Request Demo

Last update 23 Jan 2025

Hydralazine Hydrochloride

Last update 23 Jan 2025

Overview

R&D Status

Clinical Result

Translational Medicine

Overview

Basic Info

SummaryHydralazine Hydrochloride, marketed under the trade name Dralzine®, is an antihypertensive medication that has been approved since 1952 for the treatment of hypertension. Developed by Novartis, Hydralazine Hydrochloride works as AOC3 inhibitors, aiding in the management of essential hypertension, severe hypertension, heart failure, pre-eclampsia, and eclampsia. Its mechanism of action has made it a reliable option for individuals requiring immediate action for hypertension. As a trusted medication in the field of hypertension treatment, Hydralazine Hydrochloride has helped countless individuals manage their blood pressure and maintain healthy lifestyles.

Drug Type

Small molecule drug

Synonyms

(1Z)-1(2H)-Phthalazinone hydrazone, (2H)-Phthalazinone hydrazone, 1-Hydrazinophthalazine

+ [17]

Target-

Mechanism-

Therapeutic Areas

Nervous System DiseasesCardiovascular DiseasesUrogenital Diseases

Active Indication

Heart FailureEclampsiaHypertensive Encephalopathy+ [1]

Inactive Indication

Originator Organization

Novartis Pharma AG

Active Organization

Shanghai ZhongXi Pharmaceutical Co. Ltd.Sun Pharma Japan Ltd.Novartis Pharma AG

Inactive Organization

Novartis Pharmaceuticals Corp.

MacuCLEAR, Inc.

Drug Highest PhaseApproved

First Approval Date

(01 Jan 1952),

Hypertension

RegulationOrphan Drug (US)

Structure/Sequence

Molecular FormulaC8H9ClN4

InChIKeyZUXNZUWOTSUBMN-UHFFFAOYSA-N

CAS Registry304-20-1

Clinical Trials associated with Hydralazine Hydrochloride

NCT06360601

/ RecruitingPhase 1/2IIT

The Effect of Intravenous Infusion of Labetalol Versus Hydralazine on Cerebral Hemodynamics of Preeclampsia Patients Prospective Randamized Study

We study the effect of intravenous labetalol versus hydralazine in sever preeclampsia patients on cerebral blood flow and neurological outcome

Start Date01 Apr 2024

Sponsor / Collaborator

Tanta University

NCT04842552

/ Unknown statusPhase 3IIT

The Effect of Hydralazine on the Early Stage of Alzheimer's Disease: A Randomized Clinical Trial

It has been recently discovered that the FDA-approved drug, hydralazine, has anti-neurodegenerative efficacy based on three intriguing observations. hydralazine; 1) activates the Nrf2 pathway that controls more than 200 antioxidant proteins, 2) rejuvenates mitochondria and increases their respiration capacity and adenosine triphosphate production, 3) activates autophagy which has pathophysiological roles such as intracellular aggregate clearance. There is an emerging agreement that autophagy-lysosome defects occur early in the pathogenesis of Alzheimer's disease (AD). Nrf2 is another pathway known to be impaired in the hippocampus of AD patients who need antioxidant protection the most. Rejuvenation of mitochondria is crucial for fighting AD, as neuronal cells need more energy to afford activation of pathways such as autophagy and Nrf2. The prime objective of this application is to conduct a randomized clinical trial to assess the efficacy of hydralazine in early-stage AD patients who take one of the acetylcholinesterase inhibitor (AChEI) donepezil, rivastigmine, or galantamine.

Start Date02 Aug 2021

Sponsor / Collaborator

Shahid Sadoughi University of Medical Sciences and Health Services

[+1]

NCT06218199

/ RecruitingPhase 4

Diuretics vs. Afterload Reduction for Treatment of HeartLogic Alerts (DART-HA)

The DART-HA study is a single-center, open label, trial intended to evaluate the clinical efficacy of standard treatment options for congestive heart failure (observation, diuretic or afterload reduction therapy) in patients without new symptoms who have developed abnormalities of the HeartLogic heart failure diagnostic feature.

Start Date08 Jul 2021

Sponsor / Collaborator

Boston Scientific Corp.

100 Clinical Results associated with Hydralazine Hydrochloride

100 Translational Medicine associated with Hydralazine Hydrochloride

100 Patents (Medical) associated with Hydralazine Hydrochloride

4,889

Literatures (Medical) associated with Hydralazine Hydrochloride

20 Jan 2025·CHEMICAL RESEARCH IN TOXICOLOGY

Repurposing the Antihypertensive Agent Hydralazine As an Inhibitor of the Base Excision Repair Enzyme APE1

Article

Author: Gates, Kent S. ; Islam, Tanhaul ; Liyanarachchi, Don Pivithuru ; Melton, Douglas ; Nunna, Venkatrao ; Lewis, Calvin D.

Apurinic/apyrimidinic endonuclease 1 (APE1) is a central enzyme in the base excision repair (BER) pathway. APE1 catalyzes incision of the phosphodiester linkage on the 5'-side of apurinic/apyrimidinic (AP) sites during the repair of damaged nucleobases in cellular DNA. Inhibition of this enzyme can potentiate the action of DNA-damaging chemotherapeutic agents. The antihypertensive drug hydralazine generates covalent AP adducts that block the catalytic action of APE1. Hydralazine was found to be superior to the investigational drug methoxyamine in its capacity to covalently capture AP sites in duplex DNA and inhibit the action of APE1. It was further shown that hydralazine sensitized SF295 glioblastoma cells to the cytotoxic action of the anticancer drug Temozolomide, which generates alkylpurine residues requiring APE1 for repair. The results suggest that the FDA-approved drug hydralazine might be repurposed in oncology to potentiate the activity of existing chemotherapeutic agents that induce AP sites in cellular DNA.

