Pindolol

Oral
Hypertension

Oral
Angina pectoris

May be taken with or without food. May be taken w/ meals to reduce GI discomfort.

AV block (2nd and 3rd degree), severe bradycardia, sick sinus syndrome, cardiogenic shock, overt cardiac failure, metabolic acidosis, peripheral circulatory disease, Prinzmetal's angina, prolonged fasting, untreated phaechromocytoma, obstructive pulmonary disease, severe renal failure. History of cor pulmonale, bronchospasm or bronchial asthma. Concomitant use w/ thioridazine.

Patients w/ inadequate cardiac function, nonallergic bronchospasm. Avoid abrupt withdrawal as it may cause exacerbation of angina or precipitate MI or thyroid crisis. May mask symptoms of hyperthyroidism and hypoglycaemia. Patients undergoing major surgery requiring general anaesth. Renal and hepatic impairment. Pregnancy and lactation.

Bradycardia, hypotension, peripheral oedema, dyspnoea, wt gain, palpitation, claudication, coldness of extremities, syncope, tachycardia; dizziness, fatigue, insomnia, bizarre dreams, visual disturbances, paraesthesia, weakness, nervousness or anxiety, hallucination and lethargy; nausea and abdominal discomfort; muscle, leg or joint pain or cramps, chest pain; pruritus, rash, impotence; elevated AST and ALT.

PO: B

Monitor BP, heart rate and resp function.

Symptoms: Hypotension, symptomatic bradycardia, bronchospasm, acute cardiac failure. Management: Perform gastric lavage. Admin IV atropine sulfate and isoproterenol HCl cautiously for symptomatic bradycardia; epinephrine and norepinephrine for severe hypotension; cardiac glycoside and diuretic for heart failure; isoproterenol and theophylline derivative for bronchospasm.

May cause severe bradycardia w/ verapamil and diltiazem. May cause transient reduction in serum digoxin levels. May increase risk of hypotension and bradycardia w/ reserpine. May enhance hypotensive effect w/ hydralazine, hydrochlorothiazide, MAOIs. Hypotensive effects may be reduced w/ NSAIDs.
Potentially Fatal: May prolong QT interval and increase the risk of torsade de pointes w/ thioridazine.

Description: Pindolol is a non-cardioselective β-blocker w/ intrinsic sympathomimetic activity but little quinidine-like membrane-stabilising property.
Pharmacokinetics:
Absorption: Rapidly absorbed from the GI tract. Bioavailability: Approx 87%. Time to peak plasma concentration: Approx 1-2 hr.
Distribution: Crosses the placenta and enters breast milk. Volume of distribution: Approx 2 L/kg. Plasma protein binding: Approx 40-60%.
Metabolism: Undergoes partial hepatic metabolism (approx 60-65%) to hydroxylated metabolites.
Excretion: Via urine (approx 35-50% as unchanged drug) and faeces (6-9%). Elimination half-life: 3-4 hr.

Store between 15-30°C. Protect from light.

Beta-Blockers

Anon. Pindolol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 28/11/2013.

Buckingham R (ed). Pindolol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 28/11/2013.

Joint Formulary Committee. Pindolol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 28/11/2013.

McEvoy GK, Snow EK, Miller J et al (eds). Pindolol. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 28/11/2013.

Visken Tab (Novartis Pharmaceuticals Corporation). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 28/11/2013.