Management of HTN & angina pectoris. Adjunct to standard therapy in sympathomimetic heart failure. To reduce mortality in patients w/ left ventricular dysfunction after MI.
HTN Initially 12.5 mg once daily, increased to 25 mg once daily after 2 days. May be further increased to a max of 50 mg in single or divided doses at interval of at least 2 wk if necessary. Angina Initially 12.5 mg bid, increased to 25 mg bid after 2 days. Heart failure Initially 3.125 mg bid, increased to 6.25 mg bid after 2 wk, then to max: 50 mg bid in patient >85 kg & 25 mg bid in patient <85 kg. Left ventricular dysfunction after MI Initially 6.25 mg bid, increased if tolerated to 12.5 mg bid & then to a target dose: 25 mg bid after 3-10 days.
Patients w/ NYHA class IV decompensated cardiac failure. Bronchial asthma, 2nd or 3rd degree AV block, sick sinus syndrome, cardiogenic shock or severe bradycardia. Not to be initiated in severe heart failure. Not recommended in hepatic impairment.
Increased sensitivity to allergens & severity of anaphylactoid reactions. Not to be given to patients w/ bronchospasm or asthma or to those w/ history of obstructive airways disease; uncontrolled heart failure. Not to be given to patients w/ phaeochromocytoma w/o α-adrenoceptor blockers. 1st degree AV block. May block symptoms of hyperthyroidism & hypoglycaemia. May unmask myasthenia gravis. May aggravate psoriasis. May increase number of chest pain attacks in Prinzmetal's angina. Patients w/ poor cardiac reserve. Avoid abrupt w/drawal. W/draw 24 to 48 hr prior to surgery. May affect ability to drive & use machines. Pregnancy & lactation.
Sign Out
