PHARMACOLOGY 1

ANTI-HYPERTENSIVE DRUGS

DRUG/BRAND
INDICATION DOSAGE ADMINISTRATION ADVERSE REACTION CONTRAINDICATIONS SPECIAL PRECAUTIONS
NAME
ACE INHIBITORS
Captopril
Capomed  Management of HTN Adult HTN Initial: 12.5 mg bid at bedtime, Should be taken Nausea, headache, dizziness; taste  Hypersensitivity to ACE inhibitor.
 Heart failure, following MI increasing gradually at intervals of 2-4 wk on an empty disturbances, scalded mouth syndrome; skin  Aortic stenosis or outflow tract
 Diabetic nephropathy according to response. If given w/ stomach: reactions (eg, Bullous pemphigoid, obstruction & renovascular disease.
diuretic or to elderly patient 6.25 mg Take 1-2 hr after hyperhidrosis, cutaneous hypersensitivity  Pregnancy (especially during 2nd &
bid. Maintenance: 25-50 mg bid. Max: 50 meals. vasculitis), cough, pneumonitis & cholestatic 3rd trimester) & lactation.
mg tid. Heart failure Initial: 6.25 mg or jaundice.
12.5 mg tid under medical supervision.
Maintenance: 25 mg bid-tid. Max: 50 mg
tid. Following MI Initial (3 days after MI):
6.25 mg once daily, increased over
several wk to 150 mg daily in divided
doses if tolerated. Diabetic
nephropathyType 1 diabetics 75-100 mg
daily in divided doses. Patients w/ severe
renal impairment (CrCl <30
mL/min) Initial: 12.5 mg bid.
Ritemed  Management of HTN HTN Initially 25 mg bid or tid. May be Should be taken CV, nervous system, GI, hematologic,  History of angioedema associated Proteinuria, dual blockade of
(P10/25mg tab)  Heart failure, following MI increased to 100 mg bid or tid up to 150 on an empty musculoskeletal, metabolic/nutritional, resp, w/ previous ACE inhibitor therapy the renin-angiotensin-
 Diabetic nephropathy mg bid or tid. Max daily dose: 450 mg in stomach: Take 1 hepatic, skin & appendages,  Hereditary/idiopathic angioneurotic aldosterone system,
divided doses. Patients w/ severe HTN, hr before meals urogenital/reproductive & special senses edema hyperkalemia, DM. Heart
when temporary discontinuation of adverse effects. Angioedema, malaise, fatigue,  Pregnancy & lactation. failure & excessive BP
current antihypertensive therapy is not asthenia, fever. lowering in patients w/
practical or desirable, or when prompt ischemic CV or
titration to more normotensive BP cerebrovascular disease.
levels is indicated Initially 25 mg bid or Left ventricular valvular &
tid. Heart failure Initially 25 mg tid. Max outflow tract obstruction,
daily dose: 450 mg in divided cardiogenic shock &
doses. Patients w/ normal or low BP, hemodynamically significant
vigorously treated w/ diuretics & may obstruction, aortic stenosis.
be hyponatremic &/or Discontinue use when
hypovolemic Initially 6.25 or 12.5 mg jaundice or marked
tid. Left ventricular dysfunction after elevations of hepatic
MIInitially 12.5 mg tid after a single dose enzymes develop.
of 6.25 mg, increased to 25 mg tid. Persistent nonproductive
Maintenance dose: 50 mg tid. Diabetic cough, aggravate
nephropathy 75-100 mg/day in divided hypotension caused during
doses. Patients w/ severe renal procedures. May impair
impairment 12.5 mg bid. Elderly w/ ability to drive or operate
reduced renal function & other organ machinery.
dysfunctions Initially 6.25 mg bid.
Hartylox  HTN Initially 12.5 mg bid, increase gradually at intervals of 2-4 wk. Should be taken Rash, pruritus, flushing, angioedema, loss of  Impaired renal function,
P8.43/25mg tab Maintenance: 25-50 mg bid. Max: 50 mg tid. on an empty taste perception, stomatitis, GI irritation & collagen vascular
P13.50/50mg tab  Heart failure Initially 6.25-12.5 mg tid & gradually increase up to 50 mg stomach: Take 1 abdominal pain; leukopenia, cough. disorders eg SLE or
bid. hr before or 2 hr Hyperkalemia, CV effects. Hematologic scleroderma. Monitor
 MIMay initiate as early as 3 days following MI. Initially 6.25 mg, may be after meals reactions eg anemia, thrombocytopenia, regularly for proteinuria.
increased to 37.5-75 mg daily in divided doses. Max: 150 mg/day. pancytopenia & neutropenia. Regular WBC counts.
 Diabetic nephropathy 75-100 mg/day.  Pregnancy.

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Ramipril
Ramipro  HTN Initially 1.25 mg once daily, maintenance dose: 2.5-10 May be taken Hypotension, dizziness, fatigue, headache, GI  Aortic stenosis or outflow tract Peripheral vascular disease
P26/10mg tab mg. CHFInitially 1.25 mg once daily. Max: 10 mg/day, take ≥2.5 mg in with or without & taste disturbances, persistent dry cough & obstruction. or generalized
1-2 divided doses. food. other resp tract symptoms, skin rashes,  Pregnancy. atherosclerosis, history of
P15/2.5mg tab  MI 2.5 mg bid. After 2 days, increase to 5 mg bid. Maintenance dose: angioedema, hypersensitivity reactions, renal idiopathic or hereditary
2.5-5 mg bid. impairment, hyperkalemia, hyponatremia & angioedema, renal
P17.50/5mg tab  Prophylaxis of CV events Initially 2.5 mg once daily. If tolerated, blood disorders. Chest pain, palpitations, impairment. Elderly.
increase to 5 mg once daily after 1 wk. Maintenance dose: 10 mg once tachycardia, stomatitis, abdominal pain,
daily. pancreatitis, hepatocellular injury or cholestatic
jaundice, alopecia, muscle cramps,
paresthesia, mood & sleep disturbances,
impotence.
Enalapril
Pharex  Treatment of HTN & heart Initially 5 mg daily preferably given May be taken Hypotension, dizziness, fatigue, headache,  Aortic stenosis or outflow tract  Assess renal function;
Pharex Enalapril failure. at bedtime. Patient w/ renal with or without nausea & other GI disturbances. Pronounced obstruction. regular WBC counts in
Maleate tab 10  Prophylaxis in asymptomatic left impairment or those receiving food. hypotension. MI & stroke. Tachycardia,  Renovascular disease. patient w/ collagen
mg ventricular dysfunction to delay diuretic 20 mg daily, if possible the palpitations, chest pain. Renal effects.  Severe resistant HTN. vascular disease eg SLE
[ 100's the onset of symptomatic heart diuretic should be w/drawn 2 or 3 Proteinuria. Hyperkalemia & hyponatremia. Dry  Peripheral vascular disease or & scleroderma.
failure & to reduce the incidence days prior to enalapril cough & other upper resp tract symptoms & generalized atherosclerosis  Patient receiving
(P10/tab) ] of coronary ischemic effect therapy. Elderly Initially 2.5 mg. angioedema. Skin rashes, photosensitivity, immunosuppressive
Pharex Enalapril including MI. Maintenance: 10-20 mg once daily alopecia & other hypersensitivity reactions. therapy; those prone to
Maleate tab 20 up to 40 mg daily in HTN which Neutropenia, agranulocytosis, salt or water depletion.
mg may be given in divided doses if thrombocytopenia & anemias  Pregnancy
[ 100's control is inadequate w/ single
dose. Management of heart
(P13/tab) ] failureInitially 2.5 mg daily.
Pharex Enalapril Maintenance: 20 mg daily as a
Maleate tab 5 mg single dose or in 2 divided doses.
[ 100's Treatment should be initiated w/
(P800/box) ] low dose.
ARBs
Losartan
Losartan Adult : PO May be taken Upper resp infection, nasal congestion, Concomitant use w/ aliskiren in  Volume-depleted patients
 HTN 50 mg once daily, may increase to 100 mg/day as single dose or with or without sinusitis, headache, dizziness, back pain, leg patients w/ diabetes and renal including patients on
in 2 divided doses if needed. food. pain, muscle cramps, asthenia or fatigue, impairment (GFR <60 mL/min). high-dose diuretics.
neutropenia, chest pain, cough, bronchitis, UTI, Severe hepatic impairment.  Patients w/ bilateral renal
 Patients w/ intravascular volume depletion: Initial: 25 mg once daily. diarrhoea, gastritis, anaemia, hypoglycaemia, Pregnancy artery stenosis, aortic or
diabetic vascular disease, cataracts, cellulitis, mitral stenosis.
 Heart failure Initial: 12.5 mg once daily, may be doubled at wkly hyperkalaemia, myalgia, arthralgia,  Renal and mild to
intervals. Maintenance: 50 mg once daily. Max: 150 mg once daily. hypotension, muscular weakness, moderate hepatic
hypoaesthesia, infection, knee pain. Rarely, impairment.
 Diabetic nephropathy in Type 2 DM Initial: 50 mg once daily, may pruritus, rash, urticaria, angioedema, elevated  Lactation
increase to 100 mg once daily depending on BP response liver enzyme values, rhabdomyolysis
Ritemed Monotherapy or in  HTN Adult Initial & maintenance dose: May be taken CV, endocrine, GI, hematologic, liver/biliary; Pregnancy Correct intravascular vol-
combination w/ other 50 mg once daily, may be increased to with or without metabolic, musculoskeletal, nervous depletion eg, those treated
antihypertensive agents for 100 mg once daily. food. system/psychiatric, resp, skin, special senses & w/ high-dose diuretics prior
the treatment of HTN  Patients w/ intravascular vol- urogenital adverse effects. Asthenia, chest to therapy.
depletion eg, those treated w/ high- pain, edema, facial edema, fatigue, fever, Monitor serum K levels in
dose diuretics, history of liver infection, flu-like disease, orthostatic effects, diabetic patients w/
disease & moderate to severe renal syncope, trauma nephropathy.
disease 25 mg once daily. Total daily Electrolyte/fluid imbalance.
dose: 25-100 mg once or bid. Reversible changes in renal
 Hypertensive patients w/ left function, severe CHF, uni-
ventricular hypertrophy Initially 50 mg or bilateral renal artery
once daily, add hydrochlorothiazide stenosis; history of liver
(HCTZ) 12.5 mg daily &/or increased impairment. Concurrent use

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

losartan to 100 mg once daily followed w/ K-sparing diuretics, K

by an increase in HCTZ 25 mg once supplements or salt
daily based on BP response substitutes containing K &
drugs affecting renin-
angiotensin-aldosterone
system. Ischemic
cardiopathy or
cerebrovascular disease.
Lactation. Neonates, childn
w/ GFR <30 mL/min/1.73
m2 & liver impairment.
Infants w/ history of in
uteroexposure to losartan
Cozaar  Reduction in the risk of  Initial & maintenance dose: 50 mg once May be taken Dizziness, asthenia/fatigue, vertigo, Hypersensitivity. Co-administration of
Cozaar tab 100 CV morbidity & mortality daily, may be increased to 100 mg once with or without hypotension, hyperkalemia; angioedema aliskiren in patients w/ diabetes.
mg in hypertensive patients daily. food. including swelling of the larynx & glottis, liver Pregnancy.
[ 30's w/ left ventricular function abnormalities, vomiting, malaise,
(P765/pack) ] hypertrophy.  Patients w/ intravascular vol- anemia, myalgia, arthralgia, migraine,
depletion 25 mg once daily. dysgeusia, erectile dysfunction/impotence,
Cozaar tab 50  Renal protection in type 2 cough, urticaria, pruritus, erythroderma,
mg diabetic patients w/ photosensitivity.
[ 30's proteinuria.
(P645/pack) ]
Telmisartan
Telmisartan Adult : PO HTN Initial: 40 mg once daily, may be adjusted to 20-80 mg Dizziness, fatigue, headache, sinusitis, upper Concomitant use w/ aliskiren in Volume- or salt-depleted
once daily. CV risk reduction 80 mg once daily. resp tract infection, pharyngitis, UTI, back pain, patients w/ diabetes and renal patients including patients
myalgia, diarrhoea, abdominal pain, dyspepsia, impairment (GFR <60 mL/min). on prolonged diuretic
Oral nausea. Severe hepatic impairment. therapy. Patients w/ renal
Hypertension Potentially Fatal: Intermittent claudication Pregnancy. artery stenosis, aortic or
Adult: Initially, 40 mg once daily, may be adjusted to 20-80 mg once daily mitral stenosis, obstructive
if needed. biliary disease. Renal and
mild to moderate hepatic
Oral impairment. Lactation.
Cardiovascular risk reduction
Adult: 80 mg once daily.
Micardis Treatment of essential HTN.  Treatment of essential UTI, upper resp tract infection, sepsis, anemia, Biliary obstructive disorders, severe Renovascular HTN, renal &
Prevention of CV morbidity HTNRecommended dose: 40 mg once eosinophilia, thrombocytopenia, anaphylactic hepatic impairment. Concomitant use hepatic impairment & kidney
& mortality in patients ≥55 yr daily. reaction, hypersensitivity, hyperkalemia, of aliskiren in patients w/ DM or renal transplant, intravascular vol
at high risk of CV disease.  Prevention of CV morbidity & hypoglycemia, insomnia, depression, anxiety, impairment (GFR <60 mL/min/1.73 depletion, other conditions
mortalityRecommended dose: 80 mg syncope, visual disturbance, vertigo, m2). Pregnancy & lactation. w/ stimulation of the renin-
once daily. bradycardia, tachycardia, hypotension, angiotensin-aldosterone
orthostatic hypotension, dyspnea, abdominal system, primary
pain, diarrhea, dyspepsia, flatulence, vomiting, aldosteronism, aortic &
dry mouth, stomach discomfort, pruritus, mitral stenosis, obstructive
hyperhidrosis, rash, angioedema, eczema, hypertrophic
erythema, urticarial, drug eruption, toxic skin cardiomyopathy,
eruption, back pain, muscle spasm, myalgia, hyperkalemia, hereditary
arthralgia, pain in extremity, tendon pain, renal fructose intolerance, DM.
impairment including acute renal failure, chest
pain, asthenia, influenza-like illness.
Pritor Treatment of essential HTN. Adult Sepsis including fatal outcome, UTI (including Hypersensitivity. Biliary obstructive Renovascular HTN, renal
Prevention of CV morbidity  Essential HTN 20-40 mg once daily. cystitis), upper resp tract infections; anemia, disorders, severe hepatic impairment. impairment & kidney
& mortality in patients ≥55 yr Max: 80 mg once daily. eosinophilia, thrombocytopenia; anaphylactic Concomitant use w/ aliskiren in transplant, intravascular vol
at high risk of CV disease.  Severe HTNUp to 160 mg alone or in reaction, hypersensitivity; hyperkalemia, patients w/ DM or renal impairment depletion, acute renal failure
combination w/ hydrochlorothiazide hypoglycemia (in diabetic patients); anxiety, (GFR <60 mL/min/1.73 m2). Rare due to dual blockade of
12.5-25 mg daily. insomnia, depression; syncope; visual hereditary conditions of fructose renin-angiotensin-

