Which medications in the drug class Vasodilators are used in the treatment of Hypertension?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Vasodilators relax blood vessels to improve blood flow, thus decreasing blood pressure.


Oral hydralazine is indicated for essential hypertension, alone or as an adjunct. Initial dose is 10 mg given 4 times daily for the first 2 to 4 days, then 25 mg 4 times a day for 1 week. Hydralazine IV or IM is indicated for severe essential hypertension when the drug cannot be given orally or when there is an urgent need to lower BP. Hydralazine may lower blood pressure by exerting a peripheral, vasodilating effect through a direct relaxation of vascular smooth muscle. Caution should be used when hydralazine is administered in patients with concomitant coronary artery disease.


Minoxidil is indicated in severe hypertension that is symptomatic or associated with end-organ damage and is not manageable with maximum therapeutic doses of a diuretic plus 2 other antihypertensives. The initial dose is 5 mg/day as a single dose and can be titrated to 10, 20, and then 40 mg in single or divided doses as needed (maximum 100 mg/day). Minoxidil reduces elevated systolic and diastolic blood pressure by decreasing peripheral vascular resistance. The blood pressure response to minoxidil is dose-related and proportional to the extent of hypertension. Concomitant therapy with an antiadrenergic agent and loop diuretic is generally required.

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