Dosing & Uses
Dosage Forms & Strengths
capsule
- 200mg
- 400mg
Hypertension
400-1200 mg/day divided PO q12hr; not to exceed 1200 mg/day
Ventricular Arrhythmias
400-1200 mg/day divided PO q12hr; not to exceed 1200 mg/day
Angina
400-1200 mg/day divided PO q12hr; not to exceed 1200 mg/day
Renal Impairment
CrCl 25-49 mL/min: Reduce dose by 50%
CrCl < 25 mL/min: Reduce dose by 75%
Hepatic Impairment
Dose adjustment not necessary
Other Indications & Uses
Off-label: ventricular tachycardia, angina, essential tremor
Also used to control ventricular premature beats
Safety and efficacy not established
Hypertension
Initial dose: 200-400 mg PO daily; not to exceed 800 mg/day
Ventricular Arrhythmias
Initial dose: 200-400 mg PO daily; not to exceed 800 mg/day
Angina
Initial dose: 200-400 mg PO daily; not to exceed 800 mg/day
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (19)
- atenolol
acebutolol and atenolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- betaxolol
acebutolol and betaxolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- bisoprolol
acebutolol and bisoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- carvedilol
acebutolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- celiprolol
acebutolol and celiprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- esmolol
acebutolol and esmolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- labetalol
acebutolol and labetalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- lofexidine
lofexidine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.
- metoprolol
acebutolol and metoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nadolol
acebutolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- nebivolol
acebutolol and nebivolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- penbutolol
acebutolol and penbutolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- pindolol
acebutolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- propranolol
acebutolol and propranolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- saquinavir
saquinavir, acebutolol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of PR prolongation and cardiac arrhythmias.
- sotalol
acebutolol and sotalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- timolol
acebutolol and timolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.
- umeclidinium bromide/vilanterol inhaled
acebutolol, umeclidinium bromide/vilanterol inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .
- vilanterol/fluticasone furoate inhaled
acebutolol, vilanterol/fluticasone furoate inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .
Monitor Closely (170)
- aceclofenac
acebutolol and aceclofenac both increase serum potassium. Use Caution/Monitor.
aceclofenac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - acemetacin
acebutolol and acemetacin both increase serum potassium. Use Caution/Monitor.
acemetacin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - albuterol
acebutolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor. - aldesleukin
aldesleukin increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- alfuzosin
alfuzosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. The severity and duration of hypotension following the first dose of Alfuzosin may be enhanced.
- aluminum hydroxide
aluminum hydroxide decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- amifostine
amifostine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.
- amiloride
acebutolol and amiloride both increase serum potassium. Modify Therapy/Monitor Closely.
- amiodarone
amiodarone, acebutolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of cardiotoxicity with bradycardia.
- amlodipine
acebutolol and amlodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- amobarbital
amobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of amobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- arformoterol
acebutolol increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of arformoterol by pharmacodynamic antagonism. Use Caution/Monitor. - asenapine
asenapine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- aspirin
acebutolol and aspirin both increase serum potassium. Use Caution/Monitor.
aspirin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin rectal
acebutolol and aspirin rectal both increase serum potassium. Use Caution/Monitor.
aspirin rectal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
acebutolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor. - atazanavir
atazanavir increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension, bradycardia, AV block, and prolonged PR interval. Consider lowering beta blocker dose.
- atenolol
acebutolol and atenolol both increase serum potassium. Use Caution/Monitor.
- avanafil
avanafil increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- bendroflumethiazide
acebutolol increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- betaxolol
acebutolol and betaxolol both increase serum potassium. Use Caution/Monitor.
- bismuth subsalicylate
bismuth subsalicylate, acebutolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Blockage of renal prostaglandin synthesis; may cause severe hypertension.
- bisoprolol
acebutolol and bisoprolol both increase serum potassium. Use Caution/Monitor.
- bumetanide
acebutolol increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- butabarbital
butabarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- butalbital
butalbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butalbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- calcium acetate
calcium acetate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium carbonate
calcium carbonate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
calcium carbonate decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours. - calcium chloride
calcium chloride decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium citrate
calcium citrate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
- calcium gluconate
calcium gluconate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.
- candesartan
candesartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, candesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - carbenoxolone
acebutolol increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbidopa
carbidopa increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.
- carvedilol
acebutolol and carvedilol both increase serum potassium. Use Caution/Monitor.
