2.5 Antihypertensive therapy

Drugs affecting the renin-angiotensin system and some other hypertensive drugs

2.5.1 Vasodilator antihypertensive drugs
Hydralazine injection 20mg amps	R
Hydralazine tablets 25mg, 50mg	R
Sodium nitroprusside inj 50mg/5ml	F

Hydralazine is reserved for adjunctive treatment of hypertension in patients who are not controlled by or intolerant of other antihypertensive agents.

2.5.2 Centrally acting antihypertensive drugs
Clonidine injection 150mcg/1ml	R	Used as adjunctive analgesia
Clonidine tablets 25mcg, 100mcg	R
Methyldopa tablets 125mg, 250mg	F
Methyldopa suspension 250mg/5ml	F

Although clonidine is rarely used in the treatment of hypertension, a small stock will be maintained in the Pharmacy Department.

2.5.4 Alpha-adrenoceptor blocking drugs
Doxazosin tablets 1mg, 2mg	F
Indoramin tablets 20mg	R	Urology
Phenoxybenzamine capsules 10mg	R	Phaeochromocytoma
Phenoxybenzamine inj 100mg/2ml	R
Phentolamne injection 10mg/1ml	R	Phaeochromocytoma

Doxazosin has a long half-life and there is currently no evidence to suggest the XL tablets are any better than the plain tablets. Use plain tablets wherever possible. Note that the bioavailability of the XL tablets is around 50% of plain tablets.

2.5.5.1 Angiotensin-converting enzyme inhibitors
Lisinopril tablets 2.5mg, 5mg, 10mg, 20mg	F
Perindopril tablets 2mg, 4mg	F	1st line ACE inhibitors
Ramipril capsules 1.25mg, 2.5mg, 5mg	F

 

2.5.5.2 Angiotensin - II receptor antagonists
Candesartan tablets 2mg, 4mg, 8mg, 16mg	R	Heart failure
Role in hypertension remains to be established. Useful in heart failure (unlicensed) as an alternative to ACE inhibitors. Candesartan is agent of choice in heart failure.