Top 300 - Cardiovascular

Amiodarone

Brand: Cordarone, Pacerone, Nexterone

Class: Antiarrhythmic

Dosage forms: 100 mg, 200 mg, 400 mg tablet

FDA Indication:

• Secondary prophylaxis of ventricular arrhythmias

Off-label:

• Afib

• Supraventricular arrhythmia

MOA: Type III antiarrhythmic that prolongs the effective refractory period of atrial and ventricular tissue by blocking potassium

CI: Severe bradycardia, severe sinus node dysfunction, cardiogenic shock

FYI: Potent CYP3A4 inhibitor

AE: Thyroid dysfunction, vision changes, hepatotoxicity, stevens-johnsons syndrome

Amlodipine

Brand: Norvasc

Class: Calcium Channel Blocker

Dosage forms: 2.5 mg, 5 mg, 10 mg tablet

FDA Indication:

• Hypertension (5-10 mg QD)

• Chronic stable angina (5-10 mg QD)

• Vasospastic angina (5-10 mg QD)

Off-label:

• Raynaud phenomenon (5 mg QD)

MOA: Long acting dihydropyridine calcium-channel-blocking drug with potent arterial and coronary vasodilating properties

CI: Hypersensitivity

FYI: Interaction with NSAIDs

AE: Peripheral edema, dizziness, fatigue, palpitations, rash

Apixiban

Brand: Eliquis

Class: Factor Xa Inhibitor

Dosage forms: 2.5 mg, 5 mg tablet

FDA Indication:

• Afib (5 mg BID)

• Hip or knee replacement surgery (2.5 mg BID x 12 D or 35 D)

• DVT or PE treatment or prophylaxis (10 mg BID x 7 D, then 5 mg BID IND)

Off-label:

• Heparin-induced thrombocytopenia

  • With thrombosis (10 mg BID x 7 D, then 5 mg BID)

  • without thrombosis (5 mg BID)

MOA: Apixaban is a selective inhibitor of factor Xa. By inhibiting factor Xa, apixaban decreases thrombin generation and thrombus development.

CI: Hypersensitivity, active bleeding

FYI: In atrial fibrillation patients, if 2 or more of following characteristics, reduce dose to 2.5 mg bid: age ≥80 y, body weight ≤60 kg, or SCr ≥1.5 mg/dL

AE: Bleeding, elevated LFTs, nausea, hypotension

Atenolol

Brand:  Tenormin

Class:  Beta blocker, cardioselective

Dosage forms:  25 mg, 50 mg, 100 mg tablet

FDA Indication: 

•  Angina (50 mg QD, titrate to 100-200 mg QD)

• HTN (25 mg QD, titrate to 100 mg QD)

• AMI (25-50 BID)

Off-label:  

•  Cardiac dysrhythmia (25-100 QD)

• Migraine prophylaxis (25-100 mg QD)

• Marfan Syndrome with aortic aneurysm (25-100 mg QD)

• Thyrotoxicosis (25-50 mg QD)

MOA:  Atenolol is a cardioselective β-adrenergic that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmias.

CI: Hypersensitivity, sinus bradycardia, AV block, overt heart failure, cardiogenic shock

FYI: Interacts with NSAIDS, amiodarone, antidiabetic drugs, hypertension drugs

AE:  Bradyarrhythmias, cold extremeties, dizziness, fatigue, hypotension, depression

Atorvastatin

Brand: Lipitor

Class:  HMG-CoA reductase inhibitor

Dosage forms:  10 mg, 20 mg, 40 mg, 80 mg tablet

FDA Indication: 

•  Primary/Secondary prevention of ASCVD (10-20 mg QD, may increase to 40-80 mg QD)

• Secondary prevention of cardiovascular events in patients with CAD (80 mg QD, may reduce to 40 mg QD)

• Familial hypercholesterolemia (10-80 mg QD)

Off-label:  

•  Post heart/renal transplant (10 mg QD)

MOA:   HMG-CoA reductase inhibitors competitively inhibit conversion of HMG-CoA to mevalonate, an early rate-limiting step in cholesterol synthesis. A compensatory increase in LDL receptors, which bind and remove circulating LDL-cholesterol, results. Production of LDL-cholesterol also can decrease because of decreased production of VLDL-cholesterol or increased VLDL; removal by LDL receptors.

