2.5.1 Vasodilator antihypertensive drugs

General guidance

• These are potent drugs, especially when used in combination with a beta-blocker and a thiazide. Such use may result in a very rapid fall in blood pressure.
• Most agents are only available for the control of severe hypertension.
• Hydralazine is available in an oral preparation as an adjunct in moderate to severe hypertension, heart failure and hypertensive crisis.
• Hydralazine is associated with severe adverse effects.

Recommended drugs

Restricted use - Not recommended for primary care initiation

Minoxidil ££

Hydralazine ££

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low