Document Type

Article

Publication Date

12-2025

Identifier

DOI: 10.1002/cpt.70071; PMCID: PMC12641075

Abstract

Hydralazine is a vasodilator typically used in the treatment of resistant hypertension and heart failure. N-acetyltransferase 2 (NAT2) catalyzes the metabolism of hydralazine into inactive metabolites. NAT2 poor metabolizers (historically referred to as "slow acetylators") are predicted to have increased plasma hydralazine concentrations compared with NAT2 rapid and intermediate metabolizers (historically referred to as "rapid acetylators" and "intermediate acetylators," respectively), which may lead to both increased clinical efficacy and adverse effects, including drug-induced systemic lupus erythematosus. This guideline summarizes the evidence from the literature relevant to NAT2/hydralazine and provides recommendations for hydralazine prescribing based on NAT2 genotype-predicted acetylator phenotype (updates at www.cpicpgx.org).

Journal Title

Clinical pharmacology and therapeutics

Volume

118

Issue

6

First Page

1430

Last Page

1436

MeSH Keywords

Humans; Hydralazine; Arylamine N-Acetyltransferase; Genotype; Pharmacogenetics; Antihypertensive Agents; Phenotype; Hypertension; Vasodilator Agents; Heart Failure

PubMed ID

40974042

Keywords

Humans; Hydralazine; Arylamine N-Acetyltransferase; Genotype; Pharmacogenetics; Antihypertensive Agents; Phenotype; Hypertension; Vasodilator Agents; Heart Failure

Comments

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Publisher's Link: https://ascpt.onlinelibrary.wiley.com/doi/10.1002/cpt.70071

Download

Share

COinS