CI:  Hypersensitivity, breastfeeding, active liver disease, unexplained elevated transaminases

FYI:  Interacts with aliskiren, CYP3A4 substrate

AE:  Myopathy, diarrhea, headache, nasopharyngitis, muscle pain, increased A1C, rhabdomyolysis, tendon rupture

Benazepril

Brand:  Lotensin

Class:  ACE-i, antihypertensive

Dosage forms:  5 mg, 10 mg, 20 mg, 40 mg tablet

FDA Indication: 

•  Hypertension (10 mg QD, titrate to 20-40 mg QD)

Off-label:  

•  Diabetic nephropathy (10 mg QD)

• Heart failure (2 mg QD, titrate 2-14 D intervals to 20 mg QD)

• Kidney disease (10-40 mg QD)

MOA:  Benazepril is a competitive ACE-I. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin-angiotensin system.

CI:  Hypersensitivity, Hx of angioedema, anuria, use with aliskiren

FYI:  Interaction with ARBs, NSAIDS, Aliskiren, Neprilysin inhibitors, lithium

AE:  Orthostatic hypotension, dizziness, dry cough, headache, hyperkalemia, angioedema

Bisoprolol

Brand:  Zebeta

Class:  Cardioselective beta blocker

Dosage forms:  5 mg, 10 mg

FDA Indication: 

•  Hypertension (2.5-5 mg QD, titrate to 20 mg)

Off-label:  

•  Angina (5-10 mg QD, titrate to 20 mg)

• Afib (2.5-5 mg QD, titrate to 20 mg)

• Heart failrue (1.25 mg QD, titrate to 10 mg QD)

• Ventricualr arrhythmias (2.5 mg QD, titrate to 10 mg QD)

MOA:   Bisoprolol is a cardioselective β-adrenergic blocker that decreases AV nodal conduction in supraventricular tachycardia and blockade of catecholamine-induced dysrhythmias. The antihypertensive mechanism is unknown, but contributing factors are renin blockade and decrease in myocardial contractility and cardiac output.

CI:  Hypersensitivity, AV block, overt heart failure, cardiogenic shock

FYI:  Substrate of CYP3A4, interacts with antidiabetic drugs, NSAIDs,

AE:  Bradyarrhythmias, cold extremities, dizziness, hypotension, heart failure

Candesartan

Brand:  Atacand

Class:  Angiotensin II Receptor Antagonist, ARB

Dosage forms:  4 mg, 8 mg, 16 mg, 32 mg tablet

FDA Indication: 

•  Heart Failure (4-8 mg QD, titrate to 32 mg QD)

• HTN (8 mg QD, titrate to 32 mg QD)

Off-label:  

•  Proteinuric CKD (8 mg QD, titrate to 32 mg QD)

• Migraine prevention (4-8 mg QD, titrate to 16 mg QD)

• ACS (8 mg QD, max 32 mg QD)

MOA:   Candesartan is a selective, reversible, competitive antagonist of the angiotensin II receptor type 1.

CI:  Hypersensitivity, pregnancy

FYI:  Interacts with aliskirin, ACEi, potassium supplement, NSAIDs

AE: Hypotension, nephrotoxicity, dizziness, flushing, angioedema

Carvedilol

Brand:  Coreg

Class:  Alpha/beta blocker

Dosage forms:  3.125 mg, 6.25 mg, 12.5 mg, 25 mg tablet

FDA Indication: 

• HFrEF (3.125 mg BID, titrate to 25 mg BID)

• HTN (6.25 mg BID, max 25 mg BID)

Off-label:  

•  Angina (12.5 mg BID, titrate to 25-50 mg BID)

• Cardiac dysrhythmia (3.125 mg BID, titrate to 25 mg BID)

• Post-ACS (3.125 BID, titrate to 25 mg BID)

• Variceal hemorrhage prophylaxis (3.125 BID, max 6.25 BID)

MOA:  Carvedilol is a selective α₁- and nonselective β-adrenergic blocker that decreases AV nodal conduction in supraventricular tachycardias and blockade of catecholamine-induced dysrhythmia.

CI:  Hypersensitivity, bronchial asthma, severe AV block, overt HF

FYI:  Interacts with CCBs, antidiabetic, NSAIDs

AE:  Cold extremities, dizziness, fatigue, hypotension, weight gain, heart failure

Chlorthalidone

Brand:  Hygroton, Thalitone

Class:  Thiazide diuretic

Dosage forms:  15 mg, 25 mg, 50 mg

FDA Indication: 

•  HTN (12.5-25 mg QD)

• Edema (12.5-25 mg QD, max 100 mg QD)

Off-label:  

•  Calcium nephrolithiasis (25 mg QD, max 100 mg QD)

MOA:   Chlorthalidone increases sodium and chloride excretion by interfering with their reabsorption in the cortical-diluting segment of the nephron.