15 Jan 2025·The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal ObstetriciansQ4 · MEDICINE

First-trimester miscarriage rate decreases with hydralazine therapy in pregnancies with early uterine vascular insufficiency: a cohort study

Q4 · MEDICINE

Article

Author: Biron, Miguel ; Faundez, Rosana ; Leible, Sergio ; Sepulveda, Waldo ; Mitelman, Gabriel ; Canals, Andrea ; Walton, Roderick ; Castiglione, Angelo

BACKGROUND:

Miscarriage is the most frequent cause of pregnancy loss, affecting 15-20% of clinically recognized pregnancies. Early uterine vascular insufficiency (EUVI), defined as abnormal uterine artery (UA) Doppler impedance indices in early pregnancy, is present in two-thirds of pregnancies ending in miscarriage after embryonic cardiac activity has been detected. There is currently no available therapy for reducing the risk of miscarriage in these cases.

OBJECTIVE:

To determine whether vasodilator therapy with hydralazine can reduce abnormally high UA impedance indices and miscarriage rates in pregnancies with EUVI when administered from before 9 weeks' gestation until completing 13 weeks' gestation.

METHODS:

A total of 253 consecutive singleton pregnancies with a live embryo and scanned before 9 weeks' gestation were included in the study. Ninety-two pregnancies (36.3%) were classified as having EUVI. Hydralazine was administered in daily doses of 50 mg, starting 24-36 h after the initial diagnosis of EUVI and continuing throughout the first trimester. The miscarriage rate in the hydralazine-treated EUVI group was compared with the one observed in our previously reported untreated cohort and the pregnancies with EUVI that declined treatment with hydralazine.

RESULTS:

The miscarriage rate among the hydralazine-treated EUVI group was significantly lower than the previously reported untreated cohort (7.8% versus 26.2%, p = .003; odds ratio (OR) = 4.3, 95% confidence interval (CI) = 1.6-11.9). In 15 untreated pregnancies with EUVI, the miscarriage rate was similar to that of the previously reported untreated cohort (26.7% versus 26.2%; p = .603) and higher than the hydralazine-treated group (26.7% versus 7.8%, p = .05; OR = 4.4, 95% CI = 1.1-18.2).

CONCLUSIONS:

Hydralazine therapy in pregnancies with EUVI was associated with a significant decrease in the rate of miscarriage. We suggest a sequence of events leading to a higher risk of miscarriage in pregnancies with EUVI and propose a potential mechanism through which hydralazine may reduce this risk.

15 Jan 2025·Journal of Maternal-Fetal & Neonatal Medicine

Race/ethnicity differences in response to acute antihypertensive treatment of peripartum severe hypertension

Article

Author: Pon, Fay F. ; Greene, Naomi H. ; Kilpatrick, Sarah J.

BACKGROUND:

Hypertensive disorders of pregnancy increase maternal morbidity, mortality, and long-term risk for cardiovascular disease. The rising incidence of chronic hypertension and preeclampsia disproportionately affects people of color. There is a paucity of published data examining differences in the effectiveness of acute antihypertensive agents between pregnant patients of different races/ethnicities. We aimed to determine if the effectiveness of acute antihypertensive agents for peripartum severe hypertension differs by race/ethnicity.

METHODS:

A retrospective cohort study of patients with severe peripartum hypertension (systolic blood pressure ≥ 160 mmHg and/or diastolic blood pressure ≥ 110 mm Hg confirmed within 15 min) to determine whether the effectiveness of blood pressure control using nationally recommended medications (hydralazine, labetalol, nifedipine) differed by race/ethnicity. The primary outcome was reduction and maintenance of blood pressure to target ranges (140-150/90-100 mm Hg or below) for ≥4 h in each race/ethnicity group. Statistical tests included χ², Fisher's exact, analysis of variance, and multivariable logistic regression.

RESULTS:

Of 729 patients receiving treatment for severe peripartum hypertension, all medications were effective (overall 86.4% efficacy) at controlling blood pressure. Labetalol was the most effective medication in White patients (93.0 vs. 74.7% for nifedipine and 86.5% for hydralazine, p < .001). No overall differences in medication effectiveness were found in Black, Asian, or LatinX patients. Black and Asian patients were more likely to experience >1 hypertensive episode [51.0 and 49.0%, respectively vs. 35.4% (White) and 40.0% (LatinX), p = .008].

CONCLUSION:

Currently recommended therapies for severe peripartum hypertension are effective in controlling blood pressure for ≥4 h in patients of all race/ethnic groups. Labetalol was the most effective medication in White patients with no overall differences in medication effectiveness in Black, Asian, or LatinX patients.

