penbutolol (Discontinued)

Brand and Other Names:Levatol
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 20mg

Arterial Hypertension

Initial 10mg PO qDay (full effect after 4-6weeks)

Maintenance dose: 10-40mg PO qDay (full effect after 2 weeks)

No more than 80mg PO qDay

May admininster alone or in combination with other antihypertensive agents

Additional Information

Less effective than thiazide diuretics in black and geriatric patients

Shown to decrease mortality in hypertension and post-myocardial infarction

<18 years old: Safety and efficacy not established

Arterial hypertension

Initial 10mg PO qDay (full effect after 4-6weeks)

Maintenance dose: 10-40mg PO qDay (full effect after 2 weeks)

No more than 80mg PO qDay

May admininster alone or in combination with other antihypertensive agents

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Interactions

Interaction Checker

and penbutolol

No Results

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    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Aggravate CHF

            Depression

            Fatigue

            Mask symptoms of hypoglycemia

            May increase triglyceride levels

            Decrease HDL (less than other beta blockers)

            Bronchospasm

            Decreased exercise tolerance

            Raynaud's phenomenon

            May increase insulin resistance

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            Warnings

            Contraindications

            Severe peripheral vascular disease, sinus bradycardia, 2°/3° heart block, cardiogenic shock, hypersensitivity, asthma/COPD, sick sinus syndrome without permanent pacemaker

            Cautions

            IDDM, CHF, hyperthyroidism, renal impairment, liver disease

            Sudden discontinuation can exacerbate angina and lead to myocardial infarction

            Increased risk of stroke after surgery, cerebrovascular insufficiency, peripheral vascular disease, anesthesia/surgery (myocardial depression), use in pheochromocytoma

            Anesthesia/surgery (myocardial depression): chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: unknown; use with 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.

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            Pharmacology

            Mechanism of Action

            Beta adrenergic receptor blocker; intrinsic sympathomimetic activity (lowers BP with little decrease in HR)

            Pharmacokinetics

            Half-Life: 5 hr

            Peak Plasma: 2-3 hr

            Duration: >20 hr

            Peak effect: 1.3-3 hr

            Protein bound: 80-98%

            Metabolism: Liver (oxidation and conjugation)

            Excretion: Urine

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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.