1 tab once daily. Adult Recommended dose: Initially 12.5 mg once daily for the 1st 2 days. Thereafter, 25 mg once daily. May be subsequently increased at intervals of at least 2 wk up to the recommended max daily dose of 50 mg once daily or in divided doses (twice daily).
Administration
Should be taken with food.
Contraindications
Bronchial asthma or related bronchospastic conditions including severe hypotension, severe sinus bradycardia, 2nd- & 3rd-degree AV block; patients w/ NYHA class IV decompensated heart failure requiring IV inotropic support; COPD w/ a bronchospatic component; clinically manifested liver dysfunction; cardiogenic & hypovolaemic shock.
Special Precautions
Lab tests should be performed at the 1st symptom of liver dysfunction. Discontinue if liver injury or jaundice is evident. Peripheral vascular disease; spontaneous hypoglycemia or diabetic patients receiving insulin or oral hypoglycemic agents; heart failure; suspected of having Prinzmetal's (variant) angina; w/ labile or secondary HTN. Abrupt w/drawal may exacerbate symptoms of hypothyroidism or may precipitate thyroid storm. ECG & BP should be monitored when administered orally w/ Ca-channel blockers of the verapamil or diltiazem type. Pregnancy & lactation. Childn.
Rifampicin may reduce AUC or Cmax. Cimetidine & grapefruit juice may increase AUC. Quinidine, fluoxetine, paroxetine & propafenone may increase blood levels of R(+) enantiomer. Digoxin plasma conc increased when administered concomitantly. Clonidine may potentiate BP & heart rate-lowering effects.
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