News (Medical) associated with Hydralazine Hydrochloride

13 Sep 2024

·www.biospace.com

Rising Pharmaceuticals announces commercial availability of Edetate calcium disodium injection in the United States

Rising’s Edetate calcium disodium injection is FDA-approved and immediately available Edetate calcium disodium injection is indicated for the reduction of blood levels and depot stores of lead in lead poisoning (acute and chronic) and lead encephalopathy, in both pediatric populations and adults. 1 EAST BRUNSWICK, N.J.--(BUSINESS WIRE)-- #adultleadpoisoning --Rising Pharma Holdings, Inc., d/b/a Rising Pharmaceuticals, Inc. (“Rising”) announced commercial availability of Edetate calcium disodium injection. Access to Rising’s product continues despite a commercial shortage of this product in the United States. Rising’s Edetate calcium disodium injection is indicated for the reduction of blood levels and depot stores of lead in lead poisoning (acute and chronic) and lead encephalopathy, in both pediatric populations and adults. “Rising’s Edetate calcium disodium injection provides an available option for health care providers to treat patients exposed to lead poisoning,” said David Picard, Executive Vice President for Institutional Markets at Rising. “This continued availability reflects our ongoing commitment to addressing product supply shortages to help ensure health care providers have access to products for patient care.” Edetate Calcium Disodium injection, USP 5 mL single-dose vial containing 200 mg of edetate calcium disodium per mL (1000 mg per vial) Supplied in boxes containing 5 vials (NDC 64980-588-51) Wholesale Item Numbers Cardinal 5855416 Cencora 10291753 Mckesson 2830826 Morris Dickson 296285 ___________________________ 1 Full prescribing information and label available at and provided below. About Rising Pharmaceuticals, Inc. Rising Pharmaceuticals, Inc. is a leading provider of generic and specialty-branded pharmaceuticals in the U.S. Rising focuses on the development, regulatory, and commercial aspects of the product life cycle while outsourcing manufacturing to its network of strategic CMO and CDO partners. With over 182 commercialized generic medicines and over 620 active SKUs, Rising has one of the largest portfolios of any generic pharmaceutical company in the US market. Through an extensive global network of manufacturing facilities, Rising supplies almost 9 billion doses of generic medicine to the market annually. The Company is based in New Brunswick, New Jersey. For more information about the Company, please visit . Edetate Calcium Disodium Injection, USP Intravenous or Intramuscular Use Rx Only WARNINGS Edetate calcium disodium injection is capable of producing toxic effects which can be fatal. Lead encephalopathy is relatively rare in adults, but occurs more often in pediatric patients in whom it may be incipient and thus overlooked. The mortality rate in pediatric patients has been high. Patients with lead encephalopathy and cerebral edema may experience a lethal increase in intracranial pressure following intravenous infusion; the intramuscular route is preferred for these patients. In cases where the intravenous route is necessary, avoid rapid infusion. The dosage schedule should be followed and at no time should the recommended daily dose be exceeded. DESCRIPTION Edetate Calcium Disodium injection, USP is a sterile, injectable, chelating agent in concentrated solution for intravenous infusion or intramuscular injection. Each 5 mL single-dose vial contains 1000 mg of edetate calcium disodium (equivalent to 200 mg/mL) in water for injection and sodium hydroxide (as pH adjuster). Chemically, this product is called [[N,N'-1,2-ethanediyl-bis[N-(carboxymethyl)-glycinato]](4-)-N,N’,O,O’,ON,ON’]-, disodium, hydrate, (OC-6-21)-Calciate(2-). CLINICAL PHARMACOLOGY The pharmacologic effects of edetate calcium disodium are due to the formation of chelates with divalent and trivalent metals. A stable chelate will form with any metal that has the ability to displace calcium from the molecule, a feature shared by lead, zinc, cadmium, manganese, iron and mercury. The amounts of manganese and iron mobilized are not significant. Copper1 is not mobilized and mercury is unavailable for chelation because it is too tightly bound to body ligands or it is stored in inaccessible body compartments. The excretion of calcium by the body is not increased following intravenous administration of edetate calcium disodium, but the excretion of zinc is considerably increased.1 Edetate calcium disodium is poorly absorbed from the gastrointestinal tract. In blood, all the drug is found in the plasma. Edetate calcium disodium does not appear to penetrate cells; it is distributed primarily in the extracellular fluid with only about 5% of the plasma concentration found in spinal fluid. The half life of edetate calcium disodium is 20 to 60 minutes. It is excreted primarily by the kidney, with about 50% excreted in one hour and over 95% within 24 hours.2 Almost none of the compound is metabolized. The primary source of lead chelated by edetate calcium disodium is from bone; subsequently, soft-tissue lead is redistributed to bone when chelation is stopped.3,4 There is also some reduction in kidney lead levels following chelation therapy. It has been shown in animals that following a single dose of edetate calcium disodium urinary lead output increases, blood lead concentration decreases, but brain lead is significantly increased due to internal redistribution of lead.5 (See WARNINGS .) These data are in agreement with the recent results of others in experimental animals showing that after a five day course of treatment there is no net reduction in brain lead.6 INDICATIONS AND USAGE Edetate calcium disodium injection is indicated for the reduction of blood levels and depot stores of lead in lead poisoning (acute and chronic) and lead encephalopathy, in both pediatric populations and adults. Chelation therapy should not replace effective measures to eliminate or reduce further exposure to lead. CONTRAINDICATIONS Edetate calcium disodium injection should not be given during periods of anuria, nor to patients with active renal disease or hepatitis. WARNINGS See boxed warning . PRECAUTIONS General Precautions Edetate calcium disodium may produce the same renal damage as lead poisoning, such as proteinuria and microscopic hematuria. Treatment-induced nephrotoxicity is dose-dependent and may be reduced by assuring adequate diuresis before therapy begins. Urine flow must be monitored throughout therapy which must be stopped if anuria or severe oliguria develop. The proximal tubule hydropic degeneration usually