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

 Prevention of CV morbidity & disturbance; vertigo; bradycardia, tachycardia; intolerance. Pregnancy (2nd & 3rd aldosterone system, severe
mortality80 mg once daily. hypotension, orthostatic hypotension; dyspnea; trimesters) & lactation. CHF or underlying disease
abdominal pain, diarrhea, dry mouth, (including renal artery
dyspepsia, flatulence, stomach discomfort, stenosis), primary
vomiting; abnormal hepatic function/liver aldosteronism, aortic &
disorder; angioedema, eczema, erythema, mitral valve stenosis,
pruritus, hyperhidrosis, urticaria, drug & toxic obstructive hypertrophic
skin eruption, rash; arthralgia, back pain, cardiomyopathy.
muscle spasms or pain in extremity, myalgia, Hyperkalemia; periodic
tendon pain (tendonitis-like symptoms); renal monitoring of serum K &
impairment including acute renal failure; chest creatinine levels in patients
pain, influenza-like illness, asthenia; decreased w/ renal impairment. Biliary
Hb, increased hepatic enzymes, blood uric obstructive disorders or
acid, creatinine & creatine phosphokinase. hepatic insufficiency; DM &
coexistent CAD, ischemic
cardiomyopathy or CV
disease. May affect ability to
drive or operate machinery.
Pregnancy (1st trimester).
Childn <18 yr.
Olmesartan
Olmesartan Oral sprue-like enteropathy (Symptoms: Severe, Biliary obstruction. Pregnancy. Patients w/ aortic or mitral
Hypertension chronic diarrhoea w/ substantial wt loss). valve stenosis, renal artery
Adult: Initial: 10-20 mg once daily may then be increased up to max 40 mg Dizziness, headache, abdominal pain, Drug interactions: Increased risk of stenosis; at risk for
once daily if needed. dyspepsia, diarrhoea, gastroenteritis, nausea, hyperkalaemia w/ ACE inhibitors, K- hypotension (e.g. patients
bronchitis, pharyngitis, rhinitis, arthritis, back sparing diuretics, K salts or K w/ volume or salt depletion);
pain, skeletal pain, fatigue, flu-like symptoms, supplements and drugs that may history of angioedema; at
angioedema, peripheral oedema, haematuria, increase serum K (e.g. ciclosporin, risk for hyperkalaemia (e.g.
UTI, hyperkalaemia, hypertriglyceridemia, eplerenone). May potentiate BP patients w/ DM). Severe
hyperuricaemia, hyperglycaemia, elevated liver lowering effects w/ other renal and hepatic
enzymes. antihypertensives. May decrease impairment. Lactation.
glomerular filtration w/ NSAIDs which
Overdosage: Symptoms: Hypotension and can cause acute renal failure. May
tachycardia. Management: Symptomatic and increase serum concentrations and
supportive treatment. toxicity of lithium.
Ritemed HTN Adult 10 mg once daily. May be increased Dizziness, bronchitis, cough, pharyngitis, Hypersensitivity. Biliary obstruction. Vol- or salt-depleted
RiteMED to 20 mg once daily as optimal dose. May rhinitis, abdominal pain, diarrhea, dyspepsia, Pregnancy. patients. Increased risk of
Olmesartan FC be increased to a max of 40 mg daily (or gastroenteritis, nausea, arthritis, back pain, severe hypotension & renal
tab 20 mg hydrochlorothiazide therapy may be skeletal pain, hematuria, UTI, chest pain, insufficiency. Patients w/
[ 30's (P35/film- added) if requiring further BP reduction. fatigue, flu-like symptoms, peripheral edema, severe CHF or underlying
coated tab) ] pain; thrombocytopenia, hyperkalemia, renal disease including renal
headache, pruritus, exanthema, rash, allergic artery stenosis, diabetes;
reactions, muscle cramp, myalgia, asthenic suffering from aortic, mitral
conditions, abnormal renal functions & valve stenosis or obstructive
increased hepatic enzymes. hypertropic cardiomyopathy,
primary aldosteronism,
ischemic heart or
cerebrovascular disease.
Concomitant use w/ lithium
& K supplements. Monitor
serum K & creatinine levels
periodically. Renal & hepatic
impairment. Pregnancy &
lactation. Childn. Elderly.
Creasrt HTN Adult 10 mg once daily. May be increased Dizziness; bronchitis, cough, pharyngitis, Hypersensitivity. Biliary obstruction. Vol &/or Na depletion,
Content: to 20 mg once daily as optimal dose. May rhinitis; abdominal pain, diarrhea, dyspepsia, Pregnancy. severe CHF or underlying
Olmesartan be increased to a max of 40 mg daily (or gastroenteritis, nausea; arthritis, back pain, renal disease (including

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

medoxomil hydrochlorothiazide therapy may be skeletal pain; hematuria, UTI; chest pain, Drug Interactions: renal artery stenosis),
added) if requiring further BP reduction. fatigue, influenza-like symptoms, peripheral K supplements, K-sparing diuretics, severe renal & hepatic
Cresart film- edema, pain; increased creatine salt substitutes containing K, drugs impairment, recent kidney
coated tab 20 mg phosphokinase, hypertriglyceridemia, that may increase serum K levels (eg, transplantation, end-stage
[ 30's hyperuricemia; liver enzyme elevations. heparin); other antihypertensive drugs, renal disease, aortic or
(P750/box) ] NSAIDs, AIIA, lithium. mitral valve stenosis,
obstructive hypertrophic
Cresart film- cardiomyopathy, primary
coated tab 40 mg aldosteronism. Increased
[ 30's risk of hyperkalemia &
(P1,200/box) ] renovascular HTN.
Concomitant use of lithium.
Lactation.
Irbesartan
Irbesartan Oral Diarrhoea, fatigue, dyspepsia or heartburn, Concomitant use w/ aliskiren in Patients w/ unilateral or
Hypertension dizziness, orthostatic hypotension, nausea, patients w/ diabetes and renal bilateral renal artery
Adult: 150 mg once daily, may increase to 300 mg once daily if needed. vomiting, musculoskeletal pain, impairment (GFR <60 mL/min). stenosis, depletion of
Patient w/ intravascular volume depletion: Initially, 75 mg once daily. thrombocytopaenia, hyperkalaemia, elevated Pregnancy intravascular volume, aortic
Elderly: >75 yr Initially, 75 mg once daily. serum creatinine or mitral stenosis, or
obstructive hypertrophic
Oral Overdosage Symptoms: Hypotension, cardiomyopathy. Renal
Diabetic nephropathy in Type 2 diabetes mellitus tachycardia, bradycardia. Management: impairment. Lactation
Adult: Initially, 150 mg once daily, may increase to 300 mg once daily if Symptomatic and supportive treatment.
needed. Induction of emesis and/or gastric lavage.
Activated charcoal may also be helpful
Irvex Management of HTN  HTN Adult 150 mg once daily, may be Dizziness & headache; orthostatic hypotension; Hypersensitivity. Pregnancy Lactation. Elderly
Irvex tab 150 mg including treatment of renal increased to 300 mg once daily. GI disturbances, fatigue, muscle & joint pains,
[ 100's (P18/tab) disease in hypertensive  Childn 6-12 yr 75 mg once daily, may congestion, hyperkalemia, back pain, vertigo,
diabetic patients be increased to 150 mg once daily. migraine, cough, acute pancreatitis & increase
Irvex tab 300 mg  Renal disease in hypertensive type II in liver enzymes. Hypersensitivity reactions eg
[ 100's diabetics Initially 150 mg once daily. rash, urticaria, pruritus & angioedema
(P2,800/box) Maintenance: 300 mg once daily
Virbez  HTN Initially 150 mg once daily, increased if necessary to 300 mg once Dizziness, dose-related orthostatic Tab: Hypersensitivity. FC tab: Patients Tab: Patients whose renal
Virbez FC tab daily. hypotension; impaired renal function; w/ renal artery stenosis, abnormally function may depen on the
300 mg hyperkalemia, myalgia low pressure, serious muscle damage activivty of RAAS (eg,
[ 30's (P26/film-  Renal disease in hypertensive type II DM patients Initially 150 mg leading to kidney failure, giant hives, patients w/ severe CHF).
once daily decreased blood vol, hyperkalemia, Potential risk of oliguria &
coated tab) ] muscle pain & tenderness w/ progressive azotemia &
Virbez tab 150 increased creatine kinase. Pregnancy (rarely) acute renal failure.
mg Pregnancy & lactation. FC
[ 30's (P18/tab) tab: Patients w/ vol-
depletion & those receiving
high-dose diuretic therapy.
Monitor serum K conc
especially in elderly. Avoid
concomitant use w/ K-
sparing diuretics. Renal &
hepatic impairment.
Lactation
Valsartan
Valsartan Oral Dizziness, hypotension, hyperkalaemia, Concomitant use w/ aliskiren in Patients w/ renal artery
Hypertension neutropenia, viral infection, back pain, patients w/ diabetes and renal stenosis, heart failure, aortic
Adult: Initially, 80 mg once daily, may be increased to 160 mg arthralgia, fatigue, abdominal pain, diarrhoea, impairment (GFR <60 mL/min). or mitral stenosis, severe Na
once daily if needed. Max: 320 mg once daily. cough, blurred vision. Increase in BUN and Severe hepatic impairment. and/or volume depletion.
serum creatinine. Pregnancy. Renal and mild to moderate
hepatic impairment.

