II. Direct Acting Vasodilators IV

  1. Hydralazine (Apresoline)
    1. Dose: 10-40 mg IV/IM q4-6h
  2. Hydralazine with Isosorbide Dinitrate 37.5/20 (BiDil)
    1. Dose: 1-2 tablets PO tid
    2. For Class III CHF patients (esp. African American)
    3. Very expensive: $400/month
    4. Generic Drugs separately are $60/month
  3. Diazoxide (Hyperstat)
    1. Dose: 1-3 mg/kg up to 150 mg IV q5-15 min
  4. Nitroprusside Sodium (Nipride)
  5. Minoxidil (Loniten)

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Cost: Medications

HYDRALAZINE (on 2/19/2015 at Target.com)
HYDRALAZINE 10 MG Tablet #90 for $10.00 $0.11 each
HYDRALAZINE 25 MG Tablet #90 for $10.00 $0.11 each
hydralazine (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
HYDRALAZINE 10 MG TABLET Generic $0.06 each
HYDRALAZINE 100 MG TABLET Generic $0.15 each
HYDRALAZINE 25 MG TABLET Generic $0.07 each
HYDRALAZINE 50 MG TABLET Generic $0.08 each
bidil (on 11/18/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
BIDIL TABLET $2.87 each

Ontology: Diazoxide (C0012022)

Definition (NCI) A benzothiadiazine derivate with antihypertensive and hyperglycemic activities. Diazoxide increases membrane permeability to potassium ions in vascular smooth muscle, thereby stabilizing the membrane action potential and preventing vascular smooth muscle contraction; this results in peripheral vasodilatation and decreases in peripheral vascular resistance. This agent also inhibits insulin release by interacting with ATP-sensitive potassium channels of pancreatic islet beta-cells.
Definition (CSP) peripheral vasodilator that reduces blood pressure; diazoxide also has antidiuretic and hypoglycemic effects.
Definition (MSH) A benzothiadiazine derivative that is a peripheral vasodilator used for hypertensive emergencies. It lacks diuretic effect, apparently because it lacks a sulfonamide group.
Definition (PDQ) A benzothiadiazine derivate with antihypertensive and hyperglycemic activities. Diazoxide increases membrane permeability to potassium ions in vascular smooth muscle, thereby stabilizing the membrane action potential and preventing vascular smooth muscle contraction; this results in peripheral vasodilatation and decreases in peripheral vascular resistance. This agent also inhibits insulin release by interacting with ATP-sensitive potassium channels of pancreatic islet beta-cells. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39290&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39290&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C428" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D003981
SnomedCT 318642007, 325291008, 387328001, 58905004
LNC LP14713-9, MTHU001807
English Diazoxide, 2H-1,2,4-Benzothiadiazine, 7-chloro-3-methyl-, 1,1-dioxide, 3-Methyl-7-chloro-1,2,4-benzothiadiazine 1,1-Dioxide, diazoxide, Diazoxide [cardiovascular use], Diazoxide [endocrine use], diazoxide (medication), Diazoxide [Chemical/Ingredient], diazoxides, Diazoxide [cardiovascular use] (product), Diazoxide [endocrine use] (product), Diazoxide (product), Diazoxide (substance), Diazoxide [cardiovascular use] (substance), Diazoxide [endocrine use] (substance), DIAZOXIDE
Swedish Diazoxid
Czech diazoxid
Finnish Diatsoksidi
Russian DIAZOKSID, ДИАЗОКСИД
Japanese ダイアゾキサイド, ジアゾキシド
Croatian DIAZOKSID
Polish Diazoksyd
Spanish diazóxido (uso cardiovascular), diazóxido [uso endocrino], diazóxido (uso cardiovascular) (producto), diazóxido [uso endocrino] (producto), diazóxido (producto), diazóxido (sustancia), diazóxido, Diazóxido
French Diazoxide
German Diazoxid
Italian Diazossido
Portuguese Diazóxido

Ontology: Hydralazine (C0020223)

Definition (NCI) A phthalazine derivative with antihypertensive effects. Hydralazine exerts its vasodilatory effects through modification of the contractile state of arterial vascular smooth muscle by altering intracellular calcium release, and interfering with smooth muscle cell calcium influx. This agent also causes inhibition of phosphorylation of myosin protein or chelation of trace metals required for smooth muscle contraction, thereby resulting in an increase in heart rate, stroke volume and cardiac output.
Definition (MSH) A direct-acting vasodilator that is used as an antihypertensive agent.
Definition (CSP) direct-acting vasodilator that is used as an antihypertensive.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D006830
SnomedCT 22696000, 387125005
LNC LP15169-3, MTHU002558
English Apressin, Hydralazine, Hydrallazin, Hydrazinophthalazine, 1(2H)-Phthalazinone, hydrazone, apressin, 1(2H)-Phthalazinone Hydrazone, Hydralazine [Chemical/Ingredient], HYDRALAZINE, hydrALAZINE, hydralazine (medication), hydralazine, Apressinum, Hydralazine (product), Hydralazine (substance)
Swedish Hydralazin
Czech hydralazin
Finnish Hydralatsiini
Russian APRESSIN, GIDRALAZIN, АПРЕССИН, ГИДРАЛАЗИН
Italian Apressina, Idrallazina, Idrazinoftalazina, Idralazina
Spanish Hidralazina, Hidralacina, hidralazina (producto), hidralazina (sustancia), hidralazina
Polish Hydralazyna
Japanese ヒドララジン, 塩酸ヒドララジン
French Hydralazine
German Hydralazin, Hydrallazin
Portuguese Hidralazina

Ontology: Apresoline (C0699178)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D006830
English Apresoline, apresoline, Apressoline

Ontology: Hyperstat (C0699324)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D003981
English Hyperstat

Ontology: Bidil (C0968130)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C431665
English Bidil, BiDil