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Hidralazina Clorhidrato Pregnancy |
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Hidralazina Clorhidrato crosses the placenta (Lamont 1986; Liedholm 1982).
Due to pregnancy-induced physiologic changes and maternal acetylator status (NAT2 genotype), some pharmacokinetic properties of oral Hidralazina Clorhidrato may be altered. Larger studies are needed to evaluate if or how these changes influence safety or efficacy during pregnancy (Han 2019).
Chronic maternal hypertension may increase the risk of birth defects, low birth weight, preterm delivery, stillbirth, and neonatal death. Actual fetal/neonatal risks may be related to duration and severity of maternal hypertension. Untreated hypertension may also increase the risks of adverse maternal outcomes, including gestational diabetes, myocardial infarction, preeclampsia, stroke, and delivery complications (ACOG 203 2019).
Agents other than oral Hidralazina Clorhidrato are more commonly used to treat chronic hypertension in pregnancy (ACOG 203 2019; ESC [Regitz-Zagrosek 2018]). Females with preexisting hypertension may continue their medication during pregnancy unless contraindications exist (ESC [Regitz-Zagrosek 2018]).
Intravenous Hidralazina Clorhidrato is recommended for use in the management of acute onset, severe hypertension (systolic BP ≥160 mm Hg or diastolic BP ≥110 mm Hg) with preeclampsia or eclampsia in pregnant and postpartum women (ACOG 767 2019).
During the first week postpartum, 10 lactating women had blood and breast milk samples analyzed 24 hours after receiving a dose between 10 and 40 mg. The average concentration of this drug plus its pharmacologically active acid-labile metabolites in breast milk was 240 nmol/L (about half of the simultaneous concentration in maternal plasma). It was further estimated that the daily dose to a breastfed infant was unlikely to exceed 25 mcg. Serum drug concentrations were measured in 2 infants 2 hours after feeding in this study and were determined to be 557 and 293 nmol/L.
Use is considered acceptable; according to some experts, use only if the benefit outweighs the potential risk. Excreted into human milk: Yes Comments: This drug has been used without apparent harmful effects in the nursing infant.
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Information checked by Dr. Sachin Kumar, MD Pharmacology
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