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Oral Lactation.
Post-myocardial infarction
Adult: Start as early as 12 hr after MI in stable patients at an
initial dose of 20 mg bid, doubled at intervals over a few wk up to
160 mg bid if tolerated.
Elderly: No dosage adjustment needed.

Oral
Heart failure
Adult: Initially, 40 mg bid, may be increased to 160 mg bid if
tolerated.
Elderly: No dosage adjustment needed.
Valazyd  HTN Initially 80 mg once daily, may be increased to 160 mg Headache, dizziness, flu symptoms, tiredness, Hypersensitivity. Severe hepatic Monitor for hypotension.
Valazyd film-coated tab once daily. Max: 320 mg once daily. abdominal pain, low BP, diarrhea, joint & back impairment, biliary cirrhosis & Patients w/ renal or hepatic
160 mg  Heart failure Initially 40 mg bid, may be increased to 160 mg pain, high blood K levels, cough, decreased cholestasis. Pregnancy (2nd & 3rd impairment. Childn w/ CrCl
[ 100's (P36/film-coated bid. kidney function & rash trimester) <30 mL/min & those
tab) ] Post-MI patient Start as early as 12 hr after the infarction in undergoing dialysis.
Valazyd film-coated tab clinically stable patient w/ an initial dose of 20 mg bid. Dose may Lactation
40 mg be doubled at intervals over the next few wk up to 160 mg bid if
[ 100's (P14/film-coated tolerated.
tab) ]
Valazyd film-coated tab
80 mg
[ 100's (P24/film-coated
tab) ]
CCBs
Amlodipine
Amlodipine Oral Somnolence, dizziness, headache, ankle Severe hypotension, shock (including Severe hypotension, shock
Prinzmetal's angina, Stable angina swelling, oedema, flushing, fatigue, cardiogenic shock), obstruction of the (including cardiogenic
Adult: Initially, 5 mg once daily increased to 10 mg once daily if palpitations, abdominal pain, nausea. Rarely, outflow tract of the left ventricle (e.g. shock), obstruction of the
necessary. confusion, rash, gingival hyperplasia, muscle aortic stenosis), haemodynamically outflow tract of the left
Elderly: Initially, 2.5 mg once daily. cramps, dyspnoea unstable heart failure after acute MI ventricle (e.g. aortic
stenosis),
Oral Overdosage: Drug Interactions: Plasma haemodynamically unstable
Hypertension Symptoms: Excessive peripheral vasodilation concentrations may be elevated w/ heart failure after acute MI
Adult: Initially, 5 mg once daily increased to 10 mg once daily if w/ marked hypotension and possibly a reflex CYP3A4 inhibitors (e.g. azole
necessary. tachycardia. Management: Symptomatic and antifungals, ritonavir). Concomitant May impair ability to drive
Child: 6-17 yr Initially, 2.5 mg once daily, increased to 5 mg once supportive treatment. A vasoconstrictor may be therapy w/ simvastatin may increase and operate machinery
daily if necessary. beneficial in restoring vascular tone and BP. Ca risk of myopathy including
Elderly: Initially, 2.5 mg once daily. gluconate IV may be used to reverse the rhabdomyolysis. May increase Monitor BP and heart rate
effects of Ca channel blockade. Gastric lavage ciclosporin plasma levels and
may be useful in some cases conivaptan
Ritemed  Adult Usual dose: 5 mg once daily. Flushing, fatigue, edema, palpitation, vertigo, Advanced aortic stenosis, severe liver Severe bradycardia, heart
Amlodipine Besilate tab  HTN, stable & Prinzmetal's angina Initially 5 mg, may be headache, drowsiness, abdominal pain, nausea failure, history of shock. Systolic BP failure (particularly in
10 mg increased to 10 mg once daily. <90 mmHg. Pregnancy & lactation combination w/ β-blocker),
[ 100's (P10/tab)  Chronic stable or vasospastic angina, coronary artery cardiogenic shock. May
disease 5-10 mg once daily. impair ability to drive or
RiteMED Amlodipine  Elderly & patients w/ hepatic insufficiency 5 mg once daily. operate machinery. Patients
Besilate tab 5 mg Childn 6-17 yr 2.5-5 mg once daily w/ hepatic disease. Elderly
[ 100's (P725/pack)
Rhea  HTN & angina Initially 5 mg once daily. Max: 10 mg. Headache, dizziness, somnolence; palpitations; Hypersensitivity to amlodipine & Increased risk of pulmonary
Amlodipine tab 10 mg flushing; abdominal pain, nausea; edema, dihydropyridines edema in patients w/ NYHA
[ 100's (P750/box) ]  CAD 5-10 mg once daily. fatigue III & IV heart failure of non-
Rhea Amlodipine tab 5 ischemic etiology. Impaired
mg  Childn 6-17 yr HTN 2.5-5 mg once daily hepatic function. Pregnancy
[ 100's (P540/box) ] & lactation

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Vasalat Management of HTN & prophylaxis of angina Headache, edema, dizziness, flushing, Severe hypotension Hypersensitivity. Aortic
tab 10 mg palpitations; fatigue, nausea, abdominal stenosis; CHF. Monitor BP,
[ 100's (P2,100/pack) Adult Usual dose: 5-10 mg once daily. Elderly & patients w/ pain, somnolence; muscle cramps, ECG readings, heart rate;
[ 30's (P630/pack) ] hepatic function impairment Initially 2.5 mg. AnginaInitially 5 mg reduced frequency or
pruritus, rash
Vasalat tab 5 mg severity of anginal attacks;
[ 100's (P1,275/pack) ] decreased nitrate
[30's (P383/pack) ] consumption. Gingival
hyperplasia. Withdrawal
Content: amlodipine prior to surgery. Increased
besilate angina &/or MI rarely in
patients w/ severe
obstructive CAD.
Concomitant use w/ SL
nitroglycerin, long-acting
nitrates, β-blockers or other
anti-anginal agents. Hepatic
impairment. May prolong
labor duration. Pregnancy &
lactation. Childn. Elderly
Nifedipine
Nifedipine Oral Dizziness, flushing, headache, hypotension, Cardiogenic shock, acute unstable Patients w/ hypotension,
Raynaud's syndrome peripheral oedema, tachycardia, palpitations, angina, use w/in 1 mth of MI. poor cardiac reserve, heart
Adult: Immediate-release: 5-20 mg tid. nausea, constipation, other GI disturbances, Treatment of angina attack in chronic failure, severe aortic
Elderly: Dose reduction may be necessary. increased micturition frequency, lethargy, eye stable angina or acute reduction of BP stenosis, DM, underlying
pain, visual disturbances, syncope, vertigo, in adults. Concomitant use w/ strong severe GI narrowing
Oral migraine, mood disturbances, rashes (including CYP3A4 inducers. (extended-release tab).
Hypertension erythema multiforme), liver function Avoid abrupt withdrawal as
Adult: Immediate-release: Initially, 5 mg tid. Maintenance: 10-20 mg abnormalities (including cholestasis), pruritus, it may casue rebound
tid. Extended-release: Initially, 10-40 mg bid or 20-90 mg once daily. gingival hyperplasia, myalgia, gynaecomastia, angina. Hepatic impairment.
Elderly: Dose reduction may be necessary. tremor, impotence, fever. Paradoxical increase Elderly. Pregnancy and
in ischaemic chest pain during initiation of lactation.
Oral treatment. GI obstruction in some tablets
Angina pectoris covered in indigestible membrane.
Adult: Immediate-release: Initially, 5 mg tid. Maintenance: 10-20 mg
tid. Extended-release: 10-40 mg bid or 30-90 mg once daily.
Elderly: Dose reduction may be necessary.

