hydralazine hydrochloride / Generic mfg. - LARVOL DELTA

A Case of Hydralazine-Induced ANCA Vasculitis/Lupus Overlap Syndrome Presenting as Persistent Bicytopenia. (PubMed, Case Rep Rheumatol) - "Hydralazine was discontinued, and treatment was initiated with high-dose prednisone...Rituximab was then employed without clinical improvement, with eventual progression to end-stage renal disease requiring hemodialysis. This case report helps highlight the vague symptoms that can be associated with hydralazine-induced vasculitis/lupus overlap syndrome. This case will increase clinician awareness for early recognition of such a syndrome, prompting early diagnosis, preventing end-organ damage, reducing hospitalizations and improving quality of life."

Journal • Acute Kidney Injury • ANCA Vasculitis • Chronic Kidney Disease • Fatigue • Glomerulonephritis • Hematological Disorders • Immunology • Inflammatory Arthritis • Leukopenia • Lupus • Lupus Nephritis • Nephrology • Renal Disease • Vasculitis

Drug-Induced Renal Vasculitis: Etiology, Pathogenesis, Clinical Manifestations, and Therapeutic Approaches-A Narrative Review. (PubMed, Health Sci Rep) - "This review provides a comprehensive overview of drug-induced renal vasculitis, discussing what is known and identifying gaps in understanding. While discontinuing the causative drug remains the cornerstone of management, further research is needed, particularly in developing a formal tool to assess the quality of studies and minimize selection bias."

Journal • Cardiovascular • Hematological Disorders • Inflammation • Nephrology • Oncology • Renal Cell Carcinoma • Thrombosis • Vasculitis • MPO

Haptenization as the missing link between vasculitis and myeloperoxidase. (PubMed, J Clin Invest) - "These findings provide a mechanism by which hydralazine induces a type III hypersensitivity reaction associated with mild to severe vasculitis. The study serves as an example for understanding haptenation and may inform the development of diagnostics for determining susceptibility to drug-induced allergic or autoimmune responses."

Journal • Immunology • Vasculitis • MPO

Hydralazine-Induced ANCA Vasculitis Presenting With Pericarditis: A Novel Case and Literature Review. (PubMed, Case Rep Cardiol) - "Hydralazine was discontinued, and she was successfully treated with corticosteroids and tolerated immunosuppression well. Subsequently, she recovered and was discharged from the hospital."

Journal • ANCA Vasculitis • Cardiovascular • Congestive Heart Failure • Conjunctivitis • Heart Failure • Hypertension • Immunology • Infectious Disease • Inflammatory Arthritis • Lupus • Ocular Infections • Ocular Inflammation • Ophthalmology • Pneumonia • Respiratory Diseases • Vasculitis • MPO

Guideline Directed Medical Therapy Associations with Late Right Heart Failure in Patients on Heartmate 3 Support (ISHLT 2025) - "Ability to tolerate higher dosages of BB (>100mg of metoprolol or >12.5 mg of carvedilol, daily) vs no BB, were associated with lower risk of L- RHF [(HR = 0.411(0.208 - 0.811); p = 0.0103) vs (HR = 2.23(1.17 - 4.26) p = 0.0146)].Conclusion Utilization of HF-GDMT is associated with lower incidence of L-RHF in HM3 supported patients. Inability to tolerate high dosage BB and requirement for amiodarone, diuretics, hydralazine, or PDE5is identifies patients at higher risk for L-RHF."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure

Donor-Derived Post-Transplant Anaphylaxis (ISHLT 2025) - "Her only reported allergy was to trimethoprim-sulfamethoxazole with no previous food allergies...She received intravenous diphenhydramine, epinephrine, famotidine, and hydralazine...Recipient hospitals should review severe donor allergies, document allergic potential in the medical record, and educate the transplant recipient on conceivable risk. While allergen avoidance is still recommended the approval of omalizumab to treat food allergies could be potentially life-saving for such patients."

