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It is a competitive antagonist of the beta-adrenergic receptors. It has
high beta selectivity. There is no membrane-establising or partial agonist
action. Reduction in heart rate and blood pressure. Action lasts for 24
hrs.
INDICATIONS: Hypertension, Coronary artery disease.
DOSAGE: Start at 2.5 or 5mg/day and build up to 10-20mg/day. Dose reduction in severe renal impairment.
CONTRA-INDICATIONS: Bradycardia, second or third degree heart block, conduction abnormalities, congestive heart failure, chronic obstructive pulmonary disease, peripheral vascular insufficiency, pregnancy and lactation.
SPECIAL PRECAUTIONS: Poor L.V. function, bronchial asthma, diabetes, thyrotoxicosis, M.I. severe renal impairmen, abrupt withdrawal.
Paediatrics: not recommended.
Pregnancy: safety not established.
Lactation: use with caution.
Elderly: use with caution.
SIDE-EFFECTS: Giddiness, headache, fatigue, bradycardia, nausea, dyspnoea, sleepdisturbacnes, cold extremities, reduced libido.
DRUG INTERACTIONS: Enhances the action of anaesthetic agents, clonidine, calcium antagonists, hypolgycaemic agents & NSAIDs. Rifampicin cause reduction in plasma concentration & elimination half-life of drug.