- celecoxib
acebutolol and celecoxib both increase serum potassium. Use Caution/Monitor.
celecoxib decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - celiprolol
acebutolol and celiprolol both increase serum potassium. Use Caution/Monitor.
- chlorothiazide
acebutolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorthalidone
acebutolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- choline magnesium trisalicylate
acebutolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.
choline magnesium trisalicylate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - clevidipine
acebutolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- clonidine
acebutolol, clonidine. Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.
- cyclopenthiazide
acebutolol increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dasiglucagon
acebutolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- desflurane
desflurane, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- diclofenac
acebutolol and diclofenac both increase serum potassium. Use Caution/Monitor.
diclofenac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - diflunisal
acebutolol and diflunisal both increase serum potassium. Use Caution/Monitor.
diflunisal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - digoxin
acebutolol and digoxin both increase serum potassium. Use Caution/Monitor.
acebutolol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Enhanced bradycardia. - diltiazem
acebutolol and diltiazem both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- dobutamine
acebutolol increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of dobutamine by pharmacodynamic antagonism. Use Caution/Monitor. - dopexamine
acebutolol increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of dopexamine by pharmacodynamic antagonism. Use Caution/Monitor. - doxazosin
doxazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. The severity and duration of hypotension following the first dose of doxozosin may be enhanced.
- drospirenone
acebutolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.
- ephedrine
acebutolol increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of ephedrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine
acebutolol increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - epinephrine racemic
acebutolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor. - eprosartan
eprosartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, eprosartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - esmolol
acebutolol and esmolol both increase serum potassium. Use Caution/Monitor.
- ethacrynic acid
acebutolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ether
acebutolol, ether. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both beta blockers and ether depress the myocardium; consider lowering beta blocker dose if ether used for anesthesia.
- etodolac
acebutolol and etodolac both increase serum potassium. Use Caution/Monitor.
etodolac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - etomidate
etomidate, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- felodipine
acebutolol and felodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- fenbufen
acebutolol and fenbufen both increase serum potassium. Use Caution/Monitor.
- fenoprofen
acebutolol and fenoprofen both increase serum potassium. Use Caution/Monitor.
fenoprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - fingolimod
acebutolol increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.
- flurbiprofen
acebutolol and flurbiprofen both increase serum potassium. Use Caution/Monitor.
flurbiprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - formoterol
acebutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor. - furosemide
acebutolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- gentamicin
acebutolol increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- glucagon
glucagon decreases toxicity of acebutolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- glucagon intranasal
glucagon intranasal decreases toxicity of acebutolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.
- hawthorn
hawthorn increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor.
- hydralazine
hydralazine increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.
- hydrochlorothiazide
acebutolol increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ibuprofen
acebutolol and ibuprofen both increase serum potassium. Use Caution/Monitor.
ibuprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ibuprofen IV
ibuprofen IV decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
acebutolol and ibuprofen IV both increase serum potassium. Use Caution/Monitor. - indacaterol, inhaled
indacaterol, inhaled, acebutolol. Other (see comment). Use Caution/Monitor. Comment: Beta-blockers and indacaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
- indapamide
acebutolol increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- indomethacin
acebutolol and indomethacin both increase serum potassium. Use Caution/Monitor.
indomethacin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - insulin degludec
acebutolol, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin degludec/insulin aspart
acebutolol, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- insulin inhaled
acebutolol, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).
- iodixanol
acebutolol increases toxicity of iodixanol by unspecified interaction mechanism. Use Caution/Monitor. Use of beta-blockers lowers the threshold for and increases the severity of contrast reactions, and reduces the responsiveness of treatment of hypersensitivity reactions with epinephrine. .
- irbesartan
irbesartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, irbesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - isoproterenol
acebutolol increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of isoproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - isradipine
acebutolol and isradipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- ivabradine
ivabradine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Most patients receiving ivabradine will also be treated with a beta-blocker. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking ivabradine with other negative chronotropes.
- ketamine
ketamine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- ketoprofen
acebutolol and ketoprofen both increase serum potassium. Use Caution/Monitor.
ketoprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac
acebutolol and ketorolac both increase serum potassium. Use Caution/Monitor.
ketorolac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ketorolac intranasal
acebutolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.
ketorolac intranasal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - labetalol
acebutolol and labetalol both increase serum potassium. Use Caution/Monitor.
- lasmiditan
acebutolol increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.
- levalbuterol
acebutolol increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of levalbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - levodopa
levodopa increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.