Post-transplantation • Food Hypersensitivity • Immunology • Pulmonary Disease • Transplantation

Novel O-methylpyrimidine prodrugs of phenolic compounds bioactivated by aldehyde oxidase: Enhancing metabolic stability against first-pass conjugative metabolism in the intestine. (PubMed, Drug Metab Dispos) - "Prototypical prodrugs of 4-hydroxy-tamoxifen (4OH-TAM), raloxifene (RAL), rotigotine, 5-hydroxy-tolterodine, and phentolamine were all substrates for AO-mediated parent drug release in liver cytosol from humans and every preclinical species evaluated. Reaction phenotyping confirmed the role of AO; hydralazine inhibited production of 4OH-TAM and RAL from their respective prodrugs in the human liver cytosol, and recombinant human AO activated those same prodrugs...SIGNIFICANCE STATEMENT: An aldehyde oxidase-mediated biotransformation that cleaves O-linked methylpyrimidine-masked phenolic moieties was identified, and this system employed for a novel prodrug bioactivation strategy. The research herein expands existing knowledge surrounding the metabolism capabilities of this enzyme and provides medicinal chemists with a tool to enhance the oral bioavailability of phenolic compounds that otherwise would be limited due to extensive phase II metabolism and possibly low..."

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BEYOND THE HEART: HYDRALAZINE-INDUCED SWEET SYNDROME - Brandon Hanten (ACC 2025) - "This case highlights a rare but significant adverse reaction to hydralazine, a commonly used medication in heart failure management. Clinicians should maintain a high index of suspicion for drug-induced etiologies when encountering unusual dermatologic presentations in hospitalized patients."

Cardiovascular • Congestive Heart Failure • Dermatology • Heart Failure • Hematological Disorders • Infectious Disease • Oncology • Pain

REDUCING INAPPROPRIATE ANTIHYPERTENSIVE PRESCRIBING IN A COMMUNITY HOSPITAL: INSIGHTS FROM A 2023-2024 EDUCATIONAL INITIATIVE - Juan C. Perez (ACC 2025) - "At the end of the evaluation period, we used Slicer Dicer to analyze prescription rates of IV hydralazine and IV labetalol, employing chi-square analysis for statistical comparisons. In 2023, FSU attendings prescribed hydralazine and labetalol in 373 cases, showing no significant difference compared to other CCH hospitalists (819 cases) (p = 0.28). Educational interventions effectively reduced inappropriate antihypertensive prescribing in inpatient settings, warranting further exploration to enhance patient outcomes."

Clinical • Cardiovascular • Hypertension

HYPERTENSIVE URGENCY ON THE BACKGROUND OF BUSPIRONE USE - Soomal Rafique (ACC 2025) - "She was using prescribed metoprolol XR 200mg and Lisinopril 40mg once daily, clonidine 0.1 mg twice daily and buspirone 10mg three times daily...For hypertensive urgency, intravenous hydralazine was initiated, resulting in a gradual improvement in blood pressure. Medications were adjusted, switching metoprolol to carvedilol and discontinuing clonidine due to concerns about rebound hypertension... This case highlights the importance of thorough review of medical and medication history in a patient with resistant hypertension. Prompt removal of potential causative medications can prevent unnecessary and costly investigations for other secondary hypertension causes, reducing healthcare expenses."

Cardiovascular • CNS Disorders • Dyslipidemia • Endocrine Cancer • General Anxiety Disorder • Hypertension • Mood Disorders • Oncology • Psychiatry • Solid Tumor

UNCOVERING AN INCIDENTALOMA: PHEOCHROMOCYTOMA AS SECONDARY CAUSE OF HYPERTENSION IN A 32-YEAR-OLD WOMAN - Molly O'Brien (ACC 2025) - "She was treated with multiple doses of IV hydralazine with improvement in blood pressure to 150s/80s but developed subsequent tachycardia, chest pain and nausea...She had a marginally positive dexamethasone suppression test, on repeat was negative... Since advances in imaging have increased the unveiling of adrenal incidentalomas, it is more important than ever to understand the diagnostic approach to incidentalomas: when to perform biochemical testing and imaging, followed by surgical intervention. The identification and treatment of secondary hypertension before age 40 is associated with better blood pressure control but this impact should be balanced against risks such as cost, patient burden and incidental diagnoses from more invasive investigations."