recovers upon cessation of therapy. Edetate calcium disodium must be used in reduced doses in patients with pre-existing mild renal disease. Patients should be monitored for cardiac rhythm irregularities and other ECG changes during intravenous therapy. Information for patients Patients should be instructed to immediately inform their physician if urine output stops for a period of 12 hours. Laboratory tests Urinalysis and urine sediment, renal and hepatic function and serum electrolyte levels should be checked before each course of therapy and then be monitored daily during therapy in severe cases, and in less serious cases after the second and fifth day of therapy. Therapy must be discontinued at the first sign of renal toxicity. The presence of large renal epithelial cells or increasing number of red blood cells in urinary sediment or greater proteinuria call for immediate stopping of edetate calcium disodium administration. Alkaline phosphatase values are frequently depressed (possibly due to decreased serum zinc levels), but return to normal within 48 hours after cessation of therapy. Elevated erythrocyte protoporphyrin levels (> 35 mcg/dl of whole blood) indicate the need to perform a venous blood lead determination. If the whole blood lead concentration is between 25 to 55 mcg/dl a mobilization test can be considered.7,8 (See Diagnostic Test .) An elevation of urinary coproporphyrin (adults: > 250 mcg/day; pediatric patients under 80 lbs: > 75 mcg/day) and elevation of urinary delta aminolevulinic acid (ALA) (adults: > 4 mg/day; pediatric patients: > 3 mg/m2/day) are associated with blood lead levels > 40 mcg/dl. Urinary coproporphyrin may be falsely negative in terminal patients and in severely iron-depleted pediatric patients who are not regenerating heme.9 In growing pediatric patients long bone x-rays showing lead lines and abdominal x-rays showing radio-opaque material in the abdomen may be of help in estimating the level of exposure to lead. Drug Interactions There is no known drug interference with standard clinical laboratory tests. Steroids enhance the renal toxicity of edetate calcium disodium in animals.7 Edetate calcium disodium interferes with the action of zinc insulin preparations by chelating the zinc.7 Carcinogenesis, Mutagenesis, Impairment of Fertility Long term animal studies have not been conducted with edetate calcium disodium to evaluate its carcinogenic potential, mutagenic potential or its effect on fertility. Pregnancy Category B One reproduction study was performed in rats at doses up to 13 times the human dose and revealed no evidence of impaired fertility or harm to the fetus due to edetate calcium disodium.10 Another reproduction study performed in rats at doses up to about 25 to 40 times the human dose revealed evidence of fetal malformations due to edetate calcium disodium, which were prevented by simultaneous supplementation of dietary zinc.11 There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Labor and Delivery Edetate calcium disodium has no recognized use during labor and delivery, and its effects during these processes are unknown. Nursing Mothers It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when edetate calcium disodium is administered to a nursing woman. Pediatric Use Since lead poisoning occurs in pediatric populations and adults but is frequently more severe in pediatric patients, edetate calcium disodium is used in patients of all ages. The intramuscular route is preferred by some for young pediatric patients. In cases where the intravenous route is necessary, avoid rapid infusion. (See WARNINGS .) Urine flow must be monitored throughout therapy; Edetate Calcium Disodium therapy must be stopped if anuria or severe oliguria develops. (See General Precautions .) At no time should the recommended daily dosage be exceeded. (See DOSAGE AND ADMINISTRATION .) ADVERSE REACTIONS The following adverse effects have been associated with the use of edetate calcium disodium: Body as a Whole: pain at intramuscular injection site, fever, chills, malaise, fatigue, myalgia, arthralgia. Cardiovascular: hypotension, cardiac rhythm irregularities. Renal: acute necrosis of proximal tubules (which may result in fatal nephrosis), infrequent changes in distal tubules and glomeruli. Urinary: glycosuria, proteinuria, microscopic hematuria and large epithelial cells in urinary sediment. Nervous System: tremors, headache, numbness, tingling. Gastrointestinal: cheilosis, nausea, vomiting, anorexia, excessive thirst. Hepatic: mild increases in SGOT and SGPT are common, and return to normal within 48 hours after cessation of therapy. Immunogenic: histamine-like reactions (sneezing, nasal congestion, lacrimation), rash. Hematopoietic: transient bone marrow depression, anemia. Metabolic: zinc deficiency, hypercalcemia. To report SUSPECTED ADVERSE REACTIONS, contact Rising Pharma Holdings, Inc. at 1-844-874-7464 or FDA at 1-800-FDA-1088 or . OVERDOSAGE Symptoms Inadvertent administration of 5 times the recommended dose, infused intravenously over a 24 hour period, to an asymptomatic 16 month old patient with a blood lead content of 56 mcg/dl did not cause any ill effects. Edetate calcium disodium can aggravate the symptoms of severe lead poisoning, therefore, most toxic effects (cerebral edema, renal tubular necrosis) appear to be associated with lead poisoning. Because of cerebral edema, a therapeutic dose may be lethal to an adult or a pediatric patient with lead encephalopathy. Higher dosage of edetate calcium disodium may produce a more severe zinc deficiency. Treatment Cerebral edema should be treated with repeated doses of mannitol. Steroids enhance the renal toxicity of edetate calcium disodium in animals and, therefore, are no longer recommended.7 Zinc levels must be monitored. Good urinary output must be maintained because diuresis will enhance drug elimination. It is not known if edetate calcium disodium is dialyzable. DOSAGE AND ADMINISTRATION When a source for the lead intoxication has been identified, the patient should be removed from the source, if possible. The recommended dose of edetate calcium disodium for asymptomatic adults and pediatric patients whose blood lead level is 20 mcg/dl (World Health Organization recommended upper allowable level) is 1000 mg/m2/day whether given intravenously or intramuscularly. (See Surface Area Nomogram.) For adults with lead nephropathy, the following dosing regimen has been suggested: 500 mg/m2 every 24 hours for 5 days for patients with serum creatinine levels of 2 to 3 mg/dl, every 48 hours for 3 doses for patients with creatinine levels of 3 to 4 mg/dl, and once weekly for patients with creatinine levels above 4 