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Beta Blockers
atenolol (Tenormin ® ) |
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Receptor(s) affected: ß1 Selective. Dosing (Adults): Hypertension: Oral: 25-50 mg once daily, may increase to 100 mg/day. Doses >100 mg are unlikely to produce any further benefit. I.V.: Dosages of 1.25 to 5 mg every 6-12 hours have been used in short-term management of patients unable to take oral tabs. Angina: Oral: 50 mg once daily; may increase to 100 mg/day. Some patients may require 200 mg/day. Post MI: I.V.: Early treatment: 5 mg slow I.V. over 5 minutes; may repeat in 10 minutes. If both doses are tolerated, may start oral atenolol 50 mg every 12 hours or 100 mg/day for 6-9 days postmyocardial infarction. Oral: Follow I.V. dose with 100 mg/day or 50 mg twice daily for 6 to 9 days postmyocardial infarction. [Supplied: 25, 50, 100mg tablets. Injection: 10ml (0.5mg/ml) ] |
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betaxolol (Kerlone ®) |
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Receptor(s) affected: ß1 Dosing (Adults): Initially: 5-10 mg orally once daily. Maximum: 20 mg/day. [Supplied: 10, 20mg tablet] |
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bisoprolol (Zebeta ®) |
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Receptor(s) affected: ß1 Dosing (Adults): Initially: 2.5 to 5 mg orally once daily. Maximum dose: 20 mg/day. [Supplied: 5, 10 mg tablets] |
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carvedilol (Coreg ®, Coreg CR™) |
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Receptor(s) affected: ß1,ß2, alpha.
Admin: Administer with food. Extended release capsules should
not be crushed or chewed. Capsules may be opened and sprinkled on
applesauce for immediate use. Dosing (Adults): CHF: Immediate release: 3.125 mg twice daily for 2 weeks; if this dose is tolerated, may increase to 6.25 mg twice daily. Double the dose every 2 weeks to the highest dose tolerated by patient. (Prior to initiating therapy, other heart failure medications should be stabilized and fluid retention minimized.) Maximum recommended dose: Mild-to-moderate heart failure: <85 kg: 25 mg twice daily. >85 kg: 50 mg twice daily. Severe heart failure: 25 mg twice daily. Extended release: Initial: 10 mg once daily for 2 weeks; if the dose is tolerated, increase dose to 20 mg, 40 mg, and 80 mg over successive intervals of at least 2 weeks. Maintain on lower dose if higher dose is not tolerated. Hypertension: Immediate release: 6.25 mg twice daily; if tolerated, dose should be maintained for 1-2 weeks, then increased to 12.5 mg twice daily. Dosage may be increased to a maximum of 25 mg twice daily after 1-2 weeks. Maximum dose: 50 mg/day. Extended release: Initial: 20 mg once daily, if tolerated, dose should be maintained for 1-2 weeks then increased to 40 mg once daily if necessary; maximum dose: 80 mg once daily. Left ventricular dysfunction following MI: Oral: Note: Should be initiated only after patient is hemodynamically stable and fluid retention has been minimized. Immediate release: Initial 3.125-6.25 mg twice daily; increase dosage incrementally (ie, from 6.25-12.5 mg twice daily) at intervals of 3-10 days, based on tolerance, to a target dose of 25 mg twice daily. Extended release: Initial: 20 mg once daily; increase dosage incrementally at intervals of 3-10 days. Target dose: 80 mg once daily. Conversion from immediate release to extended release: Current dose immediate release tablets 3.125 mg twice daily: Convert to extended release capsules 10 mg once daily. Current dose immediate release tablets 6.25 mg twice daily: Convert to extended release capsules 20 mg once daily. Current dose immediate release tablets 12.5 mg twice daily: Convert to extended release capsules 40 mg once daily. Current dose immediate release tablets 25 mg twice daily: Convert to extended release capsules 80 mg once daily. [Supplied: 3.125 mg, 6.25 mg, 12.5 mg, 25 mg tablets. Extended release capsule: 10 mg, 20 mg, 40 mg, 80 mg ] |
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esmolol (Brevibloc ®) |