- lornoxicam
acebutolol and lornoxicam both increase serum potassium. Use Caution/Monitor.
lornoxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - losartan
losartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, losartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - lurasidone
acebutolol increases effects of lurasidone by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.
- maraviroc
maraviroc, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.
- meclofenamate
meclofenamate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.
acebutolol and meclofenamate both increase serum potassium. Use Caution/Monitor. - mefenamic acid
acebutolol and mefenamic acid both increase serum potassium. Use Caution/Monitor.
mefenamic acid decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - mefloquine
mefloquine increases levels of acebutolol by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.
- meloxicam
acebutolol and meloxicam both increase serum potassium. Use Caution/Monitor.
meloxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - metaproterenol
acebutolol increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of metaproterenol by pharmacodynamic antagonism. Use Caution/Monitor. - methyclothiazide
acebutolol increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- methylphenidate transdermal
methylphenidate transdermal decreases effects of acebutolol by anti-hypertensive channel blocking. Use Caution/Monitor.
- metolazone
acebutolol increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metoprolol
acebutolol and metoprolol both increase serum potassium. Use Caution/Monitor.
- moxisylyte
moxisylyte and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nabumetone
acebutolol and nabumetone both increase serum potassium. Use Caution/Monitor.
nabumetone decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nadolol
acebutolol and nadolol both increase serum potassium. Use Caution/Monitor.
- naproxen
acebutolol and naproxen both increase serum potassium. Use Caution/Monitor.
naproxen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - nebivolol
acebutolol and nebivolol both increase serum potassium. Use Caution/Monitor.
- nicardipine
acebutolol and nicardipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nifedipine
acebutolol and nifedipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nisoldipine
acebutolol and nisoldipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- nitroglycerin rectal
nitroglycerin rectal, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers blunt the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur.
- norepinephrine
acebutolol increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of norepinephrine by pharmacodynamic antagonism. Use Caution/Monitor. - olmesartan
olmesartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, olmesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - olodaterol inhaled
acebutolol, olodaterol inhaled. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.
- oxaprozin
acebutolol and oxaprozin both increase serum potassium. Use Caution/Monitor.
oxaprozin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - parecoxib
acebutolol and parecoxib both increase serum potassium. Use Caution/Monitor.
parecoxib decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - penbutolol
acebutolol and penbutolol both increase serum potassium. Use Caution/Monitor.
- pentobarbital
pentobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of pentobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- phenobarbital
phenobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of phenobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- phenoxybenzamine
phenoxybenzamine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- phentolamine
phentolamine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- pindolol
acebutolol and pindolol both increase serum potassium. Use Caution/Monitor.
- pirbuterol
acebutolol increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of pirbuterol by pharmacodynamic antagonism. Use Caution/Monitor. - piroxicam
acebutolol and piroxicam both increase serum potassium. Use Caution/Monitor.
piroxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - ponesimod
ponesimod and acebutolol both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Beta-blockers may have additive effects on lowering HR. Consider resting HR before initiating ponesimod in patients on stable dose of beta-blocker. Refer to the ponesimod prescribing information for more dosing information.
- potassium acid phosphate
acebutolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium chloride
acebutolol and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.
- potassium citrate
acebutolol and potassium citrate both increase serum potassium. Use Caution/Monitor.
- prazosin
prazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. The severity and duration of hypotension following the first dose of prazosin may be enhanced.
- primidone
primidone decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- propofol
propofol, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- propranolol
acebutolol and propranolol both increase serum potassium. Use Caution/Monitor.
- sacubitril/valsartan
sacubitril/valsartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, sacubitril/valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - salicylates (non-asa)
acebutolol and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.
salicylates (non-asa) decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - salmeterol
acebutolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor. - salsalate
acebutolol and salsalate both increase serum potassium. Use Caution/Monitor.
salsalate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - secobarbital
secobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of secobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.
- sevelamer
sevelamer decreases levels of acebutolol by increasing elimination. Use Caution/Monitor.
- sevoflurane
sevoflurane, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- sildenafil
acebutolol increases effects of sildenafil by additive vasodilation. Use Caution/Monitor. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy.
- silodosin
silodosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Increased risk of dizziness and orthostatic hypotension when silodosin is administered concurrently with antihypertensives.
- siponimod
siponimod, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caution when siponimod is initiated in patients receiving beta-blocker treatment because of additive effects on lowering heart rate. Temporary interruption of beta-blocker may be needed before initiating siponimod. Beta-blocker treatment can be initiated in patients receiving stable doses of siponimod.