CI:  Hypersensitivity, sulfer allergy, anuria

FYI:  CrCl < 10 mL/min, interactions with NSAIDs, CCBs, Digixin, ACEi

AE:  Dizziness, hypotension, hyperuricemia, hypokalemia, hyponatremia, orthostatic hypotension, heart failure

Clonidine

Brand:  Catapres, Kapvay

Class:  Alpha2-adrenergic Agonist

Dosage forms:  0.1 mg, 0.2 mg, 0.3 mg tablet/patch

FDA Indication: 

•  ADHD (0.1 mg QD HS, max 0.4 mg QD)

• HTN, refractory (0.1-0.6 mg QD)

Off-label:  

•  Vasomotor symptoms associated with menopause (0.1-0.3 mg QD)

• Opioid withdrawal (0.1-1.2 mg/D)

MOA:  Clonidine stimulates presynaptic α2-adrenergic receptors and blocks postsynaptic α2-adrenergic receptors in the CNS by activating inhibitory neurons to decrease sympathetic outflow. Clonidine is not a complete agonist, so some of its effects might result from antagonist actions at presynaptic α-receptors. These actions reduce peripheral vascular resistance, renal vascular resistance, HR, and BP.

CI:  Hypersensitivity

FYI:  Interaction with NSAIDs, TCAs, BB, CCBs, and cyclosporine

AE:  Erythema, headache, somnolence, xerostomia, bradycardia, fatigue, hypotension, AV block

Clopidogrel

Brand:  Plavix

Class:  Platelet aggregation inhibitor

Dosage forms:  75 mg, 300 mg tablet

FDA Indication: 

•  Acute MI (300-600 mg LD, followed by 75 mg QD with ASA)

• Thrombosis prevention (75 mg QD)

Off-label:  

•  CABG, MI

MOA:  Clopidogrel is an antiplatelet agent that prevents platelet aggregation by direct inhibition of ADP binding to receptor sites, inhibiting subsequent activation of the glycoprotein IIb/IIIa complex. This action is irreversible; therefore, platelets exposed to clopidogrel are inhibited for their lifespans.

CI:  Hypersensitivity, active bleeding

FYI:  Prodrug by CYP 2C19, metabolized by CYP 2C9, interacts with amiodarone

AE:  Headache, arthralgia, back ache, gastritis, HTN, pruritus

Colesevelam

Brand:  Welchol

Class:  Bile Acid Sequestrant

Dosage forms:  625 mg tablet, 3.75 g packet

FDA Indication: 

•  Hyperlipidemia (1.875 g BID or 3.75 g QD)

• T2DM (1.875 g BID or 3.75 g QD)

Off-label:  

•  Diarrhea associated with malabsorption (1.875 g PO BID or 3.75 QD)

MOA:  Colesevelam is a nonabsorbed, polymeric, lipid-lowering agent that binds intestinal bile acids, resulting in the increased clearance of LDL-cholesterol and a reduction in total cholesterol. Unlike cholestyramine and colestipol, colesevelam is not an anion exchange resin but binds bile acids and impedes their reabsorption.

CI:  History or bowel obstruction, hypertriglyceridemia

FYI:  Interacts with antidiabetic drugs, warfarin

AE:  Constipation, blood sugar abnormalities, pancreatitis, bowel obstruction

Dabigatran

Brand:  Pradaxa

Class:  DOAC

Dosage forms: 75 mg, 110 mg, 150 mg tablet  

FDA Indication: 

•  Treatment/prevention of DVT or PE (150 mg BID)

• Stroke prevention (150 mg BID)

• DVT prevention and PE after hip replacement (110 mg 1-4H PostOP, then 220 mg QD x 10-35 D)

Off-label:  

•  Prevention of stroke with atrial flutter (150 mg BID)

MOA:   Dabigatran is a competitive, reversible, direct thrombin inhibitor. Because thrombin enables the conversion of fibrinogen into fibrin during the coagulation cascade, its inhibition prevents the development of a thrombus. Both free and clot-bound thrombin and thrombin-induced platelet aggregation are inhibited.