mg/dl. These regimens may be repeated at one month intervals.12 Edetate calcium disodium, used alone, may aggravate symptoms in patients with very high blood lead levels. When the blood lead level is > 70 mcg/dl or clinical symptoms consistent with lead poisoning are present, it is recommended that edetate calcium disodium be used in conjunction with BAL (dimercaprol). Please consult published protocols and specialized references for dosage recommendations of combination therapy.14-18 Therapy of lead poisoning in adults and pediatric patients with edetate calcium disodium is continued over a period of five days. Therapy is then interrupted for 2 to 4 days to allow redistribution of the lead and to prevent severe depletion of zinc and other essential metals. Two courses of treatment are usually employed; however, it depends on severity of the lead toxicity and the patient’s tolerance of the drug. Edetate calcium disodium is equally effective whether administered intravenously or intramuscularly. The intramuscular route is used for all patients with overt lead encephalopathy and this route is preferred by some for young pediatric patients. Acutely ill individuals may be dehydrated from vomiting. Since edetate calcium disodium is excreted almost exclusively in the urine, it is very important to establish urine flow with intravenous fluid administration before the first dose of the chelating agent is given; however, excessive fluid must be avoided in patients with encephalopathy. Once urine flow is established, further intravenous fluid is restricted to basal water and electrolyte requirements. Administration of edetate calcium disodium should be stopped whenever there is cessation of urine flow in order to avoid unduly high tissue levels of the drug. Edetate calcium disodium must be used in reduced doses in patients with pre-existing mild renal disease. Intravenous Administration Add the total daily dose of edetate calcium disodium (1000 mg/m2/day) to 250-500 mL of 5% dextrose or 0.9% sodium chloride injection. The total daily dose should be infused over a period of 8 to 12 hours. Discard unused portion. Edetate calcium disodium injection is incompatible with 10% dextrose, 10% invert sugar in 0.9% sodium chloride, lactate Ringer’s, Ringer’s, one-sixth molar sodium lactate injections, and with injectable amphotericin B and hydralazine hydrochloride. Intramuscular Administration The total daily dosage (1000 mg/m2/day) should be divided into equal doses spaced 8 to 12 hours apart. Discard unused portion. Lidocaine or procaine should be added to the edetate calcium disodium injection to minimize pain at the injection site. The final lidocaine or procaine concentration of 5 mg/mL (0.5%) can be obtained as follows: 0.25 mL of 10% lidocaine solution per 5 mL concentrated edetate calcium disodium; 1 mL of 1% lidocaine or procaine solution per mL of concentrated edetate calcium disodium. When used alone, regardless of method of administration, edetate calcium disodium should not be given at doses larger than those recommended. Diagnostic Test Several methods have been described for lead mobilization tests using edetate calcium disodium to assess body stores.7, 9,12,13,18 These procedures have advantages and disadvantages that should be reviewed in current references. Edetate calcium disodium mobilization tests should not be performed in symptomatic patients and in patients with blood lead levels above 55 mcg/dl for whom appropriate therapy is indicated. Parenteral drugs should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. HOW SUPPLIED Edetate Calcium Disodium injection, USP 5 mL single-dose vial (NDC 64980-588-05 ) containing 200 mg of edetate calcium disodium per mL (1000 mg per vial), in boxes containing 5 vials (NDC 64980-588-51 ). Store at 25°C (77°F); excursions permitted to 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature]. Rx Only This product is non-returnable. REFERENCES 1. Thomas DJ, Chisolm JJ. Lead, zinc and copper decorporation during calcium disodium ethylene diamine tetraacetate treatment of lead-poisoned children. J Pharmacol Exp Therapeu 1986; 239: 829–835. 2. The Pharmacological Basis of Therapeutics, 7th edition, Goodman and Gilman, editors. MacMillan Publishing Company, New York, 1985, pp. 1619–1622. 3. Hammond PB, Aronson AL, Olson WC. The mechanism of mobilization of lead by ethylenediaminetetraacetate. J Pharmacol Exp Therapeu 1967; 157: 196–206. 4. Van deVyver FL, D’Haese PC, Visser WJ, et al. Bone lead in dialysis patients. Kidney Intl 1988; 33: 601–607. 5. Cory-Slecta DA, Weiss B, Cox C. Mobilization and redistribution of lead over the course of calcium disodium ethylene diamine tetraacetate chelation therapy. J Pharmacol Exp Therapeu 1987; 243: 804–813. 6. Chisolm JJ. Mobilization of lead by calcium disodium edetate. Am J Dis Child 1987;141: 1256–1257. 7. Drug Evaluations, 6th Edition, American Medical Association, Saunders, Philadelphia, 1986, pp. 1637–1639. 8. Centers for Disease Control: Preventing lead poisoning in young children. Atlanta, GA, Department of Health and Human Services, 1985 Jan. 9. Finberg L, Rajagopal V. Diagnosis and treatment of lead poisoning in children. J Family Med 1985 April: 3–12. 10. Schardein JL, Sakowski R, Petrere J, et al. Teratogenesis studies with EDTA and its salts in rats. Toxicol Appl Pharmacol 1981; 61: 423–428. 11. Swenerton H, Hurley LS. Teratogenic effects of a chelating agent and their prevention by zinc. Science 1971; 173: 62–64. 12. American Hospital Formulary Service, Drug Information, 1988, pp. 1695–1698. 13. Markowitz ME, Rosen JF. Assessment of lead stores in children: Validation of an 8-hour CaNa2EDTA (Edetate Calcium Disodium) provocative test. J Pediatrics 1984;104: 337–341. 14. Piomelli S, Rosen JF, Chisolm JJ, et al. Management of childhood lead poisoning. J Pediatrics 1984; 105: 523–532. 15. Sachs HK, Blanksma LA, Murray EF, et al. Ambulatory treatment of lead poisoning: Report of 1,155 cases. Pediatrics 1970; 46: 389. 16. Chisolm JJ. The use of chelating agents in the treatment of acute and chronic lead intoxication in childhood. J Pediatrics 1968; 73: 1. 17. Coffin R, Phillips JL, Staples WI, et al. Treatment of lead encephalopathy in children. J Pediatrics 1966; 69: 198–206. 18. Chisolm JJ. Increased lead absorption and acute lead poisoning. Current Pediatric Therapy 12, Gillis and Kagan, editors, WB Saunders, Philadelphia, 1986, pp. 667–671. Distributed by: Rising Pharma Holdings, Inc. East Brunswick, NJ 08816. Made in India Contacts For Media Inquiries: Marina Wissa, (201) 961 9013 mediainquiries@risingpharma.com For Customer Service Inquiries: Jason Eisner, (201) 961 9000 customerservice@risingpharma.com

