Betaxolol Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Hypertension

Initial dose: 10 mg orally once a day.
Maintenance dose: May be increased to 20 mg orally once a day in 7 to 14 days. If the antihypertensive response is inadequate after another 7 to 14 days, the dose may be increased to 40 mg orally once a day.

Usual Adult Dose for Angina Pectoris Prophylaxis

Initial dose: 10 mg orally once a day.
Maintenance dose: May be increased to 20 mg orally once a day in 7 to 14 days. If the antianginal effect is inadequate after another 7 to 14 days, the dose may be increased to 40 mg orally once a day.

Renal Dose Adjustments

In patients with severe renal impairment, the initial dosage of betaxolol is 5 mg orally once daily. If the desired response is not achieved, dosage may be increased by 5 mg/day increments every 2 weeks to a maximum dose of 20 mg/day.

Liver Dose Adjustments

No adjustment recommended

Dose Adjustments

Increasing the dose beyond 20 mg has not been shown to produce a statistically significant additional antihypertensive effect.

Precautions

Betaxolol is contraindicated in patients with sinus bradycardia, second- or third-degree AV heart block (unless a functioning pacemaker is present), cardiogenic shock, and overt congestive heart failure.

Beta-adrenergic blocking drugs may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Patients suspected of developing thyrotoxicosis should be managed carefully to avoid abrupt discontinuation of beta-adrenergic blocking agents, which might precipitate a thyroid storm.

Beta-adrenergic blockade has been observed to potentiate muscle weakness consistent with certain myasthenic symptoms (e.g., diplopia, ptosis, and generalized weakness).

As with other beta-blockers, betaxolol should be used with caution, if at all, in patients with reactive airways disease (bronchial asthma or a history of bronchial asthma or obstructive pulmonary disease with bronchospasm), or severe obstructive pulmonary disease. Betaxolol may mask the signs and symptoms of hypoglycemia and hyperthyroidism.

Patients with coronary artery disease receiving betaxolol should be advised to avoid abrupt discontinuation of the drug, as severe exacerbation of angina and occurrence of myocardial infarction and ventricular arrhythmias have occurred.

While taking beta-blockers, individuals with a history of atopy or a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated accidental, diagnostic, or therapeutic challenge with such allergens. Such individuals may be unresponsive to the usual doses of epinephrine used to treat anaphylactic reactions.

Withdrawal of beta-blocker therapy prior to major surgery is controversial, as the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures.

A reduction in heart rate should be expected at daily doses of 40 mg. If betaxolol is to be discontinued, gradual withdrawal over 1 to 2 weeks is recommended to avoid "rebound" hypertension or tachycardia.

Safety and effectiveness in pediatric patients have not been determined.

Dialysis

In patients undergoing dialysis the initial dose is 5 mg orally once a day. If the desired response is not achieved, dosage may be increased by 5 mg/day increments every 2 weeks to a maximum dose of 20 mg/day.

Other Comments

May be used in combination with a diuretic.

Compared with Caucasian patients, Black patients have a reduced blood pressure response to monotherapy with beta-blockers; however, the reduced response is largely eliminated if combination therapy that includes an adequate dose of a diuretic is instituted.

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