biostudies-literatureEadon MTNIEHS NIH HHSNational Institutes of Health (NIH)National Institute of CorrectionsNHGRI NIH HHSNICAmerican Lebanese Syrian Associated CharitiesNCI NIH HHSNational Institutes of HealthNational Human Genome Research InstituteALSACNational Institute of General Medical SciencesNIGMS NIH HHS1430-1436https://www.ebi.ac.uk/biostudies/studies/S-EPMC12641075biostudies-literatureUnknown118(6)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 acetylClinical pharmacology and therapeuticsClinical Pharmacogenetics Implementation Consortium Guideline for NAT2 Genotype and Hydralazine Therapy.PMC12641075U24HG013077P30-ES030283R3‐5GM145383P30 ES030283U24HG010615P30‐ES030283R01 HG011800U24 HG010615T32 ES011564R01HG013416P20‐GM113226P20-GM113226P20 GM113226U24 HG013077T32-ES011564T32‐ES011564R35 GM145383R01 HG013416K08‐CA250418P42‐ES023716P42-ES023716K08 CA250418K08-CA250418R01HG011800R3-5GM145383P42 ES023716Eadon MTChapman ABWhirl-Carrillo MKlein TEHein DWElchynski ALLimdi NADonnelly RSAndersen MADuarte JDGaedigk ASosinski LCaudle KELteif CDesta ZKarol SEZubiaur PCooper-DeHoff RMAgundez JAGfalseClinical Pharmacogenetics Implementation Consortium Guideline for NAT2 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 acetyl2025-01-01T00:00:00Z2025 Dec2026-06-05T16:55:06.612Z2026-06-05T03:06:44.847ZS-EPMC126410754097404210.1002/cpt.70071