Clinical • Cardiovascular • Endocrine Cancer • Endocrine Disorders • Gynecology • Hypertension • Oncology • Pain • Solid Tumor

Antibacterial and Antibiofilm Activities of Hydralazine, an Antihypertensive Drug: In Vitro and In Silico Approaches. (PubMed, Antibiotics (Basel)) - " In this study, the antibacterial activity of the antihypertensive hydralazine (HDZ) was evaluated against Gram-positive and Gram-negative strains through minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), growth curve with MIC and sub-MIC doses, combinatorial effect with gentamicin, scanning electron microscopy (SEM), molecular docking, and antibiofilm activity. Furthermore, hydralazine showed antibiofilm activity against the tested strains, including MRSA. Electron microscopy analysis revealed significant changes in bacterial morphology when exposed to the MIC dose of HDZ for 4 h. The overall results of the study indicate hydralazine as a potential agent in the fight against bacterial infections."

Journal • Preclinical • Infectious Disease

The Impact of DNA Methylation in Trichoderma reesei on Cellulase Production and Strain Degeneration. (PubMed, Microorganisms) - "In order to determine what the impact of DNA methylation is on strain degeneration, we induced hypomethylation with hydralazine HCL, which showed a reduced non-productive phenotype and partially restored cellulase productivity...As a final test, we carried out deletion experiments targeting the putative DNA methyltransferases Dim2 and Rid1, which initially reduced the occurrence of a non-producing subpopulation, but subsequent sub-cultivation eliminated cellulase productivity. This study shows that DNA methylation impacts T. reesei cellulase productivity, an understanding that can help us develop targeted strategies to reduce strain degeneration and improve cellulase production in industrial applications."

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Managing the Pressure: Hypertension due to Prostate Cancer Therapy (NKF-SCM 2025) - "Bicalutamide was initiated and he later underwent radiation therapy followed by abiraterone and prednisone...BP was refractory to five anti-hypertensive (HTN) medications (amlodipine, hydralazine, eplerenone, clonidine, indapamide) that were gradually added at heights tolerated doses...It not only increases the risk of cardiovascular events and stroke, but if BP is unmanageable and therapy needs to be discontinued, it may increase the risk of cancer progression. Clinicians must balance the dual threat of cardiovascular complications and potential tumor progression and adopt proactive monitoring and management strategies in this high risk population."

Cardiovascular • Genito-urinary Cancer • Hypertension • Oncology • Prostate Cancer • Solid Tumor • CYP17A1

Hydralazine-Induced ANCA-Associated Vasculitis in an Elderly Patient (NKF-SCM 2025) - "Her HTN had been managed with hydralazine, nifedipine, and furosemide...The patient was treated with rituximab and IV steroids. Upon discharge, she was prescribed avacopan, and hydralazine was permanently discontinued...Serological evaluation typically reveals ANCA antibodies, hypocomplementemia, and anti-histone antibodies, although our patient did not have anti-histone antibodies. Treatment involves discontinuation of hydralazine and the initiation of immunosuppressive therapy.Conclusion Hydralazine-induced AAV is a rare clinical entity characterized by constitutional and organ-specific symptoms, multiple antigenicity, and pauci-immune glomerulonephritis."

Clinical • Acute Kidney Injury • ANCA Vasculitis • Cardiovascular • Chronic Kidney Disease • Glomerulonephritis • Hypertension • Infectious Disease • Lupus Nephritis • Nephrology • Renal Disease • Vasculitis

Hydralazine-induced Lupus Syndrome (HILS) (NKF-SCM 2025) - "Introduction This case illustrates pericarditis as a rare manifestation of HILS in a patient with resistant hypertension and worsening kidney function, highlighting the importance of comprehensive history-taking & physical exam.Methods A 53-year-old female with HTN, T2DM, G3bA3 CKD secondary to biopsy-proven advanced diabetic kidney disease and heterozygous Alport syndrome, on bumetanide, carvedilol, doxazosin, and hydralazine was admitted with rapidly declining kidney function and progressive exertional dyspnea. Losartan and empagliflozin were held outpatient...Given the absence of lupus nephritis in a recent biopsy & the unlikely involvement of kidneys in DIL, worsening kidney function was attributed to the progression of CKD.Results Hydralazine is a useful second-line antihypertensive but with serious adverse effects & is best used sparingly in the lowest effective doses and duration. Management of DIL includes discontinuing the causative agent and a brief..."

