GlobalRPh Renal Dosing Masterv6.6
GlobalRPh source record

Hydralazine

GlobalRPh source pageBase record retrieved 2026-09-05See the evidence for this drug1 sources available - open source summaries, references and comparisons

Apresoline

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Renal measure
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The source CHF maintenance range reaches 600 mg/day despite its hypertension maximum of 300 mg/day; this discrepancy and ambiguous q8h or less wording are preserved, not endorsed.

Usual Dosing (Adults)

Injection: use only when oral dosing is not possible. Urgent inpatient therapy may be IM or rapid IV bolus; the reproduced source usual dose is 20 to 40 mg, repeated as necessary, with lower doses sometimes needed, especially with marked renal damage. Check blood pressure frequently; decline may begin within minutes, with average maximum reduction in 10 to 80 minutes. With increased intracranial pressure, lowering blood pressure may worsen cerebral ischemia. Most patients can switch to oral in 24 to 48 hours. Use immediately after opening vial; do not add to infusion solutions. Contact with metal may discolor solution; discard if discolored or particulate.

Oral: start 10 mg four times daily for 2 to 4 days, then 25 mg four times daily for the remainder of week 1; second/subsequent weeks 50 mg four times daily. Maintain the lowest effective dose. Toxicity, particularly L.E. cell syndrome, is more frequent at high doses. Resistant patients may require up to 300 mg/day; lower hydralazine with thiazide, reserpine and/or beta blocker may be considered, individually titrating every drug to the lowest effective dose.

Separate source summary: hypertension start 10 mg four times daily, increase each dose by 10 to 25 mg every 2 to 5 days (maximum 300 mg/day). Acute hypertension start 10 to 20 mg IM/IV every 4 to 6 hours as needed, possibly increasing to 40 mg/dose; switch to oral promptly. CHF start 10 to 25 mg orally three to four times daily; the historical page lists maintenance 200 to 600 mg/day in two to four divided doses.

Renal Dosing

CrCl >50 mL/min: no change. CrCl 10 to 50: source wording "Give usual dose q8h or less." CrCl <10: every 8 to 16 hours in fast acetylators and every 12 to 24 hours in slow acetylators.

Hemodialysis

Every 8 to 16 hours in fast acetylators or every 12 to 24 hours in slow acetylators.

Source revision: Historical source; revision not established here | Retrieved: 2026-09-05. Retrieval date is not the revision date.

Source: https://globalrph.com/renal/hydralazine/

Scope: Preserved historical source; no fresh clinical approval GlobalRPh v6.6.

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Retrieved: 2026-09-05

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Important source distinctions

The source CHF maintenance range reaches 600 mg/day despite its hypertension maximum of 300 mg/day; this discrepancy and ambiguous q8h or less wording are preserved, not endorsed.

Locally stored source content

Original GlobalRPh protocol

Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/hydralazine/

Usual Dosing (Adults)

Injection: use only when oral dosing is not possible. Urgent inpatient therapy may be IM or rapid IV bolus; the reproduced source usual dose is 20 to 40 mg, repeated as necessary, with lower doses sometimes needed, especially with marked renal damage. Check blood pressure frequently; decline may begin within minutes, with average maximum reduction in 10 to 80 minutes. With increased intracranial pressure, lowering blood pressure may worsen cerebral ischemia. Most patients can switch to oral in 24 to 48 hours. Use immediately after opening vial; do not add to infusion solutions. Contact with metal may discolor solution; discard if discolored or particulate.

Oral: start 10 mg four times daily for 2 to 4 days, then 25 mg four times daily for the remainder of week 1; second/subsequent weeks 50 mg four times daily. Maintain the lowest effective dose. Toxicity, particularly L.E. cell syndrome, is more frequent at high doses. Resistant patients may require up to 300 mg/day; lower hydralazine with thiazide, reserpine and/or beta blocker may be considered, individually titrating every drug to the lowest effective dose.

Separate source summary: hypertension start 10 mg four times daily, increase each dose by 10 to 25 mg every 2 to 5 days (maximum 300 mg/day). Acute hypertension start 10 to 20 mg IM/IV every 4 to 6 hours as needed, possibly increasing to 40 mg/dose; switch to oral promptly. CHF start 10 to 25 mg orally three to four times daily; the historical page lists maintenance 200 to 600 mg/day in two to four divided doses.

GRPH-hydralazine-01 · Source section: Usual Dosing (Adults)Renal section finder

Renal Dosing

CrCl >50 mL/min: no change. CrCl 10 to 50: source wording "Give usual dose q8h or less." CrCl <10: every 8 to 16 hours in fast acetylators and every 12 to 24 hours in slow acetylators.

GRPH-hydralazine-02 · Source section: Renal DosingRenal section finder

Hemodialysis

Every 8 to 16 hours in fast acetylators or every 12 to 24 hours in slow acetylators.

GRPH-hydralazine-03 · Source section: HemodialysisRenal section finder

Provenance and preservation

Additional summaries stored on this page: 0 official-label, 0 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source
https://globalrph.com/renal/hydralazine/
Source retrieval
2026-09-05. This is not the source publication or label revision date.
Original source type
globalrph individual
Local text SHA-256
383e1eeb58a7b34bac0fd1d5757c705478c5be749c2d5e9b025697214307384a
Import versus clinical validation
Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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