Clinical ResultDrug Approval

29 Mar 2024

·www.prnewswire.com

Journal of Pharmaceutical Analysis (JPA) Studies Find Promising Drug Candidates

Researchers investigate the intricacies of various cellular processes and pathologies and identify compounds with untapped therapeutic potential XI'AN, China, March 29, 2024 /PRNewswire/ -- Understanding the underlying mechanisms of normal and pathological cellular processes is essential for developing new drugs. Fortunately, modern techniques and experimental methods have greatly accelerated progress. The latest issue of JPA features three articles in which candidate compounds for treating complex disorders were successfully identified, alongside their detailed mechanisms of action. Continue Reading Recent JPA studies identify, through detailed analyses of molecular mechanisms and cellular processes, three potential drug candidates for three different pathologies. The first study investigated the use of metformin (Met), a drug used to manage type II diabetes, for treating benign prostate hyperplasia (BPH). The article was published in Volume 14, Issue 1 of the journal in January 2024. The researchers first sought to shed light on how and which dysregulated sex steroid hormone-related pathways shape the pathological characteristics of BPH, and whether Met can restore these pathways. Through retrospective analysis of data from BPH patients and clinical assessment of serum and tissue samples, the researchers identified dihydrotestosterone (DHT) as a major contributor to BPH among dysregulated sex hormones. DHT promotes prostate cell proliferation by upregulating androgen receptors and forming YAP1-TEAD4 heterodimers. In vivo experiments showed that Met treatment restored sex hormone homeostasis and inhibited DHT-induced cell proliferation. "Our study provided strong evidence that Met might be a promising clinical therapeutic approach for the treatment of BPH," remark corresponding authors Prof. Qian Lu and Prof. Xiaoxing Yin. In the second study, scientists explored the role of epimedin B (EB), the main flavonoid in the Chinese herb Epimedium brevicornum Maxim., in melanogenesis. They expanded on previous findings showing EB's ability to induce melanogenesis and activate tyrosinase family of proteins (TYRs). Through comprehensive in vitro and in vivo experiments on human and animal cells, they uncovered how EB modulated TYRs, increased melanosome numbers, promoted maturation, and aided depigmentation and repigmentation. "Our data reveals that EB can stimulate the pigmentation function of TYRs, which might provide a novel rational strategy for hypopigmentation treatment in the pharmaceutical and cosmetic industries," comments corresponding authors Dr. Yiming Li and Prof. Huali Wu. Finally, in the third study, researchers investigated ferroptosis, a type of programmed cell death, and its role in nerve regeneration after peripheral nerve injury (PNI). They found that oxidative stress at the injury site not only triggered both apoptosis and ferroptosis in nearby neurons by increasing intracellular iron via the degradation of ferroportin by UBA52. Using the Drug Signatures Database, they identified hydralazine (HYD), a potent arterial vasodilator, as a potential UBA52 disruptor. Early HYD administration after PNI in vivo expedited axon regeneration and motor function recovery, partly by suppressing ferroptosis. "The potential clinical implementation of HYD may lead to a reduction in the prevalence of individuals with mild symptoms of nerve damage, consequently mitigating the societal burden," conclude corresponding authors Dr. Bing Xia, Prof. Zhuojing Luo, and Dr. Jinghui Huang. Further studies will hopefully clarify the intricate connections among cellular processes, diseases, and potential drugs, paving the way for precise and efficient therapies. Reference Titles of original papers Metformin: A promising clinSical therapeutical approach for BPH treatment via inhibiting dysregulated steroid hormones-induced prostatic epithelial cells proliferation Epimedin B exhibits pigmentation by increasing tyrosinase family proteins expression, activity, and stability Hydralazine represses Fpn ubiquitination to rescue injured neurons via competitive binding to UBA52 Journal: Journal of Pharmaceutical Analysis DOI 1. 2. 3. Media contact Mengjie Wang [email protected] +86-(0)29-88960092 SOURCE Journal of Pharmaceutical Analysis (JPA)

