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Indication & Dosage |
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| Oral |
| MIGRAINE PROPHYLAXIS |
| Adult:
As maleate: 10-20 mg daily in 1-2 divided doses. Max: 30 mg daily. |
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| Oral |
| ANGINA PECTORIS |
| Adult:
As maleate: 5 mg bid, increased every 3 or more days to not > 10 mg daily. Maintenance: 35-45 mg daily in divided doses. Max: 60 mg daily. |
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| Oral |
| HYPERTENSION |
| Adult:
As maleate: 10 mg daily, increased according to response every 7 or more days. Maintenance: 10-40 mg/day in single or 2 divided doses. Max: 60 mg daily. Doses >30 mg should be given in 2 divided doses. |
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| Oral |
| POST MYOCARDIAL INFARCTION |
| Adult:
As maleate: Initially, 5 mg bid for 2 days, starting 1-4 wk after MI, increased up to 10 mg bid, if necessary. |
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| Ophthalmic |
| REDUCTION OF INTRAOCULAR PRESSURE IN OPEN-ANGLE GLAUCOMA AND OCULAR HYPERTENSION |
| Adult:
Eye drop: Initially, instil 1 drop of 0.25% solution bid, increased to 0.5% solution if there is inadequate response; decrease to 1 drop daily if controlled. Gel-forming eyedrop: Instil 1 drop of 0.25% or 0.5% preparation in affected eyes once daily. |
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| Administration |
Should be taken with food. |
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| Precautions |
Due to systemic absorption, side effects associated with β-blockers may occur. Heart block, cerebrovascular insufficiency, myasthenia gravis. May mask signs of hypoglycaemia, hyperthyroidism. Abrupt withdrawal may precipitate thyroid storm in patients suspected of developing thyrotoxicosis. Avoid sudden withdrawal in patients with ischaemic heart disease. |
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Potentially Life-threatening
Adverse Drug Reactions |
Fatigue, coldness of extremities, paraesthesia, GI symptoms, skin rash, alopecia, dry mouth, bradycardia. Ophthalmic use: Blurred vision, burning, stinging, ocular irritation, decreased corneal sensitivity, visual disturbances, diplopia, ptosis, cystoid macular oedema, pseudopemphigoid, choroidal detachment following filtration surgery. Systemic absorption with systemic effects may occur. |
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| Adverse Drug Reactions |
Heart failure, heart block, bronchospasm, respiratory failure. |
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| Interactions |
Hypotensive action may be reduced by NSAIDs. Increased hypotensive effect of antihypertensives, aldesleukin, general anaesthetics, catecholamine-depleting drugs e.g. reserpine. Increased risk of bradycardia with digoxin. Decreased response to sympathomimetics. Increased timolol levels with CYP2D6 inhibitors e.g. quinidine. Increased risk of prolongation of AV conduction with calcium-channel blockers and digoxin. May exacerbate rebound hypertension following discontinuance of clonidine. Additive effects on β-blockade with other β-blockers. |
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