Hydralazine-pyrimidine interactions may explain hydralazine-induced lupus erythematosus

Hydralazine, the prototypic drug that induces systemic lupus erythematosus, reacts with thymidine and deoxycytidine. Analysis of a reaction mixture of therapeutic concentrations of hydralazine with labeled thymidine reveals at least four labeled products. At higher concentrations, hydralazine reacts with labeled deoxycytidine to form at least three labeled products. Formation of these products is markedly enhanced by exposure to ultraviolet light. The reaction of hydralazine with thymidine and deoxycytidine may be in part responsible for initiating drug-induced systemic lupus erythematosus.