Acebutolol


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO HTN Initial: 400 mg once daily or 200 mg bid. If necessary, may increase dose after 2 wk to 400 mg bid. Max: 1.2 g/day in divided doses. Angina pectoris 400 mg once daily or 200 mg bid up to 300 mg tid. Max: 1.2 g/day in divided doses. Cardiac arrhythmias Initial: 200 mg bid, may increase according to patient's response. Max: 1.2 g/day in divided doses.
Dosage Details
Oral
Hypertension
Adult: Initially, 400 mg once daily or 200 mg bid. If necessary, may increase dose after 2 wk to 400 mg bid. Max: 1.2 g/day in divided doses.
Elderly: Lower maintenance dose. Avoid doses >800 mg/day.

Oral
Cardiac arrhythmias
Adult: Initially, 200 mg bid, may increase according to patient's response. Max: 1.2 g/day in divided doses.
Elderly: Lower maintenance dose. Avoid doses >800 mg/day.

Oral
Angina pectoris
Adult: 400 mg once daily or 200 mg bid up to 300 mg tid. Max: 1.2 g/day in divided doses.
Elderly: Lower maintenance dose. Avoid doses >800 mg/day.
Renal Impairment
CrCl Dosage
<25 Reduce dose by 75%.
25-50 Reduce dose by 50%.
Administration
May be taken with or without food.
Contraindications
Cardiogenic shock, 2nd and 3rd degree AV block, severe bradycardia, sick sinus syndrome, uncontrolled heart failure, severe asthma or COPD, metabolic acidosis, severe peripheral circulatory disease, untreated phaeochromocytoma.
Special Precautions
1st degree AV block. May mask symptoms of hyperthyroidism and hypoglycaemia. Patients w/ myasthenia gravis, DM. May aggravate psoriasis. Avoid abrupt withdrawal as it may precipitate thyroid storm or MI, and may exacerbate angina and ventricular arrhythmias. Patients undergoing surgery involving general anaesth. Hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Fatigue, dizziness, headache, insomnia, mental depression, nightmare, anxiety, hyperesthesia or hypoesthesia. Constipation, diarrhoea, nausea, vomiting, flatulence, dyspepsia, abdominal pain, dry mouth, thirst, epigastric distress, anorexia. Dyspnoea, cough, pharyngitis, rhinitis, shortness of breath, bronchospasm, asthma. Urinary frequency, nocturia, dysuria, impotence. Rash, pruritus, sweating, reversible alopecia. Abnormal vision, sore or gritty eyes, conjunctivitis, tinnitus. Myalgia, arthralgia, lupus erythematosus-like syndrome, hypersensitivity pneumonitis, pulmonary granulomas, pleuropulmonary fibrosis, pleurisy. Reversible alterations in LFT results; dark urine, fever, malaise.
Patient Counseling Information
May affect ability to drive or engaging in tasks that require alertness.
MonitoringParameters
Monitor BP, heart rate, ECG and blood glucose.
Overdosage
Symptoms: Excessive bradycardia or hypotension, pulmonary oedema, cardiogenic shock, AV block, conduction defects, bronchospasm, depressed level of consciousness, hypoglycaemia and rarely hyperkalaemia. Management: Induce emesis or perform gastric lavage for acute ingestion. Admin IV atropine sulfate for severe bradycardia, followed by slow IV inj of isoprenaline if initial admin of atropine sulfate is insufficient; vasopressors may be used for severe hypotension despite correction of bradycardia, diazepam can be used for seizures; for cardiac failure, a cardiac glycoside and diuretic. Glucagon may also be useful for myocardial depression and hypotension. A β-adrenergic agonist and/or a theophylline derivative may be used for bronchospasm. Haemodialysis may be useful in enhancing elimination.
Drug Interactions
Additive effect w/ reserpine. Antagonises β-adrenergic stimulating effect of sympathomimetic agents. Additive negative effect on SA or AV nodal conduction w/ cardiac glycosides, nondihydropyridine Ca channel blockers. Reduced hypotensive effect w/ NSAIDs.
Action
Description: Acebutolol is a cardioselective β-blocker w/ little effect on the bronchial receptors. It exhibits some intrinsic sympathomimetic activity and membrane-stabilising properties.
Onset: 1-2 hr.
Duration: 12-24 hr.
Pharmacokinetics:
Absorption: Well absorbed from the GI tract. Bioavailability: Approx 40%. Time to peak plasma concentration: Approx 2 hr (acebutolol); approx 4 hr (diacetolol).
Distribution: Widely distributed, crosses the placenta, enters breast milk and minute amounts penetrate into CSF. Volume of distribution: 1.2 L/kg. Plasma protein binding: Approx 26%.
Metabolism: Undergoes extensive first-pass effect to diacetolol (active metabolite).
Excretion: Via faeces (50-60%); urine (30-40%). Plasma elimination half-life: 3-4 hr (acebutolol); 8-13 hr (diacetolol).
Storage
Store between 20-25°C. Protect from light.
MIMS Class
ATC Classification
C07AB04 - acebutolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
References
Anon. Acebutolol Hydrochloride. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 02/12/2013.

Anon. Acebutolol. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/12/2013.

Buckingham R (ed). Acebutolol. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/12/2013.

Joint Formulary Committee. Acebutolol. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/12/2013.

Sectral Tablet. U.S. FDA. https://www.fda.gov/. Accessed 02/12/2013.

Disclaimer: This information is independently developed by MIMS based on Acebutolol from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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