- sodium bicarbonate
sodium bicarbonate decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sodium citrate/citric acid
sodium citrate/citric acid decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sotalol
acebutolol and sotalol both increase serum potassium. Use Caution/Monitor.
- spironolactone
acebutolol and spironolactone both increase serum potassium. Modify Therapy/Monitor Closely.
- succinylcholine
acebutolol and succinylcholine both increase serum potassium. Use Caution/Monitor.
- sulfasalazine
acebutolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.
sulfasalazine decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - sulindac
acebutolol and sulindac both increase serum potassium. Use Caution/Monitor.
sulindac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tadalafil
tadalafil increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.
- telmisartan
telmisartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, telmisartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - terazosin
terazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Additive hypotensive effects may occur when terazosin is used in combination with acebutolol.
- terbutaline
acebutolol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
acebutolol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor. - theophylline
acebutolol, theophylline. Other (see comment). Use Caution/Monitor. Comment: Beta blockers (esp. non selective) antagonize theophylline effects, while at the same time increasing theophylline levels and toxicity (mechanism: decreased theophylline metabolism). Smoking increases risk of interaction.
- timolol
acebutolol and timolol both increase serum potassium. Use Caution/Monitor.
- tolfenamic acid
acebutolol and tolfenamic acid both increase serum potassium. Use Caution/Monitor.
tolfenamic acid decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolmetin
acebutolol and tolmetin both increase serum potassium. Use Caution/Monitor.
tolmetin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis. - tolvaptan
acebutolol and tolvaptan both increase serum potassium. Use Caution/Monitor.
- torsemide
acebutolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- triamterene
acebutolol and triamterene both increase serum potassium. Modify Therapy/Monitor Closely.
- valsartan
valsartan and acebutolol both increase serum potassium. Use Caution/Monitor.
acebutolol, valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy. - verapamil
acebutolol and verapamil both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.
- xipamide
xipamide increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor.
Minor (30)
- adenosine
acebutolol, adenosine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Bradycardia.
- agrimony
agrimony increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- brimonidine
brimonidine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- cevimeline
cevimeline increases effects of acebutolol by unspecified interaction mechanism. Minor/Significance Unknown.
- ciprofloxacin
ciprofloxacin increases levels of acebutolol by decreasing metabolism. Minor/Significance Unknown. May also rarely decrease beta blocker levels.
- cocaine topical
acebutolol increases effects of cocaine topical by pharmacodynamic synergism. Minor/Significance Unknown. Risk of angina.
- cornsilk
cornsilk increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- dihydroergotamine
dihydroergotamine, acebutolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dihydroergotamine intranasal
dihydroergotamine intranasal, acebutolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.
- dipyridamole
dipyridamole, acebutolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of bradycardia.
- escitalopram
escitalopram increases levels of acebutolol by decreasing metabolism. Minor/Significance Unknown.
- fenoldopam
fenoldopam increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.
- forskolin
forskolin increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- guanfacine
acebutolol, guanfacine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.
- imaging agents (gadolinium)
acebutolol, imaging agents (gadolinium). Mechanism: unknown. Minor/Significance Unknown. Increased risk of anaphylaxis from contrast media.
- levobetaxolol
levobetaxolol increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- lily of the valley
acebutolol, lily of the valley. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown.
- maitake
maitake increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- melatonin
melatonin decreases toxicity of acebutolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.
- metipranolol ophthalmic
metipranolol ophthalmic increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- neostigmine
acebutolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- noni juice
acebutolol and noni juice both increase serum potassium. Minor/Significance Unknown.
- octacosanol
octacosanol increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- physostigmine
acebutolol, physostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.
- pilocarpine
pilocarpine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- reishi
reishi increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- shepherd's purse
shepherd's purse, acebutolol. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.
- tizanidine
tizanidine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.
- treprostinil
treprostinil increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.
- yohimbe
acebutolol decreases toxicity of yohimbe by pharmacodynamic antagonism. Minor/Significance Unknown.
