II. Indications
III. Contraindications
- Severe Liver Impairment
IV. Mechanism
- Third generation Beta Blocker (Beta-1 Selective) with vasodilatory properties (nitric oxide release)
- Unique vasodilator mechanism with nitric oxide release via Beta-3 Agonist activity
- Relaxes vascular Smooth Muscle resulting in vasodilation
- Contrast with Labetalol and Carvedilol which exert vasodilation via alpha-1 activity
V. Dosing
- Start: 5 mg orally daily
- Start at 2.5 mg in hepatic Impairment or CrCl <30 ml/min
- Maximum: 40 mg/day
VI. Adverse Effects
- See Beta Blocker
VII. Safety
- Pregnancy Category C
- Avoid in Lactation
VIII. Resources
IX. References
- (2019) Presc Lett, Resource #350503, Comparison of Oral Beta Blockers
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia