skin flushing, HA from ICP, bradycardia, confusion, and circulatory collapse activated charcoal may be effective, epi use is contraindicated... 

NITRATES ANALGESICS-NSAIDS Hypotensive effects of hydralazine, minoxidil and nitroprusside antagonized by NSAIDs NSAIDs cause sodium and water retention in the kidney and can raise BP due to 1 production of vasodilating renal prostaglandins Monitor BP at least weekly until stable... 

NSAIDs can cause increases in blood pressure due to their effects on sodium and water retention. Various NSAIDs have been reported to reduce the efficacy of other antihypertensive drug classes, for example see ACE inhibitors + NSAIDs , p.28. It would therefore be prudent to monitor concurrent use of hydralazine and NSAIDs. 

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