Adverse Effects
>10%
Fatigue (11%)
1-10%
Dizziness (6%)
Headache (6%)
Constipation (4%)
Diarrhea (4%)
Dyspnea (4%)
Dyspepsia (4%)
Nausea (4%)
Flatulence (3%)
Insomnia (3%)
Abdominal pain (2%)
Bradycardia (2%)
Chest pain (2%)
Dysuria (2%)
Edema (2%)
Heart failure (2%)
Hypotension (2%)
Impotence (2%)
Myalgia (2%)
Pharyngitis (2%)
Pruritus (2%)
Rhinitis (2%)
Vomiting (2%)
Wheezing (2%)
<1%
Hepatotoxicity
SLE
Frequency Not Defined
Bronchospasm, depression, decreased exercise tolerance, Raynaud's phenomenon
May increase triglyceride levels and insulin resistance, and decrease HDL levels
Warnings
Contraindications
Hypersensitivity
Persistently severe bradycardia; 2°/3° heart block except patients with functioning artificial pacemaker, overt cardiac failure, cardiogenic shock
Cautions
Use with caution in patients with myasthenia gravis
Exacerbation or induction of psoriasis reported with therapy; cause and effect not established
Use caution and monitor for progression of arterial obstruction in patients with peripheral vascular disease and Raynaud disease; therapy may precipitate or aggravate symptoms of arterial insufficiency
Prior to use a β-blocker, adequate alph1-receptor blockade required in patients with pheochromocytoma
While taking β-blockers, patients with a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic; such patients may be unresponsive to usual doses of epinephrine used to treat allergic reaction
Sympathetic stimulation may be essential for support of circulation in individuals with diminished myocardial contractility; inhibition by β-adrenergic receptor blockade may precipitate more severe failure; although β-blockers should be avoided in overt cardiac failure, acebutolol can be used with caution in patients with a history of heart failure who are controlled with digitalis and/or diuretics; both digitalis and acebutolol impair AV conduction; if cardiac failure persists, therapy should be withdrawn
In patients with aortic or mitral valve disease or compromised left ventricular function, continued depression of myocardium with β-blocking agents over a period of time may lead to cardiac failure; at first signs of failure, patients should be digitalized and/or be given a diuretic and response observed closely; if cardiac failure continues despite adequate digitalization and/or diuretic, acebutolol therapy should be withdrawn
Treatment with β-antagonists reduces cardiac output and can precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral or mesenteric vascular disease; exercise caution with such patients, and observe closely for evidence of progression of arterial obstruction
Chronically administered β-blocking therapy should not be routinely withdrawn prior to major surgery; however, impaired ability of the heart to respond to reflex adrenergic stimuli may augment risks of general anesthesia and surgical procedures
Beta-blockers may potentiate insulin-induced hypoglycemia and mask some of its manifestations such as tachycardia; however, dizziness and sweating are usually not significantly affected; patients with diabetes should be warned of possibility of masked hypoglycemia
Beta-adrenergic blockade may mask certain clinical signs (tachycardia) of hyperthyroidism; abrupt withdrawal of β-blockade may precipitate a thyroid storm; therefore, patients suspected of developing thyrotoxicosis from whom this drug is to be withdrawn should be monitored closely
Bronchospastic disease
- In general, patients with bronchospastic disease should not receive a β-blocker; because of its relative β1-selectivity, however, low doses of this drug may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate, alternative treatment
- Since β1-selectivity is not absolute and is dose-dependent, the lowest possible dose should be used initially, preferably in divided doses to avoid higher plasma levels associated with longer dose-interval; a bronchodilator, such as theophylline or a β2-stimulant, should be made available in advance with instructions concerning its use
Impaired renal or hepatic function
- Studies on effect of this drug in patients with renal insufficiency have not been performed in the US; foreign published experience shows that it has been used successfully in chronic renal insufficiency
- Acebutolol is excreted through GI tract, but the active metabolite, diacetolol, is eliminated predominantly by the kidney; there is a linear relationship between renal clearance of diacetolol and creatinine clearance
- Therefore, the daily dose of acebutolol should be reduced by 50% when creatinine clearance is less than 50 mL/min and by 75% when it is less than 25 mL/min; acebutolol should be used cautiously in patients with impaired hepatic function
- This drug has been used successfully and without problems in elderly patients in the US clinical trials without specific adjustment of dosage; however, elderly patients may require lower maintenance doses because the bioavailability of both Acebutolol and its metabolite are approximately doubled in this age group
Exacerbation of ischemic disease following withdrawal
- Following abrupt cessation of therapy with certain β-blocking agents in patients with coronary artery disease, exacerbation of angina pectoris and, in some cases, myocardial infarction and death reported; such patients should be cautioned against interruption of therapy without a physician’s advice
- Even in absence of overt ischemic heart disease, when discontinuation of the drug is planned, the patient should be carefully observed and should be advised to limit physical activity to a minimum while the drug is gradually withdrawn over a period of about two weeks (if therapy with an alternative β-blocker desired, patient may be transferred directly to comparable doses of another agent without interruption of β-blocking therapy)
- If exacerbation of angina pectoris occurs, antianginal therapy should be restarted immediately in full doses and patient hospitalized until condition stabilizes
Pregnancy & Lactation
Pregnancy Category: B; D in 2nd and 3rd trimesters (expert analysis). Neonates of mothers who have received acebutolol during pregnancy have reduced birth weight, decreased blood pressure, and decreased heart rate.
