Direct-acting vasodilators to reduce blood pressure

A direct-acting vasodilator, such as minoxidil or hydralazine, is usually only used when other drugs have not controlled a patient’s blood pressure (BP) or are not tolerated.

If a direct-acting vasodilator is considered appropriate to reduce BP, use:

Minoxidil should always be given with a loop diuretic to prevent fluid retention, and another drug (usually a beta blocker) to prevent tachycardia.

Hydralazine may be used if minoxidil is not tolerated.