Renal Dose Adjustment (Based on CrCl)
- >50 mL/min: Reduced dose by 50%
- >25 mL/min: Reduced dose by 75%
Hepatic Dose Adjustment
- Hepatic impairment: Use cautiously, dose adjustments not defined
- Beta-adrenergic receptor blockade precipitates more severe heart failure in individuals with diminished myocardial contractility. Use cautiously in patients with a history of heart failure who are controlled with digitalis and/or diuretics. Acebutolol therapy should be withdrawn if cardiac failure persists
- Continues depression of the myocardium with beta-blocking agents over a period of time can lead to cardiac failure in patients with aortic or mitral valve disease or compromised left ventricular function. Digitalize and give diuretics at the first sign of failure, and discontinue the acebutolol therapy if cardiac failure still persist
- Exacerbation of angina pectoris, myocardial infarction and death have been reported with abrupt cessation of therapy with certain beta-blocking agents
- Caution the patients against the sudden interruption of therapy, and when discontinuation of acebutolol is planned, it should be withdrawn gradually over a period of 2 weeks and patients should be advised to limit physical activity to a minimum. If an exacerbation of angina pectoris occurs, restart the antianginal therapy immediately and hospitalize the patient until his condition stabilizes
- Beta antagonists can precipitate or aggravate the symptoms of arterial insufficiency insufficiency in patients with peripheral or mesenteric vascular disease as it reduces cardiac output, use cautiously in such patients and closely monitor them for evidence of progression of arterial obstruction
- Patients with bronchospastic diseases should not receive beta blockers, but lower dose, preferably in divided doses can be used cautiously in these patients who cannot tolerate alternative treatment. Concerning the use of bronchodilator, such as theophylline or a beta2- stimulant, it should be made available in advance
- It is controversial whether to continue or to withdraw a beta blocking therapy before a major surgery, as it might benefit in preventing arrhythmic response but there is also a risk of excessive myocardial depression during general anesthesia. If beta blocker treatment is continued, use it cautiously with lowest possible dose and particular care should be taken when using anesthetic agent
- Beta blockers potentiate insulin-induced hypoglycemia and mask some of its manifestations, such as tachycardia; Caution the diabetic patients of the possibility of masked hypoglycemia
- Beta blockade precipitate a thyroid storm on sudden withdrawal, and may mask certain clinical signs of hyperthyroidism. Closely monitor the patients at risk of thyrotoxicosis from whom acebutolol therapy is to be withdrawn
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- History of heart failure
- Coronary artery disease
- Peripheral vascular disease
- Mesenteric vascular disease
- Bronchospastic disease
- Major Surgery
- Diabetes mellitus
- Thyroid disorder
- History of severe anaphylactic reactions
Pregnancy Category:B
Breastfeeding: As acebutolol and its active metabolite diacetolol are extensively excreted in to breastmilk and have extensive renal excretion, other agents may be preferred, especially while nursing a newborn or preterm infant. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 25 February 2011). As per manufacturer data acebutolol and diacetolol are excreted in m ilk in the ratio of 7.1 and 12.2 respectively. It is not recommended in nursing mother.
Pricing data from www.DrugStore.com in U.S.A.
- Sectral 400 MG CAPS [Bottle] (PROMIUS PHARMA)
30 mg = $125
90 mg = $364.95 - Acebutolol HCl 400 MG CAPS [Bottle] (AMNEAL PHARMACEUTICALS)
30 mg = $21.99
90 mg = $57.98 - Sectral 200 MG CAPS [Bottle] (PROMIUS PHARMA)
60 mg = $186.99
180 mg = $538.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
