Polyneuritis Occurring During Hydralazine Therapy

Drugs Acting on Arteriolar Smooth Muscle (Vasodilator Drugs)

“…Besides the characteristic hydralazine syndrome, polyneuropathy has also been reported in connection with long-term hydralazine treatment (KIRKENDALL and PAGE, 1958;RASKIN and FISHMAN, 1965). It was presumed that pyridoxine deficiency, caused by the binding of pyridoxine to hydralazine, was responsible for this reaction, which was considered comparable to the polyneuropathy induced by INH.…”

Hydralazine‐induced peripheral neuropathy seen in a Japanese slow acetylator patient.

“…that has been below 100 mg daily, while in the U.S. the range of 100-400 mg daily have been used) (Blaschke & Melmon, 1980). (2) The probable mechanism of hydralazine-induced peripheral neuropathy is mediated via pyridoxine (vitamine B6) deficiency (Kirkendall & Page, 1958;Raskin & Fishman, 1965;Koch-Weser, 1976;Argov & Mastaglia, 1979), perhaps because of formation of a pyridoxal-hydralazine complex (a hydrazone) that inactivates the coenzyme and facilitates its urinary excretion (Raskin & Fishman, 1965). Therefore, this untoward effect appears to be dose-related and it has been anticipated that this complication would occur more common in slow acetylators of this antipyridoxal drug (KochWeser, 1976).…”

“…This patient's past medical history showed that he took INH for the treatment of pulmonary tuberculosis. Since INH-induced sensory disorder has been considered via the same mechanism as that of hydralazine-induced peripheral neuropathy (Kirkendall & Page, 1958;Raskin & Fishman, 1965;Argov & Mastaglia, 1979), it seems reasonable to expect that he should experience the same disabilities during INH therapy. Our careful inquiries about this matter, however, could not provide any evidence for it.…”