II. Indications
- Hypertension
- Migraine Prophylaxis
- Atrial Fibrillation Rate Control
- Angina
- Esophageal Varices Prevention of Recurrent Bleeding
III. Mechanism
- Nonselective Beta Blocker (Beta-1 and Beta-2 Adrenergic Blockade)
IV. Dosing
- Dose: 40 mg orally daily
- Target: 40 to 80 mg/day
- Maximum 240 mg/day (Angina, Migraines, Atrial Fibrillation) to 320 mg/day (Hypertension)
- Renal Dysfunction
- Start 20 mg orally daily
- Decrease dosing frequency with Renal Insufficiency
- Creatinine Clearance 31 to 50 ml/min: Take every 24 to 36 hours
- Creatinine Clearance 10 to 30 ml/min: Take every 24 to 48 hours
- Creatinine Clearance <10 ml/min: Take every 40 to 60 hours
V. Adverse Effects
- See Beta Blocker
VI. Metabolism
- Not lipophilic
- Renal excretion
- Long Half life
VII. Safety
- Pregnancy Category C
- Avoid in Lactation
VIII. Resources
IX. References
- (2019) Presc Lett, Resource #350503, Comparison of Oral Beta Blockers
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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