HTN & chronic stable angina pectorisAdult Initially 5 mg/day. Usual dose: 10 mg once daily. Max: 20 mg/day. Patient w/ renal impairment (CrCl <20 mL/min) Do not exceed 10 mg once daily. Stable CHF Titration phase: 1.25 mg once daily for 1 wk, if well tolerated increase to 2.5 mg once daily for a further wk, if well tolerated increase to 3.75 mg once daily for a further wk, if well tolerated increase to 5 mg once daily for the 4 following wk, if well tolerated increase to 7.5 mg once daily for the 4 following wk, if well tolerated increase to 10 mg once daily for maintenance therapy. Max: 10 mg once daily.
Should be taken with food: Should be taken w/ food in the morning. Swallow whole, do not chew.
Contraindications
Hypersensitivity. CHF patients w/ acute heart failure or during episodes of heart failure decompensation requiring IV inotropic therapy, cardiogenic shock, 2nd- or 3rd-degree AV block (w/o pacemaker), sick sinus syndrome, SA block; symptomatic bradycardia & hypotension; severe bronchial asthma or COPD; late stages of peripheral arterial occlusive disease & Raynaud's syndrome; untreated pheochromocytoma; metabolic acidosis.
Avoid abrupt w/drawal. Patients w/ HTN or angina pectoris & accompanying heart failure, DM showing large fluctuations in blood glucose values; Prinzmental's angina, peripheral arterial occlusive disease; strict fasting, on-going desensitization therapy, AV block of 1st degree. Symptoms of hypoglycemia can be masked. Cases of coronary vasospasm. Intensification of complaints may occur especially when starting therapy. General anesth. Pregnancy & lactation. Not recommended for childn. Elderly.
Dizziness, headache; GI complaints eg, nausea, vomiting, diarrhea, constipation; feeling of coldness or numbness in the extremities, hypotension, fatigue.
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