Indications: hypertension; angina; adjunct to diuretics, digoxin or ACE-inhibitors in symptomatic chronic heart failure.

Cautions: unstable angina; reduced performance of the heart; recent heart attack; impaired renal function. (see Propranolol).

Contra-indications: severe chronic heart failure, constrictive respiratory tract diseases; allergic rhinitis (see Propranolol).

Side Effects: postural hypotension, dizziness, headache, GI disturbances, bradycardia; occasionally diminished peripheral circulation; peripheral oedema, and painful extremities; dry mouth, dry eyes, eye irritation, or disturbed vision; impotence, disturbances of micturition, influenza like symptoms, rarely angina, AV block, exacerbation of intermittent claudification or Raynaud’s phenomenon; allergic skin reactions, exacerbation of psoriasis; nasal stuffiness, wheezing, depressed mood, sleep disturbances, paraesthesia, heart failure, changes in liver enzymes; thrombocytopenia, leucopenia.

Dose: hypertension, initially 12.5 mg once daily increased after 2 days to 25 mg once daily. Max. daily dose is 50 mg. Elderly may require much lower dosage, usually 12.5mg once daily.

Angina, initially 12.5 mg twice daily increased after 2 days up to 25 mg twice daily.

Heart failure, initially 3.125 mg twice daily increased at intervals of 2 weeks to 6.25 mg twice daily then 25 mg twice daily.

Max. 50 mg twice daily in patients over 85 kg body weight.