CI:  Active bleeding, mechanical heart valve, hypersensitivity

FYI:  Interacts with other antiplatelet agents, NSAIDs, vitamin E

AE: Dyspepsia, gastritis, bleeding, abdominal pain, GERD, intracranial hemorrhage

Digoxin

Brand:  Digitek, Digox, Lanoxin

Class:  Digitalis glycoside

Dosage forms:  62.5 mcg, 125 mcg, 250 mcg tablet

FDA Indication: 

•  Afib (LD of 0.25-0.5 mg, then 0.25 mg Q6H), then 0.0625-0.025 mg QD)

• HFrEF (0.125-0.25 mg QD)

Off-label:  

•  Fetal tachycardia

• Supraventricular tachycardia

MOA:   Digitalis glycosides exert positive inotropic effects through improved availability of calcium to myocardial contractile elements, thereby increasing cardiac output in heart failure. Antiarrhythmic actions are caused primarily by an increase in AV nodal refractory period via increased vagal tone, sympathetic withdrawal, and direct mechanisms.

CI:  Hypersensitivity, Vfib

FYI:  Interacts with amiodarone, BB, diuretics, sulcrafate

AE:  Dizziness, ECG changes, nausea, visual disturbances, reduced color vision, seizures

Diltiazem

Brand:  Cardizem, Cartia XT, Dilt-XR, & more

Class:  Non-dihydropyradine CCB

Dosage forms:  30 mg, 60 mg, 90 mg, 120 mg tablet

FDA Indication: 

•  HTN (60-120 mg ER BID, max 360 mg/day OR 120-240 mg ER QD, max 540 mg/day)

• Chronic angina (30 mg IR QID, max 360 mg/d OR 120-180 mg ER QD, max 540 mg/day)

Off-label:  

•  PAH

• Afib

MOA:   Diltiazem is a calcium-channel-blocking drug that decreases HR, prolongs AV nodal conduction, and decreases arteriolar and coronary vascular tone. It also has negative inotropic properties.

CI:  Hypersensitivity, AV lock, sick sinus syndrome

FYI:  Substrate of CYP 3A4, interacts with BB, isocarboxazid

AE:  Edema, bradycardia, dizziness, fatigue, hypotension, rash, heart failure

Dipyridamole

Brand:  Aggrenox, Persantine

Class:  Platelet aggregation inhibitor

Dosage forms:  25 ng, 50 mg, 75 mg tablet

FDA Indication: 

•  Thromboprophylaxis after heart valve replacement (75-100 mg QID as adjunct to warfarin)

• Secondary prevention of stroke + ASA (200/25 mg)

Off-label:  

•  Carotid artery stenosis

• Patency of hemodialysis graft

MOA:  Inhibits the uptake of adenosine into platelets, endothelial cells, and erythrocytes resulting in an increase in local concentrations of adenosine, which is a coronary vasodilator and a platelet aggregation inhibitor.

CI:  Hypersensitivity

FYI:  Inx with other anti coagulants, SSRIs, SNRIs

AE: Dizziness, abdominal pain, headache, ventricular arrhythmia

Doxazosin

Brand:  Cardura, Cardura XL

Class:  Alpha1-adrenergic blocker

Dosage forms:  1 mg, 2 mg, 4 mg, 8 mg tablet

FDA Indication: 

•  BPH (1-8 mg QD)

• HTN (1-16 mg QD)

Off-label:  

•  Expulsion of distal ureteral stone (2-4 HS x 4 W)

MOA:   Doxazosin selectively blocks postsynaptic α1-adrenergic receptors, reducing peripheral resistance through arterial and venous dilations. Reflex tachycardia that occurs with other vasodilators is infrequent because there is no presynaptic α2-receptor blockade. Increase urine flow by relaxing smooth muscle tone in the bladder neck and prostate.

CI:  Hypersensitivity

FYI:  Substrate of CYP 3A4, INx with BB, PDE-5i, nifedipine

AE:  Dizziness, fatigue, malaise, edema, hypotension, somnolence, heptotoxicity, priaprism

Endoxaban

Brand:  Savaysa

Class:  Factor Xa Inhibitor

Dosage forms:  15 mg, 30 mg, 60 mg tablet

FDA Indication: 

•  Non-valvular afib (30 mg QD)

• VTE treatment (30 mg QD)

Off-label:  

•  Prophylaxis of VTE post knee arthroplasty

MOA:  Edoxaban is a selective inhibitor of FXa. By inhibiting FXa, edoxaban decreases thrombin generation and thrombus development.

