A 56-year-old man on hydralazine, hydrochlorothiazide, lisinopril, and metoprolol begins to develop a malar rash and arthralgias.
Which of the above antihypertensive agents is known to cause drug-induced lupus?
A. HydralazineHydralazine. Hydralazine is known to cause a lupus-like syndrome in 5% to 20% of patients taking the medication. This syndrome is characterized by arthralgias, myalgias, pericarditis, fever, and rash. Lisinopril, metoprolol, and hydrochlorothiazide are not known to induce lupus. Other side effects of hydralazine include nausea, vomiting, tachycardia, anorexia, flushing, and diarrhea. Treatment of hydralazine-induced lupus involves withdrawal of the medication.