Cardiovascular • Chronic Kidney Disease • Diabetic Nephropathy • Genetic Disorders • Glomerulonephritis • Hypertension • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Pulmonary Disease • Renal Disease • Type 2 Diabetes Mellitus

Hydralazine-Induced ANCA Vasculitis: A Case of Hypertensive Urgency, Alveolar Hemorrhage, and Renal Involvement (IARS-SOCCA 2025) - "Hydralazine was discontinued, and high dose steroids(1 mg/kg/day) and cyclophosphamide(2 mg/kg/day) were started. Hydralazine induced ANCA-associated vasculitis (HAV) is a severe inflammatory condition affecting small blood vessels. This condition is associated with significant morbidity and mortality if not adequately treated with immunosuppressants. The exact mechanism underlying hydralazine-induced ANCA vasculitis is unclear, but it is believed to involve myeloperoxidase-induced neutrophil apoptosis leading to the release of autoantigens and subsequent inflammation of small blood vessels."

Clinical • ANCA Vasculitis • Anemia • Cardiovascular • Glomerulonephritis • Hematological Disorders • Hypertension • Immunology • Inflammation • Ischemic stroke • Lupus Nephritis • Nephrology • Renal Disease • Respiratory Diseases • Vasculitis

Testing Pulmonary Vascular and Gas-Exchange Vasoreactivity in PH-HFpEF with Nitrate-Hydralazine and a Two-Step Invasive CPET: Protocol and Pilot Results[WITHDRAWN] (ISHLT 2025) - "After the first iCPET, participants were rested for 15 minutes, 'baseline' hemodynamics repeated and then vasodilator challenge was given: 20 mg oral hydralazine, followed by 0.4 mg sublingual nitroglycerine. Four participants were vasoreactive (3 IpcPH, 1 CpcPH) and two were non-vasoreactive (1 IpcPH, 1 CpcPH). Among vasoreactive (vs. non-vasoreactive) participants, rest pulmonary vascular resistance decreased (Δ-0.1 to -0.4, vs. +0.3 to 5.6), and rest pulmonary arterial compliance trended towards an increase (Δ-0.7 to +2.7, vs. -0.1 to -1.7).Conclusion Combining pulmonary vascular hemodynamics and gas exchange response to vasodilator challenge reveals variable vasoreactivity in PH-HFpEF, which is not defined by resting hemodynamic-based PH phenotypes (Ipc vs Cpc-PH)."

Clinical • Cardiovascular • Congestive Heart Failure • Heart Failure • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

A Rare Case of Overlapping Complications of Hydralazine: Bullous Sweet Syndrome and Airway Angioedema From Drug-induced Lupus (ATS 2025) - No abstract available

Clinical • Cardiovascular • Dermatology • Immunology • Inflammatory Arthritis • Lupus

Hydralazine Strikes Again- Anti-Neutrophil Cytoplasmic Antibody Positive Vasculitis With Hemorrhagic Bullae (ATS 2025) - No abstract available

Hematological Disorders • Vasculitis

Hydralazine-induced ANCA Vasculitis: A Case of Hypertensive Urgency, Alveolar Hemorrhage, and Renal Involvement (ATS 2025) - No abstract available

Clinical • ANCA Vasculitis • Hematological Disorders • Vasculitis

Diffuse Alveolar Hemorrhage in Hydralazine Induced Vasculitis With Rapidly Progressive Glomerulonephritis: A Case of Pulmonary Renal Syndrome (ATS 2025) - No abstract available

Clinical • Glomerulonephritis • Hematological Disorders • Lupus Nephritis • Nephrology • Renal Disease • Vasculitis

Hydralazine Induced Vasculitis Presenting as Diffuse Alveolar Hemorrhage (ATS 2025) - No abstract available

Hematological Disorders • Vasculitis

Drug Induced Lupus Secondary to Hydralazine Presenting as Diffuse Alveolar Hemorrhage and Glomerulonephritis (ATS 2025) - No abstract available

Glomerulonephritis • Hematological Disorders • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology

Bleeding Lungs: A Case Report of Hydralazine Induced Systemic Lupus Erythematosus Presenting With Diffuse Alveolar Hemorrhage (ATS 2025) - No abstract available

Case report • Clinical • Hematological Disorders • Immunology • Inflammatory Arthritis • Lupus • Systemic Lupus Erythematosus