CI:  Hypersensitivity, active bleeding

FYI:  INx NSAIDs, anti coagulants, warfarin

AE:  Bleeding, anemia, elevated LFTs, stroke

Enalapril

Brand:  Vasotec, Epaned

Class:  ACEi

Dosage forms: 2.5 mg, 5 mg, 10 mg, 20 mg  

FDA Indication: 

•  HF (2.5-40 mg QD)

• HTN (5-10 mg QD)

Off-label:  

•  AMI

• CKD with proteinuria

MOA:  Enalapril is a prodrug that is rapidly converted to its active metabolite, enalaprilat, a competitive ACEI. It reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and inhibits the sympathetic nervous system and tissue renin-angiotensin system. The net effect is reduction in total peripheral resistance and BP in hypertensive patients and reduction in elevated afterload in patients with heart failure.

CI:  Hypersensitivity, Hx of angioedema, pregnancy

FYI:  Prodrug, INx ARBs, NSAIDs, ASA, Aliskiren, lithium

AE: Increased SCr, dizziness, dry cough, fatigue, hypotension, hyperkalemia, rash, angioedema

Enoxaparin

Brand:  Lovenox

Class:  LMWH

Dosage forms:   30 mg/0.3 mL, 40 mg/0.4 mL, 60 mg/0.6 mL, 80 mg/0.8 mL, 100 mg/1 mL, 120 mg/0.8 mL, 150 mg/1 mL prefilled syringes

FDA Indication: 

•  DVT prophylaxis, abdominal (40 mg 2H prior to surgery, then QD x 10-14 D)

• DVT prophylaxis, knee or hip (30 mg Q12H x 10-14 D)

• DVT treatment (1 mg/kg Q12H or 1.5 mg/kd/day)

• STEMI

• Unstable angina

Off-label:  

•  Mechanical heart valve

• Superficial vein thrombosis

• Bariatric surgery

MOA:  Enoxaparin is a low-molecular-weight heparin which has anti–factor Xa and IIa properties.

CI:  Hypersensitivity, active bleeding, neuraxial analgesia, HIT

FYI:  CrCl < 30 mL/min dose reduction to 1 mg/kg QD, INx with NSAIDs and other antiplatelets

AE:  Anemia, hemorrhage, thrombocytopenia, injection site reaction, peripheral edema, afib

Ezetimibe

Brand:  Zetia

Class:  Cholesterol absorption inhibitor

Dosage forms:  10 mg tablet

FDA Indication: (10 mg QD)

•  Familial hypercholesterolemia with atorvastatin or simvastatin

• Mixed hyperlipidemia with fenofibrate

• Primary hypercholesterolemia

Off-label:  

•  None

MOA: Ezetimibe localizes at the brush border of the small intestine and inhibits the absorption of cholesterol, leading to a decrease in the delivery of intestinal cholesterol to the liver. This causes a reduction of hepatic cholesterol stores and an increase in clearance of cholesterol from the blood; this distinct mechanism is complementary to that of statins and of fenofibrate. 

CI:  Hypersensitivity, gallbladder disease, severe hepatic dysfunction, concurrent use with a statin in pregnant mothers.

FYI:  INx with cholestyramine, fibrates, warfarin

AE:  Abdominal pain, constipation, myopathy, rhabdomyolysis

Felodipine

Brand:  Plendil

Class:  CCB (DHP)

Dosage forms:  2.5 mg, 5 mg, 10 mg tablet

FDA Indication: 

•  HTN (2.5-10 mg QD)

Off-label:  

•  Chronic stable angina (2.5-5 mg QD, max 10 mg QD)

MOA:  . Felodipine is a dihydropyridine calcium-channel-blocking drug with potent arterial and coronary vasodilating properties. A reflex increase in sympathetic tone (in response to vasodilation) counteracts the direct depressant effects on SA and AV nodal conduction. This renders felodipine ineffective in the treatment of supraventricular tachycardias.

CI:  Hypersensitivity

FYI:  Substrate of CYP 3A4, INx with dantrolene

AE:  Peripheral edema, dizziness, fatigue, flushing, hypotension, hyperkalemia, rash, hepatotoxicity

Fenfibrate

Brand:  Tricor, Antara, Lipogen, Fenoglide, etc.