Immediate-Release: May be taken with or without food. Avoid

grapefruit juice.
Adalat CHD eg, chronic stable angina pectoris (angina of effort), HTN. May be taken Initially mild & transient vasodilatation, CV shock. Concomitant use of Severe hypotension; close
Adalat GITS with or without hypotension, rarely GI, skin & other reactions. rifampicin. Pregnancy & lactation. monitoring of dialysis
modified-release tab Initially 1 tab of GITS 20 or GITS 30 once daily. Recommended dose: food: Avoid Very rarely: Transient visual change; chest patients w/ malignant HTN;
20 mg 1 tab of GITS 30 or GITS 60 once daily. Dose can be increased in grapefruit juice. discomfort (if relation established, discontinue heart failure, severe aortic
[ 30's stages to 120 mg once daily. Swallow whole, therapy). Extremely rare: On prolonged use stenosis.
do not gingival hyperplasia, gynecomastia (both
(P1,149/pack) ] chew/crush. regressing on discontinuation); temporary
Adalat GITS hyperglycemia, liver function disturbances
modified-release tab (including intrahepatic cholestasis). May impair
30 mg ability to drive or operate machinery.
[ 30's (P1,386/pack) ]
Nelapine Treatment & prophylaxis of angina pectoris & treatment of HTN, CHD, May be taken Dizziness, flushing, headache, hypotension, Pregnancy & lactation. Low-cardiac reserve,
Nelapine SR tab 20 coronary spasm, Raynaud's disease. with or without peripheral edema. Rarely, abnormalities in liver hepatic impairment.
mg food: Swallow function. Chest pain.
[ 100's 1 tab bid. May increase slowly to 2 tab bid. whole, do not
(P2,300/pack) ] chew/crush.
Avoid grapefruit
juice.

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Verapamil (Verapamil HCl)

Ritemed Control of supraventricular arrhythmias. Management of angina Nausea, bloating, constipation; fatigue, Hypersensitivity. CV shock, acute MI Monitor in cases of 1st-
RiteMED Verapamil pectoris & HTN. nervosity; vertigo or somnolence, paresthesia, w/ complications (bradycardia, degree AV block,
SR tab 240 mg neuropathy & tremor; cardiac insufficiency hypotension, left-sided heart failure), hypotension, bradycardia,
[ 100's (P47/SR Adult & adolescent >50 kg body wt CHD, paroxysmal, supraventricular development or preexisting cardiac conduction disturbances (2nd- or 3rd- diseases w/ impaired
tachycardia, atrial fibrillation/flutter 240-480 mg/day in 2 single insufficiency exacerbation, excessive degree SA or AV block), sick sinus neuromuscular
tab) ] doses. HTN 240-480 mg in 1-2 single doses in the morning. If the hypotension, orthostatic dysregulation, sinus syndrome, manifest cardiac transmission, (myasthenia
efficacy is insufficient, additional 240 mg in the evening. bradycardia, 1st-degree AV block, swollen insufficiency, atrial fibrillation/flutter & gravis, Lambert-Eaton
ankle, flush, skin reddening, sensation of existing Wolff-Parkinson-White syndrome, advanced
warmth; allergic reactions eg, erythema, syndrome. Concurrent IV use w/ β- Duchenne muscular
pruritus, urticaria, maculopapular exanthema, blockers. dystrophy). Renal
erythromelalgia; headache. impairment. Patients w/
angina pectoris after MI.
Patients w/ rare hereditary
problems of fructose &
galactose intolerance,
lactose deficiency or
glucose-galactose
malabsorption or
saccharase-isomaltase
deficiency. May impair
ability to drive or operate
machinery. Pregnancy (1st
& 2nd trimester) & lactation.
Isoptin  Tab Adult CAD, paroxysmal supraventricular tachycardia, atrial Should be taken Dizziness, headache; bradycardia; flushing, Hypersensitivity. Cardiogenic shock; Acute MI; heart block/1st-
Isoptin FC tab 40 mg flutter/fibrillation IR: 120-480 mg in 3 or 4 divided doses; SR: 120- with food: Take hypotension; constipation, nausea; peripheral 2nd- & 3rd-degree AV block & sick degree AV
[ 100's 480 mg in 1 or 2 divided doses. HTN IR: 120-480 mg in 3 divided preferably w/ or edema. sinus syndrome (except in patients w/ block/bradycardia/asystole;
(P3,875/pack) ] doses; SR: 120-480 mg in 1 or 2 divided doses. Childn 6-14 yr 80- shortly after a functioning artificial pacemaker); antiarrhythmics, β-blockers;
360 mg in 2-4 divided doses, up to 6 yr 80-120 mg in 2-3 divided meals. Swallow heart failure w/ reduced ejection digoxin; heart failure;
Isoptin inj 5 mg/2 mL doses. whole, do not fraction of <35% &/or pulmonary hypotension; HMG-CoA
[ (amp) 5 × 1's Inj Adult Initially 5-10 mg (0.075-0.15 mg/kg) IV bolus over at least 2 suck/chew. wedge pressure >20 mmHg; atrial reductase inhibitors; other
(P1,066/box) ] min. Repeat dose: 10 mg (0.15 mg/kg) 30 min after the 1st fibrillation/flutter in the presence of an neuromuscular transmission
dose. Childn 1-15 yr 0.1-0.3 mg/kg (single-dose range: 2-5 mg) IV accessory bypass tract (W-P-W or L- disorders. Renal & hepatic
Isoptin SR tab 180 bolus over at least 2 min (max: 5 mg), 0-1 yr 0.1-0.2 mg/kg (single G-L syndromes). Inj: Severe impairment. May impair
mg dose range: 0.75-2 mg) IV bolus over at least 2 min under continuous hypotension. Patients receiving IV β- ability to drive or operate
[ 60's (P4,380/pack) ] ECG monitoring. Repeat dose: Childn 1-15 yr 0.1-0.3 mg/kg (single blockers (eg, propranolol); ventricular machinery. Pregnancy &
dose range: 2-5 mg) 30 min after the 1st dose. Max single dose: 10 tachycardia. lactation. Inj: Monitor ECG &
Isoptin SR tab 240 mg, 0-1 yr 0.1-0.2 mg/kg (single dose range: 0.75-2 mg) 30 min after BP, AV block or excessive
mg the 1st dose. bradycardia; potentiation of
[ 60's (P5,799/pack) ] CV effects w/
antiarrhythmics & β-
Isoptin tab 80 mg blockers; digoxin; heart
[ 100's failure; hypotension w/
(P5,461/pack) ] quinidine; additive effects on
the reduction of myocardial
contractility, prolonging AV
conduction & repolarization
w/ flecainide. Disopyramide
should not be administered
w/in 48 hr before or 24 hr
after verapamil
administration. May depress
myocardial contractility or
AV conduction, the
possibility of detrimental int
w/ oral β-blockers.

