Dosage- ADULTS- HTN: Initial: 50 mg qd. Titrate: may increase after 1-2 weeks. Max: 100 mg qd. Angina: Initial: 50 mg qd. Titrate: May increase to 100 mg after 1 week. Max: 200 mg qd. AMI: Initial: 5 mg IV over 5 min, repeat 10 mins later. If tolerated, give 50 mg PO 10 min after IV dose. Followed by another 50 mg PO 12 hours later. Maint: 100 mg qd or 50 mg bid for 6 to 9 days. Renal Impairment/Elderly: HTN: Initial: 25 mg qd. HTN/Angina/AMI: Max: CRCL 15-35 mL/ min: 50 mg/day CRCL< 15 mL/min: 25 mg/day. Hemodialysis: 25-50 mg after each dialysis.
Route: Oral Administration
Indications: Management of hypertension. Long term management of angina pectoris. Management of hemodynamically stable patients with definite or suspected Acute MI to reduce Cardiovascular mortality.
Contraindications: Sinus bradycardia, > 1st degree heart block, cardiogenic shock, overt cardiac failure.
Brand: Toprol XL, Lopressor
Dosage: Adults: individualized. For once-daily administration. HTN: Initial: 25-100 mg qd. Titrate: May increase weekly (or longer) intervals until optimum BP reduction is achieved. Max: 400 mg/day. Angina: Initial: 100 mg qd. Titrate: may increase weekly until optimum clinical response has been obtained or there is pronounced slowing of heart rate. Max: 400 mg/day. HF: Initial: (NYHA Class II) 25 mg qd for 2 weeks, Severe HF: 12.5 mg qd for 2 weeks. Titrate: Double dose every two weeks as tolerated. Max: 200 mg/day. Monitor during up-titration. Reduce dose if experiencing symptomatic bradycardia. Dose should not be increased until symptoms of worsening HF have been stabilized. Hepatic impairment: May require lower initial dose; gradually increase dosage to optimize therapy. Elderly: Start at low initial dose. Pediatrics > 6 yrs. HTN: Initial: 1 mg/kg qd up to 50 mg/day. Adjust dose according to BP response. Max: 2.0mg/kg qd.
Route: oral route. tabs are scored and may be divided, Whole or half-tab should be swallowed whole, not chewed or crushed.
Indications: Treatment of HTN; may be used alone or in combination with other antihypertensive agents. Long term treatment of angina pectoris, Treatment of stable symptomatic (NYHA Class II or III) heart failure (HF) of ischemic, hypertensive, or cardiomyopathic origin.
Contraindications: Severe bradycardia, 2nd-or 3rd-degree heart block cardiogenic shock, sick sinus syndrome (unless a pacemaker is present), decompensated cardiac failure.
Generic: Propranolol HCI
Dosage: Adults: HTN (Tab) Initial: 40 mg bid. Titrate: Increase gradually. Maint:120-240 mg/day. Angina: (Tab) 80-320 mg/day, given bid-qid. Arrhythmia: (inj) 1-3 mg IV at 1 mg/min. (Tab)
10-30 mg tid-qid ac and qhs. MI: (Tab) 180mg-240mg/day, given bid-tid. Migraine: (Tab) Initial: 80 mg/day in divided doses. Usual 160-240 mg/day in divided doses. Tremor: (Tab) Initial: 40 mg bid. Maint: 120 mg/day Max: 320/day. Hypertrophic Subaortic Stenosis: (Tab) 20-40 mg tid-qid, ac and qhs. Pheochromocytoma: (Tab) 60mg/day in divided doses for 3 days before surgery with a-blocker. Inoperable Tumor: (Tab) 30mg/day in divided doses.
Pediatrics: HTN (Tab): Initial: 1 mg/kg/day PO. Usual 1-2 mg/kg bid. Max: 16 mg/kg/day.
Indications: (Tab) Management of hypertension, angina pectoris, hypertrophic subaortic stenosis, atrial fibrillation, MI, and familial or hereditary essential tremor, Migraine prophylaxis. (inj/Tab) For cardiac arrhythmias (supraventricular, ventricular tachyarrhythmia of digitalis intoxication, resistant tachyarrhythmia), reduction of cardiovascular mortality post-MI, essential tremor, and pheochromocytoma.
Contraindications: Cardiogenic Shock, Sinus Bradycardia and > 1st-degree block, bronchial asthma, CHF (unless failure is secondary to tachyarrhythmia treatable with propranolol).
Route: Oral administration
Brand: Betapace, Sotalex
Dosage: Adults: Intitial: 80mg bid. Titrate: Increase to 120-160