Lactation: excreted into milk/not recommended
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
Cardioselective for beta-1 at low doses; has intrinsic sympathomimetic activity, ie, can lower BP with less decrease in HR
Class 2 antiarrhythmic
Pharmacokinetics
Peak Plasma Time: 2-3 hr
Toxic range: acetabutalol >15-20 mcg/mL, & diacetolol (the active metabolite) < 90-150 mcg/mL
Onset: 1.5-3 hr (initial response); 3-8 hr (peak response)
Duration: 12-24 hr
Bioavailability: 40%
Absorption: 40% (oral)
Protein Bound: 10-26%
Vd: 1.2 L/kg
Metabolism: metabolized in the liver to active met, diacetolol
Metabolites: diacetolol (active), free amine of acebutolol (inactive)
Excretion: principally in feces 56%, urine 30-40%, bile 3-8%
Dialyzable: Yes (HD)
Less effective than thiazide diuretics in black and geriatric patients Shown to decrease mortality in hypertension and post-myocardial infarction
Half-Life
- Parent drug (acebutalol): 3-4 hr
- Active metabolite (diacetolol): 8-13 hr
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| acebutolol oral - | 400 mg capsule |  | |
| acebutolol oral - | 400 mg capsule |  | |
| acebutolol oral - | 200 mg capsule |  | |
| acebutolol oral - | 200 mg capsule |  | |
| acebutolol oral - | 400 mg capsule |  | |
| acebutolol oral - | 200 mg capsule |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
acebutolol oral
ACEBUTOLOL - ORAL
(A-se-BUE-toe-lol)
COMMON BRAND NAME(S): Sectral
WARNING: Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Get medical help right away if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.
USES: Acebutolol is used to treat high blood pressure and irregular heartbeat (arrhythmia). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Treating irregular heartbeat helps the heart work better and with less strain. Irregular heartbeats can be serious and may sometimes even lead to a heart attack.This medication belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers heart rate, blood pressure, and strain on the heart.
HOW TO USE: See also Warning section.Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Tell your doctor if your condition does not improve or if it worsens (for example, if your routine blood pressure readings remain high or increase).
SIDE EFFECTS: See also Warning and Precautions sections.Tiredness, dizziness, lightheadedness, nausea, upset stomach, slow heartbeat, or trouble sleeping may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: symptoms of asthma (for example, feelings of tightness in the chest, shortness of breath, cough, wheezing), blue fingers/toes, fainting, very slow heartbeat, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as confusion, depression, memory problems), vision changes, symptoms of liver disease (such as nausea that doesn't stop, dark urine, vomiting, stomach/abdominal pain, yellowing eyes/skin).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking acebutolol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood circulation problems (such as Raynaud's disease, peripheral vascular disease), breathing problems (such as asthma, chronic bronchitis, emphysema), heart problems (such as heart failure, previous heart attack, heart rhythm problems), kidney problems, liver problems, mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis), overactive thyroid disease (hyperthyroidism), serious allergic reactions, including those needing treatment with epinephrine.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This product may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). The risk is higher if you have diabetes, or are vomiting, fasting, or not eating regularly. Other symptoms of low blood sugar level, such as dizziness and sweating, are not affected by this drug.If you have diabetes, this product may make it harder to control your blood sugar levels. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia) while using this drug, especially if they are vomiting or not eating regularly. To help prevent low blood sugar, make sure children eat regularly. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, shaking), tell the doctor right away.During pregnancy, this medication should be used only when clearly needed. Babies born to mothers taking this drug during pregnancy may have a low birth weight and require monitoring for problems such as low blood pressure and slow heartbeat. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: fingolimod.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: unusually slow heartbeat, fainting, severe weakness.
NOTES: Do not share this medication with others.Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Check your blood pressure and pulse (heart rate) regularly while taking this medication. Learn how to check your blood pressure and pulse at home, and share the results with your doctor.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised April 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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