Dosing & Uses
Dosage Forms & Strengths
5-20 mg PO qDay
Severe impairment: 5 mg PO qDay; may increase every 2 weeks to maximum 20 mg/day
Less effective than thiazide diuretics in black and geriatric patients
Shown to decrease mortality in hypertension and post-myocardial infarction
Safety and efficacy not established
Hypertension: 5 mg PO qDay
Consideration should be given to reducing the starting dose to 5 mg in elderly patients
Elderly are especially prone to beta-blocker–induced bradycardia, which appears to be dose related and sometimes responds to reductions in dose
Serious - Use Alternative
Significant - Monitor Closely
Chest pain (2-7%)
Cold extremeties (2%)
Frequency Not Defined
Decreased exercise tolerance, Raynaud's phenomenon
May increase triglyceride levels and insulin resistance, and decrease HDL levels
Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure, hypersensitivity, sick sinus syndrome without permanent pacemaker
Bronchospastic disease, cerebrovascular insufficiency, CHF, cardiomegaly, DM, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease (potential risk of reduced placental perfusion, fetal bradycardia, hypoglycemia), use in pheochromocytoma, IDDM
Surgery/Anesthesia: Chronically administered beta-blockers should not be routinely withdrawn prior to major surgery; however, impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures
Pregnancy & Lactation
Pregnancy Category: C
Lactation: excreted in milk; use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Beta adrenergic receptor blocker; cardioselective for Beta-1 receptor at low doses
Half-Life: 14-22 hr
Protein Bound: 50%
Onset of action: 1-1.5hr
- Time: 3 hr
- Concentration: 21.6 ng/mL
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.