Class: Beta-adrenergic blocking agent
- Tablets 5 mg
- Tablets 10 mg
Sandoz Pindolol (Canada)
Nonselectively blocks beta receptors, which primarily affect heart (slows rate), vascular musculature (decreases blood pressure), and lungs (reduces function).
Rapidly and reproducibly absorbed (more than 95%). T max is 1 h. Bioavailability is approximately 100%.
Protein binding is 40%. Evenly distributed between plasma red cells. Vd is 2 L/kg.
Metabolized in the liver (60% to 65%) as hydroxy metabolites.
Urine (amount of dose excreted 60% to 65%; as unchanged 35% to 40%); feces (6% to 9%). T 1/2 is approximately 8 h (polar metabolites). T 1/2 is 3 to 4 h.
Special PopulationsRenal Function Impairment
50% decreased in volume of distribution in uremic patients, generally excreted in less than 15% of dose as unchanged in the urine.Hepatic Function Impairment
In cirrhosis patients, elimination was more variable in rate and slower, half-life ranged from 2.5 h to more than 30 h. Exercise caution; dosage adjustments may be necessary.Elderly
In elderly hypertensive patients, the half-life is more variable, averaging 7 h.
Indications and Usage
Management of mild to moderate hypertension.
Greater than first-degree heart block; CHF unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; sinus bradycardia; cardiogenic shock; hypersensitivity to beta-blockers; bronchial asthma or bronchospasm, including severe COPD.
Dosage and AdministrationAdults
PO 5 mg twice daily. May be increased by 10 mg every 3 to 4 wk until desired response; max dose is 60 mg/day.
Administer without regard to meals. Administer with food if GI upset occurs.
Store at or below 86°F.
May enhance or reverse antihypertensive effect; potentially life-threatening situations may occur, especially on withdrawal.Epinephrine
Initial hypertensive episode followed by bradycardia may occur.Ergot derivatives
Peripheral ischemia, manifested by cold extremities and possible gangrene, may occur.Insulin
Prolonged hypoglycemia with masking of symptoms may occur.Lidocaine
Lidocaine levels may increase, leading to toxicity.NSAIDs
Some agents may impair antihypertensive effect.Prazosin
Orthostatic hypotension may be increased.Theophyllines
Elimination of theophylline may be reduced. Also, effects of both drugs may be reduced by pharmacologic antagonism.Verapamil
Effects of both drugs may be increased.
Laboratory Test Interactions
None well documented.
Bradycardia; hypotension; CHF; edema; worsening angina.
Depression; visual disturbances; short-term memory loss; dizziness.
Skin rash; increased sensitivity to cold.
Dry eyes; visual disturbances.
Nausea; vomiting; diarrhea.
Impotence; urinary retention; difficulty with urination.
May increase AST or ALT; rarely increases LDH or alkaline phosphatase.
May increase or decrease blood glucose, uric acid.
Wheezing; bronchospasm; difficulty breathing (at higher doses).
Category B .
Excreted in breast milk.
Safety and efficacy not established.
Dosage may need to be reduced.
Dosage may need to be reduced.
Deaths have occurred; aggressive therapy may be required.
Administer cautiously in CHF patients controlled by digitalis and diuretics. Notify health care provider at first sign or symptom of CHF or unexplained respiratory symptoms in any patient.
May mask signs and symptoms of hypoglycemia (eg, tachycardia, BP changes). May potentiate insulin-induced hypoglycemia.
Peripheral vascular disease
May precipitate or aggravate symptoms of arterial insufficiency.
May mask clinical signs of developing or continuing hyperthyroidism (eg, tachycardia). Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm.
Bradycardia, hypotension, seizures, respiratory depression.
- Teach patient and family technique for measuring BP and pulse rates and to keep written record.
- Instruct patient to notify health care provider if pulse rate is less than 50 bpm or systolic BP is less than 90 mm Hg.
- Warn patient not to engage in activities that require mental alertness until drug effects are apparent because it may cause blurred vision, drowsiness, and dizziness.
- Explain that decreased blood supply to extremities may cause patient to be more sensitive to cold temperatures.
- Encourage patients with diabetes to monitor blood glucose carefully.
- Advise patient to report the following symptoms to health care provider: any asthma-like symptoms, cough or nasal stuffiness, skin rash, fever, sore throat, unusual bleeding or bruising.
- Instruct patient to sit or lie down immediately if dizziness or faintness occurs.
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