Furosemide with Hydralazine Interaction Details

Brand Names Associated with Furosemide

Brand Names Associated with Hydralazine

Medical Content Editor Dr. Brian Staiger, PharmD
Last updated Nov 10, 2023

Interaction Effect

An enhanced diuretic response to furosemide

Interaction Summary

Concomitant hydrALAZINE and furosemide therapy has been reported to result in decreases in the furosemide half-life associated with increases in the plasma clearance. Furosemide plasma concentrations decreased despite unchanged endogenous creatinine clearance, indicating that the increased furosemide clearance was due to an increase in renal blood flow caused by hydrALAZINE.

Severity

Minor

Onset

Rapid

Evidence

Probable

How To Manage Interaction

Monitor patients receiving hydrALAZINE and furosemide for appropriate diuretic response. Monitor serum electrolytes and creatinine clearance and make dose adjustments if needed.

Mechanism Of Interaction

Increased furosemide renal clearance

Literature Reports

A) Twenty-five hospitalized patients with congestive heart failure (CHF) were divided into two groups, depending on the severity of their disease. Group 1 consisted of ten patients with moderate CHF whose physical activity was not restricted. Group 2 was made up of 15 patients with advanced CHF whose physical activity was greatly restricted. All patients were receiving conventional treatment for CHF, had been hospitalized for at least a week, and had been taking furosemide daily for at least four weeks. Both groups 1 and 2 received furosemide 40 mg as an intravenous bolus to determine the furosemide pharmacokinetics in patients with CHF. Eight patients from group 2 then received hydrALAZINE 0.2 mg/kg intravenously 30 minutes prior to a furosemide bolus. The elimination half-life was prolonged and the elimination rate constant and plasma clearance were smaller in group 2 (advanced CHF) than in group 1 (moderate CHF). In the group 2 patients who received both furosemide and hydrALAZINE, the furosemide half-life decreased from 96 minutes to 81 minutes, plasma clearance increased from 72.6 mL/min to 88.1 mL/min, and renal clearance rose from 45.4 mL/min to 60.9 mL/min. Creatinine clearance was not altered. These results indicated that hydrALAZINE increased renal blood flow, causing an increase in the diuretic effect of furosemide .

Furosemide Overview

• Furosemide is used alone or in combination with other medications to treat high blood pressure. Furosemide is used to treat edema (fluid retention; excess fluid held in body tissues) caused by various medical problems, including heart, kidney, and liver disease. Furosemide is in a class of medications called diuretics ('water pills'). It works by causing the kidneys to get rid of unneeded water and salt from the body into the urine.

• High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

Hydralazine Overview

• Hydralazine is used to treat high blood pressure. Hydralazine is in a class of medications called vasodilators. It works by relaxing the blood vessels so that blood can flow more easily through the body.

• High blood pressure is a common condition and when not treated, can cause damage to the brain, heart, blood vessels, kidneys and other parts of the body. Damage to these organs may cause heart disease, a heart attack, heart failure, stroke, kidney failure, loss of vision, and other problems. In addition to taking medication, making lifestyle changes will also help to control your blood pressure. These changes include eating a diet that is low in fat and salt, maintaining a healthy weight, exercising at least 30 minutes most days, not smoking, and using alcohol in moderation.

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Definitions

Severity Categories

Contraindicated

These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.

Major

This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.

Moderate

This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.

Minor

While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.

Onset

Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.

Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.

Evidence

Level of documentation of the interaction.

Established: The interaction is documented and substantiated in peer-reviewed medical literature.

Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.

How To Manage The Interaction

Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.

It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.

Mechanism Of Interaction

The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.

Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.

Where Does Our Information Come From?

Information for our drug interactions is compiled from several drug compendia, including:

• Gold Standard Drug Database
• Micromedex
• Lexicomp
• DrugBank

The prescribing information for each drug, as published on DailyMED, is also used. 

Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.

The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.