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  • Type: beta blocker
  • Dosage Forms:
  • Routes of Administration: PO
  • Common Trade Names:

Adult Dosing

  • 40-160mg PO daily

Pediatric Dosing

Special Populations

Pregnancy Rating

  • C

Lactation risk

  • Excreted in breastmilk. AAP says compatible with breastfeeding[1]

Renal Dosing

  • CrCl 31-50 mL/min: Give q24-36hr
  • CrCl 10-30 mL/min: Give q24-48hr
  • CrCl <10 mL/min: Give q40-60hr===Hepatic Dosing===


  • Allergy to class/drug
  • Overt cardiac failure, 2°/3° heart block, cardiogenic shock
  • Asthma/COPD
  • Avoid during breastfeeding
  • Sinus bradycardia
  • Sick sinus syndrome without permanent pacemaker
  • Caution if:
    • Nonallergenic bronchospasm
    • Cerebrovascular insufficiency
  • Well-compensated CHF
  • DM
    • Hyperthyroidism/thyrotoxicosis
    • Liver disease
    • Renal impairment
    • Peripheral vascular disease
    • Planned surgery
    • Pheochromocytoma
    • Abrupt cessation may lead to worsened angina and myocardial infarction

Adverse Reactions


  • Bronchospasm
  • Hypotension


  • Drowsiness, insomnia
  • Decreased sexual ability
  • Bradycardia
  • Dizziness, fatigue
  • Hypotension
  • Abdominal discomfort, constipation, diarrhea, nausea
  • Cough, nasal congestion
  • Bronchospasm
  • Depression
  • Decreased exercise tolerance
  • Raynaud's phenomenon
  • Increased triglycerides and insulin resistance, decreased HDL

May increase triglyceride levels and insulin resistance, and decrease HDL levels


  • Half-life: 10-24h
  • Metabolism: none
  • Excretion: urine

Mechanism of Action

  • Blocks response to beta-adrenergic stimulation to beta1 and beta2 receptors; may reduce portal pressure through beta2 receptor, which reduces portal blood flow


See Also