29 Aug 2023

·www.sciencedaily.com

A 'mini-brain' traces the link between concussion and Alzheimer's disease

Damage associated with Alzheimer's disease begins within hours after a concussion according to results from research that uses a 'mini-brain' lab on a chip device. How much time elapses between a blow to the head and the start of damage associated with Alzheimer's disease? A device that makes it possible to track the effects of concussive force on a functioning cluster of brain cells suggests the answer is in hours. The "traumatic brain injury (TBI) on a chip" being developed at Purdue University opens a window into a cause and effect that announces itself with the passage of decades but is exceedingly difficult to trace back to its origins. "We're basically creating a miniature brain that we can hit and then study," said Riyi Shi, lead researcher and the Mari Hulman George Endowed Professor of Applied Neuroscience in Purdue University's College of Veterinary Medicine. "We know there's a link between TBI and Alzheimer's; that's well established in clinical observation. But teasing out the basic essential pathway is not easy. With the TBI on a chip, we're able to test a lot of hypotheses that would be very difficult to do in living animals." In a study recently published in Lab on a Chip, a research team led by Shi subjected functioning clusters of cultured neurons from embryonic mice to three blows of 200 g-force, each approximating the higher end of what a football player receives in a single hit. The trauma leads to an immediate surge in production of acrolein -- a molecule associated with oxidative stress and neurodegenerative disease -- and a rise in misfolded clumps of the protein amyloid beta 42 (AB42), which is found in masses called plaques in the brains of people with Alzheimer's disease. Additional experiments traced the links between impact, acrolein and AB42. The device can also be used to test possible therapeutics, including drugs known to reduce acrolein levels. In the current study, Shi's team used the device to show that the drug hydralazine, a known acrolein scavenger that is approved by the U.S. Food and Drug Administration for lowering blood pressure, reduces the amount of acrolein and levels of misfolded AB42 produced in the cluster of neurons after a hit. Shi, who has a long history of studying neurodegenerative disease, acrolein and hydralazine, said the TBI on a chip enabled a finding he's sought over two decades of study. "Now that we know what's happening, is there something we can do about it? And the answer is yes," said Shi, who is also a member of the Purdue Institute for Integrative Neuroscience. "Acrolein is time-dependent; the longer it's there, the more AB42 aggregation it will cause. Here we show that if we lower acrolein with this drug, we can lower inflammation and AB42 aggregation." The device, custom-fabricated at the Purdue Center for Paralysis Research, uses a pendulum to deliver a specific g-force to a small chamber housing a cluster of a quarter million neurons supported by a bed of nutrients. A microelectronic array embedded in the chamber measures the electrical activity of the neurons, which will sustain functional firing patterns for several weeks, while a clear viewing port allows microscopic observation of the neurons. Researchers remove the cluster of neurons from the chamber at intervals to take specific biochemical measurements. "There's several unique things that we do here, but one of the biggest is that you can hit this chip without damaging it, so you can give an impact to a live model and continue to study it," Shi said. Shi began working on the device in graduate school, incorporating over the course of several decades features that make it possible to study the aftereffects of an initial blow. A 2022 paper in Nature Scientific Reports used the device to show the surge in acrolein that occurs after a hit, and Shi said the most recent findings hint at the power of the model. "Thanks to this device, people should know that when you get a concussion, you don't have 10 years before you will see damage," Shi said. "The clock starts ticking immediately, and if we want to do something about it, we need to act quickly." Within the first 24 hours after a hit, results show elevated levels of acrolein in the neuron clusters and a 350% increase in production of misfolded AB42. Shi said acrolein deforms normal AB42 by binding to sections of the protein that contribute to structural stability. Indeed, when the team conducted a simple experiment by combining large amounts of acrolein with normal purified AB42 suspended in fluid, they found elevated levels of misfolded AB42. The properly folded protein is sufficiently fragile that even subjecting normal purified AB42 in fluid (without acrolein) to an impact was enough to provoke misfolding. "This amyloid beta pathology started within hours, maybe immediately. That's never been heard of," Shi said. "It's like attacking the weight-bearing stud in a house wall. If you break that stud, of course the house is going to fall down." Shi was joined in the research by Purdue colleagues Edmond A. Rogers, first author, and co-authors Timothy Beauclair, Jhon Martinez, Shatha J. Mufti, David Kim, Siyuan Sun, Rachel L. Stingel, Nikita Krishnan and Jennifer Crodian, senior research associate at Purdue's Center for Paralysis Research, as well as Alexandra M. Dieterly of Charles River Laboratory. The study was supported by the state of Indiana, the National Institutes of Health and Plexon Inc. Moving forward, Shi said, he may be able to incorporate multiple additional features, which would allow the measurements of minute forces that cells experience during the blow, and biochemical testing -- like checking levels of acrolein -- without removing cells from the chamber.

