Dosing & Uses
Dosage Forms & Strengths
tablet
- 10mg
- 20mg
Hypertension
5-20 mg PO qDay
Renal Impairment
Severe impairment: 5 mg PO qDay; may increase every 2 weeks to maximum 20 mg/day
Other Information
Less effective than thiazide diuretics in black and geriatric patients
Shown to decrease mortality in hypertension and post-myocardial infarction
Hypertension
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
2-10%
Fatigue (2-10%)
Bradycardia (6-8%)
Chest pain (2-7%)
Dyspepsia (2-5%)
Lethargy (3%)
Cold extremeties (2%)
Diarrhea (2%)
Dyspnea (2%)
Edema (2%)
Palpitation (2%)
Pharyngitis (2%)
<2% (selected)
Angina
Arrhythmia
Flushing
Depression
Fever
Hallucinations
Malaise
Neuropathy
Rash
Diabetes
Hyperglycemia
Anemia
Hypercholesterolemia
Hyperlipidemia
Leukocytosis
cataracts
Constipation
Dysphagia
Libido decreased
Proteinuria
Bronchospams
Cough
Frequency Not Defined
Decreased exercise tolerance, Raynaud's phenomenon
May increase triglyceride levels and insulin resistance, and decrease HDL levels
Warnings
Contraindications
Sinus bradycardia, 2°/3° heart block, cardiogenic shock, overt cardiac failure, hypersensitivity, sick sinus syndrome without permanent pacemaker
Cautions
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Surgery/Anesthesia: Chronically administered beta-blockers should not be routinely withdrawn prior to major surgery; however, impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical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
Pregnancy Categories
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.Pharmacology
Mechanism of Action
Beta adrenergic receptor blocker; cardioselective for Beta-1 receptor at low doses
Pharmacokinetics
Half-Life: 14-22 hr
Bioavailability: 89%
Protein Bound: 50%
Excretion: Urine
Onset of action: 1-1.5hr
Peak Plasma
- Time: 3 hr
- Concentration: 21.6 ng/mL
Images
Patient Handout
Formulary
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.
