Celiprolol

Celiprolol

[11 cents per tablet]

ADMINISTRATION ROUTES:

  • PO

ALTERNATIVE NAMES:

  • Celol, Selectol

ICU INDICATIONS:

  1. hypertension
  2. acute myocardial infarction
  3. secondary prevention in patients with coronary artery disease
  4. angina
  5. rate control

Note: celiprolol may be used with caution in patients with asthma or COPD (see WARNINGS)

PRESENTATION AND ADMINISTRATION:

  • PO:
    Celol 200mg tablets (yellow)
    Should be taken on an empty stomach. Absorption is significantly affected by food. Unknown effects with NG feed – consider alternatives.

DOSAGE

  • PO:
    Initially 200mg daily; increasing to up to 600mg daily

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose in renal impairment [GFR (ml/min)]
    <10: 150-300mg daily
    10-20: Dose as in normal renal function
    >20-50: Dose as in normal renal function
  • Dose in renal replacement therapy
    CAPD: 150-300mg daily
    HD: 150-300mg daily
    CVVHDF: Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • PO:
    5-10mg/kg daily

CLINICAL PHARMACOLOGY:

  • Celiprolol is a cardioselective beta-blocker, whose beta-blocking action results from a selective competitive blockade at the level of the beta-1 receptors; it is a partial agonist at beta-2 receptors. The vasodilative effect of Celiprolol probably results in part from its partial agonist properties at the level of the beta-2 receptors. Celiprolol lacks a membrane stabilising effect. It is devoid of any cardiodepressive effect at the doses used in clinical practice. It does not appear to have bronchoconstrictive effect at therapeutic doses.

CONTRAINDICATIONS:

  1. sinus bradycardia
  2. heart block greater than first degree
  3. cardiogenic shock
  4. overt cardiac failure

WARNINGS

  • Cardiac Failure
    Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure.
  • Discontinuation of therapy
    Discontinuation of therapy in a patient with coronary artery disease may lead to rebound angina, arrhythmia or myocardial infarction. Diabetes and Hypoglycemia Beta blockers may mask tachycardia occurring with hypoglycaemia.
  • Thyrotoxicosis
    Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm. Asthma Due to its beta-1 selective blocking and beta-2 agonist properties, celiprolol may be used with caution in asthmatics out of acute episodes and in patients with compensated chronic obstructive pulmonary disease (see CLINICAL PHARMACOLOGY). It may still precipitate bronchospasm in these patients and should be used with caution.

PRECAUTIONS

  • General:
    Atenolol may aggravate peripheral arterial circulatory disorders.
  • Laboratory Tests:
    No tests in addition to routine ICU tests are required
  • Drug/Laboratory Test Interactions :
    None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine

ADVERSE REACTIONS

  • Body as a Whole:
    Tiredness, Fatigue
  • Cardiovascular System:
    Bradycardia , Cold extremities, Hypotension, Leg pain
  • Respiratory System:
    Wheeziness, Dyspnoea
  • Digestive System:
    Diarrhoea, Nausea
  • Nervous System:
    Dizziness, Vertigo, Light-headedness

Critical Care Drug Manual

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