Hydralazine Therapy in Heart Failure Patients

Adverse Effects

Hydralazine can cause gastrointestinal complaints as a common adverse effect, particularly when used in combination with isosorbide dinitrate, which may limit treatment adherence in heart failure patients 1, 2
Gastrointestinal complaints are among the most frequent adverse reactions reported with hydralazine therapy 1, 2
The combination of hydralazine and isosorbide dinitrate produced frequent adverse reactions, primarily headache and gastrointestinal complaints 1, 2
These GI side effects contributed to poor medication adherence, with many patients unable to continue treatment at target doses 2
Poor compliance has been attributed to both the large number of tablets required and the high incidence of adverse reactions 1, 2

For African American patients with heart failure, the combination of hydralazine and isosorbide dinitrate has shown particular efficacy 2
However, GI side effects remain a concern and may affect compliance with this beneficial therapy 2
The benefit is presumed to be related to enhanced nitric oxide bioavailability 2

The American Heart Association recommends considering the potential for GI side effects when prescribing hydralazine, particularly in combination with isosorbide dinitrate 1, 2
Clinicians should monitor for GI complaints, as they may limit patient adherence and therapeutic efficacy 1, 2