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Receptor(s) affected: ß1 Dosing (Adults): Intraoperative tachycardia and/or hypertension (immediate control): IV: Initial bolus: 80 mg (~1 mg/kg) over 30 seconds, followed by a 150 mcg/kg/minute infusion, if necessary. Adjust infusion rate as needed to maintain desired heart rate and/or blood pressure, up to 300 mcg/kg/minute. For control of postoperative hypertension, as many as one-third of patients may require higher doses (250-300 mcg/kg/minute) to control blood pressure; the safety of doses >300 mcg/kg/minute has not been studied. Supraventricular tachycardia or gradual control of postoperative tachycardia/hypertension: IV: Loading dose: 500 mcg/kg over 1 minute; follow with a 50 mcg/kg/minute infusion for 4 minutes; response to this initial infusion rate may be a rough indication of the responsiveness of the ventricular rate. Infusion may be continued at 50 mcg/kg/minute or, if the response is inadequate, titrated upward in 50 mcg/kg/minute increments (increased no more frequently than every 4 minutes) to a maximum of 200 mcg/kg/minute. Note: To achieve more rapid response, following the initial loading dose and 50 mcg/kg/minute infusion, rebolus with a second 500 mcg/kg loading dose over 1 minute, and increase the maintenance infusion to 100 mcg/kg/minute for 4 minutes. If necessary, a third (and final) 500 mcg/kg loading dose may be administered, prior to increasing to an infusion rate of 150 mcg/minute. After 4 minutes of the 150 mcg/kg/minute infusion, the infusion rate may be increased to a maximum rate of 200 mcg/kg/minute (without a bolus dose). Supraventricular tachycardias (SVT); usual dose range: Usual dosage range: 50-200 mcg/kg/minute with average dose of 100 mcg/kg/minute. Onset of action: Beta-blockade: I.V.: 2-10 minutes (quickest when loading doses are administered)
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labetalol (Normodyne ®) |
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Receptor(s) affected: ß1,ß2, alpha Dosing (Adults): Oral: initial: 100 mg orally twice a day. Usual: 200-400mg orally twice a day. Maximum: 2400 mg/day. Hypertensive emergency: 20mg IV slow injection, then 40-80 mg IV every 10 minutes as needed. (up to 300 mg total dose) until desired BP is reached or start continuous infusion: 2 mg/min (range: 1 to 3 mg/min)--titrate to BP. [Supplied: 100, 200, 300mg tablets; 5 mg/ml--20ml vial] |
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metoprolol (Lopressor ®) |
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Receptor(s) affected: ß1 Dosing (Adults): Acute MI: 5 mg IV q5-15min up to 15 mg, followed by 50mg orally every 6 hours x 48 hours. Hypertension: Initially 25 to 50mg orally twice a day. Maximum: 450 mg/day. (Toprol XL): initially 50-100mg orally once daily. Maximum: 400mg/day. |
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nadolol (Corgard ®) |
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Receptor(s) affected: ß1,ß2 Dosing (Adults): (Hypertension / angina): Initially 20-40mg orally once daily. Maximum: 320mg/day. [Supplied: 20, 40, 80, 120, 160mg tablets] |
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pindolol (Visken ®) |
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Receptor(s) affected: ß1,ß2, ISA Dosing (Adults): Start 5 mg orally twice a day . Increase as necessary by 10 mg/day every 3-4 weeks. Maximum of 60mg/day. [Supplied: 5, 10mg tablet] |
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propranolol (Inderal ®) |
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Receptor(s) affected: ß1,ß2 Dosing (Adults): Initially 20-40 mg orally twice a day. Maximum 640 mg/day. Angina: 80-320 mg/day in 2 to 4 divided doses. Inderal LA: Start 80 mg orally once daily. IV : Life-threatening arrhythmia: usually 1- 3 mg (maximum rate: 1 mg/min)-may dilute in D5W-50ml. May repeat 1 mg dose q5 minutes to maximum of 5 mg total. Subsequent doses no sooner than 4 hours. May start IV infusion: usual rate: 2 to 3 mg/hr. Titrate to HR/BP. |
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sotalol (Betapace ®) |
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Receptor(s) affected: ß1,ß2 Dosing (Adults): Ventricular arrythmias: initially 80mg orally twice a day. Usual maintenance dose: 160-320mg/day in 2 to 3 divided doses. [Supplied: 80,120,160,240mg tablets] |
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timolol (Blocadren ®) |
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Receptor(s) affected: ß1,ß2 Dosing (Adults): Start 10 mg orally twice a day. Usual dosage: 20-40 mg/day. Maximum: 60 mg/day. [Supplied: 5, 10, 20mg tablet] |
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Listed dosages are for - Adult patients ONLY. PLEASE READ THE
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GlobalRPH does not directly or indirectly practice medicine or provide
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kind for the information and data accessed through the Service or for
any diagnosis or treatment made in reliance thereon. David F. McAuley, Pharm.D., R.Ph. GlobalRPh Inc. |
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