Clinical Pharmacogenetics Implementation Consortium Guideline for NAT2 Genotype and Hydralazine Therapy
Year: 2025
Type: article
Abstract: Hydralazine is a vasodilator typically used in the treatment of resistant hypertension and heart failure. N-acetyltransferase 2 (NAT2) catalyzes the metabolism of hydralazine into inactive metabolites. NAT2 poor metabolizers (historically referred to as "slow acetylators") are predicted to have increased plasma hydralazine concentrations compared with NAT2 rapid and intermediate metabolizers (historically referred to as "rapid acetylators" and "intermediate acetylators," respectively), which may lead to both increased clinical efficacy and adverse effects, including drug-induced systemic lupus erythematosus. This guideline summarizes the evidence from the literature relevant to NAT2/hydralazine and provides recommendations for hydralazine prescribing based on NAT2 genotype-predicted acetylator phenotype (updates at www.cpicpgx.org).
DOI: 10.1002/cpt.70071
Authors: Michael T. Eadon, David W. Hein, Michael A. Andersen, Arlene B. Chapman, Rhonda M. Cooper‐DeHoff, Zeruesenay Desta, Julio D. Duarte, Amanda L. Elchynski, Andrea Gaedigk, Seth E. Karol, Nita A. Limdi, Christelle Lteif, Laura Sosinski, Pablo Zubiaur, Michelle Whirl‐Carrillo, Teri E. Klein, Kelly E. Caudle, Roseann S. Donnelly, José A.G. Agúndez
Institutions: Indiana University Indianapolis, Indiana University School of Medicine, University of Louisville, Frederiksberg Hospital, Bispebjerg Hospital, Copenhagen University Hospital, University of Chicago, University of Florida Health, University of Florida, Arkansas Children's Hospital, Children’s Mercy Research Institute, University of Missouri–Kansas City, St. Jude Children's Research Hospital, University of Alabama at Birmingham, UAB Medicine, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, Stanford University, Massachusetts College of Pharmacy and Health Sciences, Universidad de Extremadura
Language: English
Subfield: Pharmacology
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,410
Funders: American Lebanese Syrian Associated Charities, National Institutes of Health, National Institute of Corrections, National Human Genome Research Institute, National Cancer Institute, National Institute of General Medical Sciences, National Institute of Environmental Health Sciences, National Center for Complementary and Integrative Health
Awards: G1157759535, G259145303, G2737321838, G4130961695, G6761932316, G738042423, G766588337, University of Louisville Center for Integrative Environmental Health Sciences, G8609000519, G9000029792, G9000243245, Indiana University Comprehensive Training in Clinical Pharmacology, Hepatobiology and Toxicology COBRE, UOFL ENVIRONMENTAL HEALTH SCIENCES TRAINING PROGRAM, Clinical Implementation Resources for Pharmacogenomics (CIRP), Genomic and drug-drug interaction mechanisms of interindividual variability in drug disposition
OpenAlex ID: W4414377830