Hydralazine is also associated with a high incidence of drug-induced lupus. With chronic therapy, the incidence of ANA induction is approximately 50% and that of a symptomatic lupus-like syndrome is approximately 10%; however, it depends on the acetylator phenotype (Perry 1973, Perry et al. 1970). In addition, as mentioned previously, the incidence is dose dependent, and if the daily dose is kept below 200 mg, the incidence is lower. Unlike most drug-induced lupus, there have been several reports of significant kidney involvement with hydralazine-induced lupus (Shapiro et al. 1984). As with procainamide, the use of hydralazine has significantly declined because many effective alternative drugs have been developed.

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