Acebutolol

Acebutolol is a beta-adrenoceptor blocking drug that blocks beta-adrenoceptors in the heart, peripheral vasculature, bronchi, pancreas, and liver. It slows the heart and can depress the myocardium. Due to its intrinsic sympathomimetic activity, it tends to cause less bradycardia. In hypertension, it reduces cardiac output, alters baroreceptor reflex sensitivity, blocks peripheral adrenoceptors, and may depress plasma renin secretion.

Adult

Hypertension: Initially 400 mg daily, alternatively initially 200 mg twice daily; maximum 1.2 g per day by mouth. Arrhythmias: 0.4–1.2 g daily in 2–3 divided doses by mouth. Severe angina: Initially 300 mg 3 times a day; maximum 1.2 g per day by mouth.

Renal adjustment

Halve dose if eGFR 25–50 mL/minute/1.73 m2; use quarter dose if eGFR less than 25 mL/minute/1.73 m2; do not administer more than once daily.

Max dose

1.2 g per day

• Second- or third-degree heart block
• Worsening unstable heart failure
• History of asthma
• Frequent episodes of hypoglycaemia
• abrupt discontinuation (withdrawal syndrome)