Adult HTN 5 mg once daily. May increase dose at intervals of 2 wk. Max: 40 mg once daily. Heart failure Initially 1.25 mg once daily. May double dose every 1-2 wk. Max: 10 mg once daily.
Administration
May be taken with or without food.
Contraindications
Sick-sinus syndrome, 2nd or 3rd degree heart block (w/o pacemaker), decompensated cardiac failure, severe bradycardia, cardiogenic shock, untreated phaeochromocytoma, metabolic acidosis, severe peripheral circulatory disturbances. History of bronchospasm & bronchial asthma. Hepatic impairment.
Special Precautions
Patients w/ inadequate cardiac function, well-compensated heart failure & myasthenia gravis. Patients undergoing major surgery involving general anaesth. May mask signs & symptoms of hypoglycaemia & hyperthyroidism. Abrupt w/drawal may exacerbate angina symptoms &/or precipitate MI & ventricular arrhythmias in patients w/ CAD. Pregnancy & lactation.
Increased plasma conc w/ potent CYP2D6 inhibitors (eg, paroxetine, fluoxetine, propafenone, thioridazine, quinidine). May cause conduction disturbance w/ antiarrhythmics (eg, amiodarone, disopyramide) or nondihydropyridine Ca channel blockers (eg, diltiazem, verapamil). Additive -ve effects on AV conduction & heart rate w/ other β-adrenergic blockers or digoxin. May result in additive hypotension or bradycardia w/ catecholamine-depleting agents (eg, reserpine). May increase risk of rebound HTN w/ abrupt w/drawal of clonidine.
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