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Diltiazem
Ritemed
Angiozem  Management of chronic stable angina, angina due to coronary Headache, ankle edema, hypotension, Patients w/ sick sinus syndrome or Prinzmetal's angina.
Angiozem tab 30 mg artery spasm; alone or in combination, for the treatment of dizziness, flushing, nausea, GI disturbances, 2nd- & 3rd-degree AV block except in Worsening of CHF in
[ 100's (P1,400/pack) ] HTN. mild & transient rash, erythema multiforme or the presence of a functioning patients w/ preexisting
exfoliative dermatitis, transient elevations in ventricular pacemaker. Hypotension impairment of ventricular
Angiozem tab 60 mg Angina pectoris 30 mg tid-qid. HTN 60 mg tid. liver enzyme values, hepatitis, CV or CNS (<90 mmHg systolic), acute MI, function; impaired renal or
[ 100's (P2,200/pack) ] effects. pulmonary congestion. Lactation. hepatic function.
Dilzem  Angina pectoris Initially 120 mg/day in equally divided doses. Should be taken Edema, asthenia, flushing, sinus bradycardia, Hypersensitivity. Sick sinus syndrome, Concomitant use w/ β-
Dilzem OD tab 120 mg Optimum dose range: 180-360 mg/day in divided doses. on an empty 1st-degree AV block, headache, nausea, rash , 2nd- or 3rd-degree AV block, blockers or digitalis may
[ 60's (P5,323/pack) ] stomach: joint swelling, fatigue, dizziness; mycoclonus & hypotension, acute MI, X-ray result in additive effects on
 HTN Initially 120-240 mg/day in divided doses. Usual dose Preferably taken extrapyramidal disorders. documented pulmonary congestion. cardiac conduction. Patients
Dilzem SA tab 90 mg range: 240-360 mg/day in divided doses. before meals & Pregnancy & lactation. w/ hepatic & renal
[ 60's (P4,826/pack) ] at bedtime. SA & impairment; CHF. Patients
 Kidney transplantation Initially 120 mg/day in 2 equally SR tab: Swallow at risk for heart irregularities
Dilzem SR tab 180 mg divided doses. Optimum dose range: 180-360 mg/day in 3 whole, do not or those w/ long QT
[ 60's (P7,182/pack) ] equally divided doses. chew/crush manifestations should avoid
concurrent use w/
Dilzem tab 30 mg erythromycin. Discontinue
[ 200's (P7,308/pack) ] once dermatological events
progressed to serious skin
Dilzem tab 60 mg reaction.
[ 200's (P10,277/pack) ]
BETA BLOCKERS
Metoprolol tartrate
Neibloc Adult Initially 100 mg daily. May increase at wkly intervals to max: Gl & sleep pattern disturbances, headache, Heart block >1st degree, AV block II & Avoid abrupt w/drawal.
Neobloc tab 100 mg 400 mg/day. Maintenance: 100-400 mg/day. dizziness & weakness. III, cardiogenic shock, overt cardiac Diabetes, anesth,
[ 100 × 1's (P06/pack) ] failure, sinus bradycardia, hyperthyroidism. 1st
[ 500 × 1's (P06/pack) ] bronchospastic disease. trimester of pregnancy.

Neobloc tab 50 mg
[ 100 × 1's (P04/pack) ]
[500 × 1's (P04/pack) ]
Pharex Metoprolol HTN Initially 100 mg daily, increased wkly up to 400 mg. To be Bradycardia, hypotension, heart failure or heart Bronchospasm or asthma. History of Heart failure. May mask
Pharex Metoprolol tab taken once-bid. Maintenance dose: 100-200 mg daily. block. Depression, dizziness, hallucination, obstructive airway disease. Metabolic symptoms of
100 mg Angina pectoris 50-100 mg bid-tid. confusion & sleep disturbances. Fatigue, acidosis, sinus bradycardia, or partial hyperthyroidism &
Cardiac arrhythmias 50 mg bid-tid, max: 300 mg daily in divided paresthesia, peripheral neuropathy, myopathy, heart block. hypoglycemia. Renal or
[ 100's (P05/tab) ] doses. muscle cramps. GI effects. Interference w/ hepatic dysfunction.
Pharex Metoprolol tab 50 MI 50 mg 6 hrly for 2 days (for patients who have received full IV carbohydrate & lipid metabolism. Skin Patients under long-term
mg dose), 100 mg bid (for patients who did not receive by IV inj). reactions, ocular symptoms & hematologic treatment should be
Maintenance dose: 100 mg. Hyperthyroidism Adjunct dose of reactions. gradually discontinued over
[ 100's (P03/tab) ] 50 mg qid. 1-2 wk.
Migraine prophylaxis 100-200 mg daily in divided doses.
Ritemed  HTN Initially 100 mg daily, dose may be increased at wkly GI & sleep disturbances, exertional tiredness & AV block, refractory heart failure, Hyperthyroidism or
Metoprolol tab 100 mg intervals to max of 400 mg daily. lassitude, headache, dizziness. severe & sinus bradycardia, thyrotoxicosis, DM, asthma
cardiogenic shock, acute or pulmonary conditions,
[ 100's (P450/pack) ]  Angina pectoris Initially 25-50 mg bid, usual dose range of bronchospasm, MAOIs. severe hepatic disease.
RiteMED Metoprolol tab 100-400 mg daily in 2 divided doses. Pregnancy.
50 mg
[ 100's (P275/pack) ]
Metroprolol sucinate
 Betazok
 Cardiosel-OD

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Bisoprolol (Bisoprolol fumarate)

