Clinical Pharmacogenetics Implementation Consortium Guideline for <scp> <i>NAT2</i> </scp> Genotype and Hydralazine Therapy
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).
Authors
- Andrea Gaedigk (ORCID: https://orcid.org/0000-0001-6968-1893)
- Seth E. Karol (ORCID: https://orcid.org/0000-0001-8113-8180)
- Michelle Whirl‐Carrillo (ORCID: https://orcid.org/0000-0003-2414-9312)
- Arlene B. Chapman (ORCID: https://orcid.org/0000-0003-4538-4565)
- Michael Asger Andersen (ORCID: https://orcid.org/0000-0001-9729-9974)
- Pablo Zubiaur (ORCID: https://orcid.org/0000-0002-6150-4320)
- Amanda L. Elchynski (ORCID: https://orcid.org/0000-0002-4020-7052)
- Kelly E. Caudle (ORCID: https://orcid.org/0000-0002-5663-3793)
- Julio D. Duarte (ORCID: https://orcid.org/0000-0001-9766-4038)
- Rhonda M. Cooper‐DeHoff (ORCID: https://orcid.org/0000-0002-5198-130X)
- Roseann S. Donnelly (ORCID: https://orcid.org/0000-0001-7550-042X)
- Christelle Lteif (ORCID: https://orcid.org/0000-0002-0468-8936)
- Michael T. Eadon (ORCID: https://orcid.org/0000-0003-3066-2876)
- Nita A. Limdi (ORCID: https://orcid.org/0000-0002-4672-8406)
- Teri E. Klein (ORCID: https://orcid.org/0000-0001-5527-6475)
- José A. G. Agúndez (ORCID: https://orcid.org/0000-0001-6895-9160)
- David W. Hein (ORCID: https://orcid.org/0000-0003-3261-9775)
- Zeruesenay Desta (ORCID: https://orcid.org/0009-0001-1513-1295)
- Laura Sosinski
Institutions
- Arkansas Children's Hospital (US)
- St. Jude Children's Research Hospital (US)
- Children's Mercy Hospital (US)
- University of Louisville (US)
- Massachusetts College of Pharmacy and Health Sciences (US)
- Frederiksberg Hospital (DK)
- Copenhagen University Hospital (DK)
- Walgreens (United States) (US)
- University of Alabama at Birmingham (US)
- University of Florida (US)
- University of Chicago (US)
- Hospital Universitario de La Princesa (ES)
- Mercy Research (US)
- Indiana University School of Medicine
- Indiana University – Purdue University Indianapolis (US)
- Universidad Autónoma de Madrid (ES)
- University of Missouri–Kansas City (US)
- Universidad de Extremadura (ES)
- Florida College (US)
- Stanford University (US)
Publication Details
- Journal
- Clinical Pharmacology & Therapeutics
- Published
- 2025-09-19
- DOI
- https://doi.org/10.1002/cpt.70071
- Citations
- 1
- Primary Topic
- Pharmacogenetics and Drug Metabolism
- Type
- article
- Field-Weighted Citation Impact
- 1.56