Class:  Antihyperlipidemic

Dosage forms:  35 - 160 mg tablet

FDA Indication: 

•  Hypertriglyceridemia (35-200 mg QD)

Off-label:  

•  None

MOA:  Fibric acid derivatives activate peroxisome proliferator-activated receptor α (PPARα), which increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein C-III (an inhibitor of lipoprotein lipase activity). The resulting fall in triglycerides produces an alteration in the size and composition of LDL from small, dense particles to large, buoyant particles. These larger particles have a greater affinity for cholesterol receptors and are catabolized rapidly.

CI:  Hypersensitivity, gallbladder disease, severe renal dysfunction, hepatic dysfunctions, nursing mothers

FYI:  INx with HMG-CoA reductase inhibitors, cholestyramine, ezetimibe, warfarin

AE:  Abdominal pain, constipation, headache, myopathy, rash, rhabdomyolysis, mood disorder

Fosinopril

Brand:  Monopril

Class:  ACEi

Dosage forms: 10 mg, 20 mg, 40 mg tablet  

FDA Indication: 

•  HF (5-10 mg QD, max 40 mg QD)

• HTN (10 mg QD, max 80 mg QD)

Off-label:  

•  Neuropathy caused by HIV

MOA:  Fosinopril is a competitive ACEI. It also reduces serum aldosterone, leading to decreased sodium retention, potentiates the vasodilator kallikrein–kinin system, and can alter prostanoid metabolism, inhibit the sympathetic nervous system, and inhibit the tissue renin–angiotensin system.

CI:  Hypersensitivity, Hx of angioedema, use with aliskiren

FYI:  INx with Antacids, ARBs, potassium supplements, PSD, NSAIDs, Aliskiren, diuretics

AE:  Dizziness, dry cough, hypotension, hyperkalemia, rash, angioedema

Furosemide

Brand:  Lasix

Class:  Loop diuretic

Dosage forms:  20 mg, 40 mg, 80 mg tablet

FDA Indication: 

•  Edema of volume overload related to HF (20-80 mg QD, max 600 mg/day)

Off-label:  

•  Ascities due to cirrhosis

MOA: Furosemide is a loop diuretic that is actively secreted via the nonspecific organic acid transport system into the lumen of the thick ascending limb of Henle's loop, where it decreases sodium reabsorption by competing for the chloride site on the Na+-K+-2Cl- cotransporter.

CI:  Hypersensitivity, sulfur allergy, anuria

FYI:  INx with ACEi, aminoglycosides, antidiabetic drugs, digoxin, lithium, NSAIDs, SGLT2i

AE:  Hyperuricemia, headache, hyperglycemia, hypocalcemia, hypokalemia, hypomagnesemia, muscle spasms, orthostatic hypotension, nephrotoxicity, ototoxicity

Gemfibrozil

Brand:  Lopid

Class:  Fibric acid antihyperlipidemic

Dosage forms:  600 mg tablet

FDA Indication: 

•  Coronary arteriosclerosis (600 mg BID)

• Hyperlipidemia (600 mg BID)

Off-label:  

•  None

MOA:  Fibric acid derivatives activate PPAR-α, which increases lipolysis and elimination of triglyceride-rich particles from plasma by activating lipoprotein lipase and reducing production of apoprotein C-III (an inhibitor of lipoprotein lipase activity). Activation of PPAR-α also induces an increase in the synthesis of apoproteins A-I and A-II and HDL-cholesterol.

CI:  Hypersensitivity, concurrent repaglinide or simvastatin, gallbladder disease, or severe renal or hepatic dysfunction.

FYI:  INx with statins, cholestyramine, glyburide, warfarin

AE:  Indigestion, headache, myopathy, rash, rhabdomyolysis, nausea

Hydralazine

Brand:  Apressoline

Class:  Peripheral vasodilator

Dosage forms:  10 mg, 25 mg, 50 mg, 100 mg tablet

FDA Indication: 

• HTN (10 mg QID for 2-4 d, titrate to 25 mg QID for 3-5 d, then lowest effective dose)

Off-label:  

•  Heart failure (25 mg TID with isosorbide dinitrate)

MOA:   Hydralazine is a vasodilator that reduces total peripheral resistance by direct action on vascular smooth muscle, with an effect greater on arterioles than on veins.

CI: Hypersensitivity, dissecting aortic aneurysm, CAD, mitral valve heart disease

FYI:  INx with NSAIDs, furosemide, and BB

AE:  Anorexia, chest pain, dizziness, headache, hypotension, nasal congestion, agranulocytosis, leukopenia, lupis