Hydralazine (Apresoline)*

Initial dose: 5 mg IV or 10 mg IM

When blood pressure is controlled, repeat initial dose as needed (usually about every 3 hours; maximum, 400 mg per day).

If blood pressure is not controlled in 20 minutes, repeat initial dose every 20 minutes until maximum dosage is reached, or go immediately to next step.

If blood pressure is not controlled with a total of 20 mg IV or 30 mg IM, consider using a different antihypertensive drug (labetalol,† nifedipine [Procardia], sodium nitroprusside [Nitropress]).

Labetalol (Normodyne, Trandate)*

Initial dose: 20 mg in IV bolus

If blood pressure is not controlled, give 40 mg 10 minutes after initial dose and then 80 mg every 10 minutes for two additional doses (maximum: 220 mg).

If blood pressure is not controlled, use a different antihypertensive drug (hydralazine, nifedipine, sodium nitroprusside).