100 Deals associated with Hydralazine Hydrochloride

External Link

KEGG	Wiki	ATC	Drug Bank
D01302	Hydralazine Hydrochloride	C02DB02	DB01275

R&D Status

Approved

10 top approved records.

to view more data

Indication	Country/Location	Organization	Date
Heart Failure	CN	Shanghai ZhongXi Pharmaceutical Co. Ltd.	01 Jan 1995
Eclampsia	JP	Sun Pharma Japan Ltd.	21 Feb 1968
Hypertensive Encephalopathy	JP	Sun Pharma Japan Ltd.	21 Feb 1968
Hypertension	-	Novartis Pharma AG	01 Jan 1952

Developing

10 top R&D records.

to view more data

Indication	Highest Phase	Country/Location	Organization	Date
dry age-related macular degeneration	Phase 3	US	MacuCLEAR, Inc.	01 Apr 2014
Age Related Macular Degeneration	Phase 3	US	MacuCLEAR, Inc.	01 Oct 2012
Dystrophy, Macular	Phase 3	US	MacuCLEAR, Inc.	01 Oct 2012
Geographic Atrophy	Phase 3	US	MacuCLEAR, Inc.	01 Oct 2012
Early onset of age-related macular degeneration	Phase 1	US	MacuCLEAR, Inc.	01 Aug 2009

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT04116112 (BEST-II, CTgov)	Phase 2	Thrombosis \| Stroke	120	Labetalol+Nicardipine+Hydralazine (Higher Systolic Blood Pressure (SBP) Target)	xlqmetxwhj(slkarbphqt) = wvxiluzspa zolmcjfamu (nmkjuwgybz, ddstkswepy - olstfamqxg) View more	-	12 Oct 2023
NCT04116112 (BEST-II, CTgov)	Phase 2	Thrombosis \| Stroke	120	Labetalol+Nicardipine+Hydralazine (Lower SBP (<160 mmHg) Target)	xlqmetxwhj(slkarbphqt) = knzwatrhwf zolmcjfamu (nmkjuwgybz, bhqaqdlkak - rfimfaqcbn) View more	-	12 Oct 2023
ATS2023	Not Applicable	-	-	Hydralazine	kjfwaiyqsz(musdjxfsse) = positive ueoxfcvqoc (esynyswzdg ) View more	-	21 May 2023
ATS2023	Not Applicable	Cardiac Tamponade \| Lupus Erythematosus	-	Hydralazine	fzriqrvwqd(rrboqfelvh) = Repeat CXR and bedside POCUS were concerning for pericardial effusion, with an echocardiogram report confirming impending tamponade hqlwghcwmm (zpleubkker ) View more	-	21 May 2023
ASN2022	Not Applicable	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ANA Homogneous pattern \| c-ANCA antibody \| p-ANCA antibody ... View more	-	Hydralazine	oukxrwddkz(ozsqcldppc) = presenting with acute renal failure fowqnyzaug (oydipqufyo )	Negative	06 Nov 2022
ASN2022	Not Applicable	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis	-	Hydralazine	ghhyxeoxto(kyiyogkumx) = bzoqxdnaxw fuipboeawe (bwnhtvnlbc, 6.8) View more	-	04 Nov 2022
ASN2022	Not Applicable	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis	-	IV Methylprednisolone	fdskrmifpz(caakpwofuv) = bnycgdasez pebzktkcdv (onzebypijw )	-	04 Nov 2022
ASN2022	Not Applicable	anti-histone antibodies \| anti-PLA2R	-	Hydralazine	gwxmoroivh(xsczztvqlq) = nxiehcasao qzcrrwriki (rioixtrfet ) View more	-	04 Nov 2022
ASN2022	Not Applicable	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis	-	Hydralazine 100mg TID	xvkouhfzxp(pastxfgvuw) = czqgmmlhaz zuzxhzyoux (mignpzfdyb )	-	03 Nov 2022
NCT01516346 (CTgov)	Phase 2	Heart Failure	44	Isosorbide Dinitrate (Isosorbide Dinitrate)	pzaxeuieod(aupdsndkou) = gxmgilnpvw azwyhdtujk (ibbhkpfytk, qhgcviiuoo - dwwwvqljsh) View more	-	21 Jun 2022
NCT01516346 (CTgov)	Phase 2	Heart Failure	44	Isosorbide Dinitrate+Hydralazine (Isosorbide Dinitrate + Hydralazine)	pzaxeuieod(aupdsndkou) = kbkjachmiy azwyhdtujk (ibbhkpfytk, schrmlpqhz - unzzskfxft) View more	-	21 Jun 2022
ATS2022	Not Applicable	-	-	Hydralazine	azdrqeuxgd(dzhvcsqswz) = Alloimmunization to certain blood group system antigens causes significant diagnostic and transfusion problems bjgwqfulai (pxvuhbkuor )	-	15 May 2022
ASN2021	Not Applicable	Lupus Nephritis \| Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ANCA positivity \| histone antibody	-	Hydralazine	iyvmwysmru(cmplwlgfcy) = persistent hemoptysis with worsening dyspnea, skin rash, and oral ulcers brmdfrhtel (ciphamzbjo ) View more	Negative	27 Oct 2021

Translational Medicine

Boost your research with our translational medicine data.

view full example data

Deal

Boost your decision using our deal data.

view full example data

Core Patent

Boost your research with our Core Patent data.

view full example data

Clinical Trial

Identify the latest clinical trials across global registries.

view full example data

Approval

Accelerate your research with the latest regulatory approval information.

view full example data

Regulation

Understand key drug designations in just a few clicks with Synapse.

view full example data

Chat with Hiro

Get started for free today!

Accelerate Strategic R&D decision making with Synapse, PatSnap’s AI-powered Connected Innovation Intelligence Platform Built for Life Sciences Professionals.

Start your data trial now!

Synapse data is also accessible to external entities via APIs or data packages. Empower better decisions with the latest in pharmaceutical intelligence.

Bio

Bio Sequences Search & Analysis

Chemical

Chemical Structures Search & Analysis