Nadolol


Thông tin thuốc gốc
Chỉ định và Liều dùng
Oral
Angina pectoris
Adult: Initially, 40 mg once daily. Doses may be increased gradually at weekly intervals until an adequate response is achieved. Usual maintenance dose: 40 mg or 80 mg once daily. Max: 160 mg or 240 mg once daily.
Elderly: Initiate at the lower end of the dosing range.

Oral
Cardiac arrhythmias
Adult: Initially, 40 mg once daily. Doses may be increased to 160 mg once daily if needed. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initiate at the lower end of the dosing range.

Oral
Hypertension
Adult: Initially, 40-80 mg once daily. Doses may be increased weekly by 40-80 mg increments according to response. Max: 240 mg or 320 mg once daily.
Elderly: Initiate at the lower end of the dosing range.

Oral
Prophylaxis of migraine
Adult: Initially, 40 mg once daily. Doses may be increased gradually in 40 mg increments according to response. Usual maintenance dose: 80-160 mg once daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initiate at the lower end of the dosing range.

Oral
Hyperthyroidism
Adult: As an adjunct to conventional therapy: 80-160 mg once daily. Treatment recommendations may vary among countries and individual products (refer to specific product guidelines).
Elderly: Initiate at the lower end of the dosing range.
Suy thận
Dose adjustment may be required.
Cách dùng
May be taken with or without food.
Chống chỉ định
Bronchial asthma or history of asthma, sinus bradycardia, heart block greater than 1st degree, cardiogenic shock, right ventricular failure secondary to pulmonary hypertension, overt cardiac failure.
Thận trọng
Patient with compensated heart failure, history of severe anaphylaxis to allergens, conduction abnormality (e.g. sick sinus syndrome), diabetes mellitus, myasthenia gravis, peripheral vascular disease, Raynaud's disease, untreated phaeochromocytoma. Not for use in patients with bronchospastic disease. Patient undergoing surgery. Avoid abrupt withdrawal. Renal and hepatic impairment. Elderly. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: Hypersensitivity to catecholamines (following treatment withdrawal); exacerbation of angina, hypertension, MI (following abrupt withdrawal); ocular changes (e.g. conjunctivitis and dry eye); induced thyroid storm (following abrupt withdrawal in thyroid patients), mask signs of hyperthyroidism; cardiac failure; may potentiate hypoglycaemia and/or mask signs and symptoms; induction or exacerbation of psoriasis.
Cardiac disorders: Bradycardia, rhythm or conduction disturbances, palpitation.
General disorders and administration site conditions: Fatigue, cold extremities, oedema.
Nervous system disorders: Dizziness, drowsiness.
Psychiatric disorders: Insomnia.
Vascular disorders: Hypotension, symptoms of peripheral vascular insufficiency (usually of Raynaud's type).
Chỉ số theo dõi
Monitor heart rate, blood pressure; signs and symptoms of exacerbation of angina (when discontinued).
Quá liều
Symptoms: Excessive bradycardia, cardiac failure, hypotension, bronchospasm, transitory increase in BUN, serum electrolyte changes. Management: Symptomatic and supportive treatment. Perform gastric lavage or haemodialysis. Administer atropine (0.25-1 mg) for excessive bradycardia; if no response to vagal blockade, administer isoprenaline cautiously. Administer digitalis glycoside and diuretic for cardiac failure; glucagon may also be useful. Administer fluid for hypotension but if ineffective, give vasopressors (e.g. dopamine, epinephrine, dobutamine). Administer β2-agonists and/or theophylline derivative for bronchospasm.
Tương tác
May increase the risk of protracted severe hypotension with myocardial depressants (e.g. lidocaine, procainamide) and general anaesthetics that cause myocardial depression (e.g. chloroform, cyclopropane, trichloroethylene, ether). Reversed hypotensive effects and increased vasoconstrictor activity with β-adrenoreceptor stimulants (e.g. isoprenaline, verapamil, norepinephrine, epinephrine). Additive effects with catecholamine-depleting drugs, antihypertensives, phenothiazine, haloperidol, ergot alkaloids. May increase the risk of bradycardia with MAOIs, fingolimod. Potentiated effects with Ca channel blockers. May increase the risk of depression with diltiazem. May cause additive or antagonistic effects with other antiarrhythmics. May increase serum concentration of lidocaine. May have reduced antihypertensive effects with indometacin and other NSAIDs.
Ảnh hưởng đến kết quả xét nghiệm
Significantly affects the accuracy of all types of stress tests.
Tác dụng
Description:
Mechanism of Action: Nadolol is a non-selective β-adrenergic blocker that competitively blocks response to β1- and β2-adrenergic stimulation. It decreases portal pressure by producing splanchnic vasoconstriction thereby reducing portal blood flow. Additionally, it does not exhibit any membrane stabilising or intrinsic sympathomimetic activity.
Duration: 17-24 hours.
Pharmacokinetics:
Absorption: Incompletely absorbed from the gastrointestinal tract. Time to peak plasma concentration: Approx 3-4 hours.
Distribution: Widely distributed. Enters the breast milk. Volume of distribution: Approx 2 L/kg. Plasma protein binding: Approx 30%.
Metabolism: Not metabolised.
Excretion: Via urine (as unchanged drug). Elimination half-life: 20-24 hours.
Đặc tính

Chemical Structure Image
Nadolol

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 39147, Nadolol. https://pubchem.ncbi.nlm.nih.gov/compound/39147. Accessed July 26, 2022.

Bảo quản
Store below 25°C. Protect from light.
Phân loại MIMS
Thuốc chẹn thụ thể bêta
Phân loại ATC
C07AA12 - nadolol ; Belongs to the class of non-selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
Tài liệu tham khảo
Anon. Nadolol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/06/2022.

Apotex NZ Ltd. Apo-Nadolol 40 mg and 80 mg Tablets data sheet 16 June 2017. Medsafe. http://www.medsafe.govt.nz. Accessed 09/06/2022.

Buckingham R (ed). Nadolol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/06/2022.

Corgard Tablet (USWM, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 09/06/2022.

Joint Formulary Committee. Nadolol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/06/2022.

Nadolol 80 mg Tablets (Neon Healthcare Ltd). MHRA. https://products.mhra.gov.uk. Accessed 09/06/2022.

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