Ritemed Essential HTN 5 mg once daily. Bradycardia; worsening of preexisting heart Hypersensitivity. Acute heart failure, Patients w/ ischemic heart
RiteMED Bisoprolol FC Diastolic BP up to 105 mmHg 2.5 mg once daily. May be failure, dizziness, headache; GI complaints eg, cardiogenic shock, 2nd- or 3rd-degree disease, HTN, angina
tab 10 mg increased up to 10 mg once daily if required. Max: 20 mg once nausea, vomiting, diarrhea, constipation; AV block (w/o pacemaker), sick sinus pectoris & accompanying
[ 100's (P24/film-coated daily. feeling coldness or numbness in extremities, syndrome, SA block; symptomatic heart failure; DM, 1st-
tab) ] CHD (angina pectoris) 5 mg once daily. May be increased to 10 hypotension & asthenia. bradycardia or hypotension; severe degree AV block,
RiteMED Bisoprolol FC mg once daily. Max: 20 mg once daily. bronchial asthma or COPD, severe Prinzmetal's angina,
tab 5 mg forms of peripheral arterial occlusive peripheral arterial occlusive
[ 100's (P1,600/box) ] disease or Raynaud's syndrome, disease, ongoing
untreated pheochromocytoma & desensitization therapy &
metabolic acidosis. those on strict fasting;
existing or history of
psoriasis,
pheochromocytoma & those
undergoing general anesth.
Avoid abrupt w/drawal. May
impair ability to drive or
operate machinery.
Pregnancy & lactation.
Childn.
Carvedilol
Ritemed Essential HTN Dizziness, headache, cardiac failure,
Carvedilol tab 25 mg  Adult Initially 12.5 mg once daily for the 1st 2 days, continued hypotension, asthenia; bronchitis, pneumonia,
[ 100's (P850/box) ] at 25 mg/day thereafter. upper resp tract infection, UTI, anemia,
 Elderly Initially 12.5 mg once daily, may be increased increased wt, hypercholesterolemia, impaired
gradually at ≥2-wk interval. blood glucose, depression, depressed mood,
visual impairment, decreased lacrimation, eye
Chronic stable angina pectoris Adult & elderlyInitially 12.5 mg irritation, bradycardia, edema, hypervolemia,
bid for the 1st 2 days, continued at 25 mg bid thereafter. May be fluid overload, orthostatic hypotension,
increased gradually at ≥2-wk interval. Max: 100 mg (adult) & 25 peripheral circulation disturbances, dyspnea,
mg (elderly) in 2 divided doses. pulmonary edema, asthma in predisposed
patients, nausea, diarrhea, vomiting,
Moderate to severe heart failure Initially 3.125 mg bid for 2 wk. dyspepsia, abdominal pain, pain in extremities,
If tolerated, may be increased slowly for not <2-wk interval up to renal failure & function abnormalities,
6.25 mg bid, then up to 12.5 mg bid & finally up to 25 mg bid. micturition disorders, pain.
 Patient >85 kg body wt Max: 50 mg bid,
 <85 kg body wt Max: 25 mg bid.
Carvid HTN Initially 12.5 mg once daily or 6.25 mg bid, may be Diarrhea, nausea, dizziness, abnormal or Unstable/decompensated heart failure, Diabetes & hypoglycemia,
25 mg increased at 2-wk intervals. Max: 50 mg. blurred vision. clinically manifest hepatic impairment, peripheral vascular disease,
[ 30's (P537/pack) ] marked fluid retention or overload thyrotoxicosis,
Angina pectorisInitially 12.5 mg bid for 2 days then increase to requiring IV inotropic support, 2nd- or pheochromocytoma,
Carvid tab 6.25 mg 25 mg bid. Dose may be increased at 2-wk intervals. Max: 100 3rd-degree AV block, severe Raynaud's phenomenon,
[ 30's (P322/pack) ] mg bid. CHF Initially 3.125 mg bid for 2 wk. If dose is tolerated, bradycardia or hypotension, sick sinus psoriasis, Prinzmetal's
increase to 6.25 mg bid, followed by 12.5 mg bid & thereafter 25 syndrome, cardiogenic shock, variant angina. Pregnancy &
mg bid at 2-wk intervals. metabolic acidosis, history of lactation. Childn.
 Mild to moderate heart failure in patients >85 kgMax: 50 mg bronchospasm or asthma, other
bid. obstructive lung disorders.
 Severe heart failure & mild to moderate heart failure in patients
<85 kg Max: 25 mg bid.

Left ventricular dysfunction following MI Initially 6.25 mg, then

increase to bid & maintain for 3-10 days. Decrease dose to 3.125
mg bid if patient develop signs of tolerance. Max: 25 mg bid.

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

Nebivolol
Nebil Treatment of essential HTN & stable, mild & moderate CHF in Headache, dizziness, paresthesia, dyspnea, Hypersensitivity. Severe hepatic Concomitant use of anesth.
tab 2.5 mg addition to standard therapies in elderly patients ≥70 yr, alone or constipation, nausea, diarrhea, tiredness, insufficiency. Acute heart failure, Patients w/ compensated
[ 14's (P126/box) ] in combination w/ other antihypertensive drugs. edema; bradycardia. cardiogenic shock or episodes of heart congestive heart failure,
failure decompensation requiring IV peripheral vascular disease,
Nebil tab 5 mg inotropic therapy. Sick sinus syndrome history of psoriasis & those
Adult 5 mg once daily. Max dose: 10 mg once daily.
[ 14's (P252/box) ] including SA block; 2nd & 3rd degree on dialysis. May mask
heart block (w/o pacemaker); history symptoms of hypoglycemia
Elderly & renal insufficiency Initially 2.5 mg once daily, may be
of bronchospasm & bronchial asthma; in diabetic patients. Abrupt
increased to 5 mg.
untreated pheochromocytoma; w/drawal may lead to
metabolic acidosis; bradycardia (heart transitory worsening of heart
Hepatic insufficiency2.5 mg once daily.
rate <60 bpm); hypotension (systolic failure. Pregnancy &
BP <90 mmHg); severe peripheral lactation. Elderly >75 yr.
circulatory disturbances. Rare
hereditary problems of galactose
intolerance, Lapp-lactase deficiency or
glucose-galactose malabsorption
Nebilet HTN
Nebilet tab 5 mg  Adult 5 mg once daily. In combination w/ other
[ 30's (P516/box) ] antihypertensive agents 5 mg plus hydrochlorothiazide 12.5
 25 mg.
 Elderly >65 yr Start at 2.5 mg daily. May be increased to 5 mg
daily.

Chronic heart failure Initially 1.25 mg once daily, increase at

interval of 1
CENTRALLY-ACTING ANTIADRENERGICS
Clonidine
Catapres  HTN of any etiology except the pheochromocytoma form. Dizziness, headache, paresthesia, sedation, Diseases affecting rhythmic
 Catapres infusion 150 gynecomastia, confusion state, delusional & AV conduction system of
mcg/mL  Tab Mild to moderate HTN 75-150 mcg bid. Severe perception, depression, hallucination, the heart; renal failure.
[ (amp) 5 × 1's HTN Increase single dose to 300 mcg. Could be repeated up decreased libido, nightmare, sleep disorder, Sudden discontinuance.
(P967/box) ] to tid (900 mcg). accommodation disorder, decreased May impair ability to drive or
 lacrimation, AV block, bradyarrhythmia, sinus operate machinery
Catapres tab 150 mcg  Infusion 0.2 mcg/kg/min IV infusion, not >150 mcg/infusion. bradycardia, orthostatic hypotension.
[ 100's (P4,512/pack) ] Raynaud's phenomenon, nasal dryness,
 alopecia, pruritus, rash, urticaria, erectile
Catapres tab 75 mcg dysfunction, fatigue, malaise, colonic pseudo-
[ 100's (P2,961/pack) ] obstruction, constipation, dry mouth, nausea,
salivary gland pain, vomiting
Ritemed Mild to moderate HTN Initially 75-150 mcg bid (morning & Dry mouth, drowsiness, dizziness, sedation,
 Clonidine tab 150 mcg bedtime). Dose may be increased in increments of 100 mcg/day constipation
[ 100's (P2,850/box) ] until optimum response is achieved
 RiteMED Clonidine tab
75 mcg
[ 100's (P1,850/box) ]
Methyldopa
Aldomet HTN
tab 250 mg
[ 100's (P2,131/pack) Adult Initially 250 mg bid or tid for 1st 48 hr adjusted thereafter.
Max: 3 g daily.

