Symptomatic treatment of chronic stable angina pectoris in CAD adults w/ normal sinus rhythm & heart rate ≥70 bpm, who are unable to tolerate or w/ contraindication to the use of β-blockers; or in combination w/ β-blockers in patients inadequately controlled w/ an optimal β-blocker dose. Chronic heart failure (NYHA II-IV) w/ systolic dysfunction in combination w/ standard therapy including β-blocker therapy, or when β-blocker is contraindicated or not tolerated in patients in sinus rhythm & whose heart rate is ≥75 bpm.
CAD Initially 5 mg bd, may be increased to 7.5 mg bd after 3-4 wk depending on the therapeutic response. Titrate dose downward or 2.5 mg bd if heart rate is <50 bpm or symptoms of bradycardia is present. Chronic heart failure Initially 5 mg bd, may be increased to 7.5 mg bd after 2 wk if resting heart rate is >60 bpm. If heart rate is between 50-60 bpm, 5 mg bd should be maintained. Elderly ≥75 yr 2.5 mg bd.
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