Childn Initially 10 mg/kg daily in 2-4 doses. Max: 65 mg/kg or 3 g

daily, whichever is less

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

DIURETICS
Hydrochlorothiazide
Hydrochlorothiazide Adult : PO HTN Initial: 12.5 mg/day, may increase to 25-50 mg Should be taken Hypersensitivity to sulfonamide-derived drugs,
once daily, either alone or w/ other with food. anuria, severe renal impairment.
antihypertensives. Oedema 25-100 mg/day in 1-2 divided doses.
Diuzid Edema Usual dose: 25-100 mg daily, up to 200 mg daily (for Should be taken Dry mouth, thirst, weakness, lethargy, Pregnancy & lactation. Patients w/ Patients w/ renal
Diuzid tab 12.5 mg severe cases). Reduced to 25-50 mg daily or intermittently. with food. drowsiness, restlessness, muscle pain & severe renal impairment or anuria, impairment, existing fluid &
[ 100's (P05/tab) ] cramps, seizures, oliguria, hypotension & GI Addison's disease, preexisting electrolyte disturbances.
Nephrogenic diabetes insipidus Up to 100 mg daily. disturbances. Anorexia, gastric irritation, hypercalcemia. Elderly. May precipitate
Diuzid tab 25 mg  HTN Usual dose: 25-50 mg daily. nausea, vomiting, constipation, diarrhea, attacks of gout, cause
[ 100's (P06/tab) ]  Childn 1-2 mg/kg body wt daily in 2 divided doses. siaredenitis, headache, dizziness, hyperglycemia & aggravate
 Infants <6 mth Up to 3 mg/kg daily. photosensitivity reactions, postural or unmask DM.
hypotension, paraesthesia, impotence & yellow
vision. Skin rashes, fever, pulmonary edema,
pneumonitis, anaphylaxis & toxic epidermal
necrolysis.
Chlorthalidone
Chlorthalidone Oral Should be taken  Significant: Hypersensitivity, hypokalaemia, Hypersensitivity to chlortalidone and
Hypertension with food. hyperlipidaemia, hyperuricaemia, other sulfonamide derivatives. Anuria,
Adult: Initially, 12.5 or 25 mg daily given alone or w/ other hyponatraemia, hypomagnesaemia, symptomatic hyperuricaemia (i.e.
antihypertensive; may increase to 50 mg daily if necessary. hypochloremic alkalosis, hyperglycaemia, history of gout or uric acid calculi);
Child: Initially, 0.5-1 mg/kg 48 hrly. Max: 1.7 mg/kg 48 hrly. gout, photosensitivity. refractory hypokalaemia,
Elderly: Initially, 6.25-12.5 mg once daily or on alternate days. hyponatraemia, and hypercalcaemia;
Max: 25 mg daily.  Rarely, hypercalcaemia. adrenal insufficiency (e.g. Addison’s
Nervous: Dizziness, vertigo. disease), HTN during pregnancy.
Oral CV: Postural hypotension. Severe hepatic or renal (CrCl <30
Diabetes insipidus GI: Mild GI disturbance, loss of appetite. mL/min) impairment. Concomitant
Adult: Initially, 100 mg bid. Maintenance: 50 mg daily. Genitourinary: Erectile dysfunction. lithium therapy.
Child: Initially, 0.5-1 mg/kg 48 hrly. Max: 1.7 mg/kg 48 hrly. Dermatologic: Rash, urticaria.
Others: Weakness.
Oral
Oedema, Oedema associated with heart failure
Adult: Initially, 25-50 mg daily given alone or w/ digitalis, ACE
inhibitor, or both; may increase to 100-200 mg daily in severe
cases. Maintenance: 25-50 mg daily or on alternate days.
Child: Initially, 0.5-1 mg/kg 48 hrly. Max: 1.7 mg/kg 48 hrly.
Indapamide
Indapamide Adult : PO

 HTN 1.25-2.5 mg once daily.

 Oedema 2.5 mg once daily, up to 5 mg/day after 1 wk if

needed.
Natrillix SR Essential HTN Should be taken Commonly, raised skin rashes, allergic Hypersensitivity to sulfonamides;
1.5 mg daily, preferably in the morning. with food: reactions, mainly dermatological, in subjects severe hepatic or renal failure, hepatic
Indapamide Swallow whole, predisposed to allergic or asthmatic reactions. encephalopathy, hypokalemia.
hemihydrate do not Lactation.
chew/crush.
Natrilix SR tab 1.5 mg
[ 30's (P1,082/pack) ]
COMBINATION THERAPY
CCB + ACEi
Amlodipine + Benazepril Oral Cough, peripheral oedema, angioedema, History of angioedema. Concomitant
Hypertension headache, dizziness; asthenia, fatigue; use w/ aliskiren esp in patient w/ DM.
Adult: Each cap contains amlodipine (mg)/benazepril (mg): insomnia, nervousness, anxiety, tremor, Severe renal impairment (CrCl ≤30
2.5/10, 5/10, 5/20, 5/40, 10/20 or 10/40: Initially, 2.5 mg/10 mg decreased libido; flushing, hot flashes, rash, mL/min). Pregnancy and lactation.

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 PHARMACOLOGY 2 Anti-Hypertensive Drugs Module #, Lecture #

once daily, may be titrated according to clinical response. Max: skin nodule, dermatitis; dry mouth, nausea,
Amlodipine 10 mg and benazepril 40 mg once daily. abdominal pain, constipation, diarrhoea,
Elderly: Start w/ 2.5 mg amlodipine component once daily. dyspepsia, oesophagitis, neutropenia;
ACEi + Thiazide Diuretic
Captopril + Oral Should be taken Skin rashes, dysgeusia, cough, hypochloraemic Hypersensitiviry, anuria and severe Neonates and children,
Hydrochlorothiazide Hypertension, Chronic heart failure on an empty alkalosis, rarely haemolytic anaemia, renal impairment, allergy to elderly patients, renal
Adult: Per tablet contains captopril 25 mg and stomach. Take 1 thrombocytopenia, jaundice, pancreatitis, sulphonamide-related drugs, collagen disease, liver disease, DM,
hydrochlorothiazide 15 mg: Initially, 1 tablet once daily. Daily hr before meals. noncardiogenic pulmonary oedema, - vascular disease, renal artery gout, hyperlipidaemia, ECG
dose should not exceed: 150 mg (captopril) and 50 mg hypomagnesaemia leading to fatigue, stenosis. Pregnancy (2nd and 3rd evidence of LVH. Lactation.
(hydrochlorothiazide). weakness and paralysis. Hyperuricaemia, trimesters).
impotence in diabetics, significant reduction in
tear production and glucose tolerance and
increase in plasma Ca concentrations.
Potentially Fatal: Hyperkalaemia in patients
having renal impairment, rarely idiosyncratic
hypersensitivity reactions like Stevens-Johnson
syndrome, SLE and acute pancreatitis. Severe
hyponatraemia.
ARB + Thiazide Diuretic
Pharex Treatment of HTN Initially 1 tab once daily, may be increased Facial edema, fever, orthostatic effects, Hypersensitivity to losartan K &/or Impaired hepatic function or
 Losartan K 50 mg, in patients who do to 2 tab once daily if BP remains syncope; anemia; gout; CV, digestive, hydrochlorothiazide or other progressive liver disease.
hydrochlorothiazide not respond to uncontrolled after 3 wk. musculoskeletal, nervous system/psychiatric, sulfonamide-derived drugs. Pregnancy (2nd & 3rd
12.5 mg monotherapy. resp, skin & urogenital disorders; blurred vision, trimesters) & lactation.
burning/stinging in the eye, conjunctivitis, taste Childn. Elderly.
 Pharex Losartan perversion, tinnitus, decrease in visual acuity.
Potassium +
Hydrochlorothiazide FC
tab
[ 100's (P1,400/box) ]
CCB + ARB
Amlodipine + Losartan  Amlodine tab HTN, stable & Prinzmetal's angina Initially, 5 Dizziness, flushing, headache, hypotension, Hypersensitivity. Cardiogenic shock, Patients w/ hypotension,
mg once daily. Increase to 10 mg once daily if necessary. peripheral edema, tachycardia, palpitations; recent MI, acute unstable angina & poor cardiac reserve, heart
 Amlodine Plus 5 mg/50 nausea, GI disturbances, increased micturition chronic stable angina attack. failure, vol depletion; severe
mg (content:  Amlodine Plus FC tab Stable & Prinzmetal's angina Initially 1 frequency, lethargy, eye pain, mental Pregnancy. aortic stenosis; hepatic &
Amlodipine besilate 5 FC tab daily. Increase to 2 FC tab daily if necessary. depression. Paradoxical increase in ischemic renal impairment; renal
mg, losartan K 50 mg). chest pain at the start of treatment. Rashes, artery stenosis. Sudden
 Amlodine Plus 5 fever, abnormalities in liver function w/drawal may exacerbate
mg/100 mg (content: (cholestasis), gingival hyperplasia, myalgia, angina. Discontinue if
Amlodipine besilate 5 tremor, impotence. ischemic pain following
mg, losartan K 100 mg) administration occurs.
Monitor serum K conc.
Avoid concomitant use w/ K-
sparing diuretics. Lactation.

Transcribed By: [PRUDENCIANO, TUAZON] Checked by: [BANDAYREL] Page 13 of 13