acebutolol (Rx)

Brand and Other Names:Sectral
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

capsule

  • 200mg
  • 400mg

Hypertension

400-1200 mg/day divided PO q12hr; not to exceed 1200 mg/day

Ventricular Arrhythmias

400-1200 mg/day divided PO q12hr; not to exceed 1200 mg/day

Angina

400-1200 mg/day divided PO q12hr; not to exceed 1200 mg/day

Renal Impairment

CrCl 25-49 mL/min: Reduce dose by 50%

CrCl < 25 mL/min: Reduce dose by 75%

Hepatic Impairment

Dose adjustment not necessary

Other Indications & Uses

Off-label: ventricular tachycardia, angina, essential tremor

Also used to control ventricular premature beats

Safety and efficacy not established

Hypertension

Initial dose: 200-400 mg PO daily; not to exceed 800 mg/day

Ventricular Arrhythmias

Initial dose: 200-400 mg PO daily; not to exceed 800 mg/day

Angina

Initial dose: 200-400 mg PO daily; not to exceed 800 mg/day

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Interactions

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              Serious - Use Alternative (19)

              • atenolol

                acebutolol and atenolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • betaxolol

                acebutolol and betaxolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • bisoprolol

                acebutolol and bisoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • carvedilol

                acebutolol and carvedilol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • celiprolol

                acebutolol and celiprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • esmolol

                acebutolol and esmolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • labetalol

                acebutolol and labetalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • lofexidine

                lofexidine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that decrease pulse or blood pressure to mitigate risk of excessive bradycardia and hypotension.

              • metoprolol

                acebutolol and metoprolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • nadolol

                acebutolol and nadolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • nebivolol

                acebutolol and nebivolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • penbutolol

                acebutolol and penbutolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • pindolol

                acebutolol and pindolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • propranolol

                acebutolol and propranolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • saquinavir

                saquinavir, acebutolol. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Increased risk of PR prolongation and cardiac arrhythmias.

              • sotalol

                acebutolol and sotalol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • timolol

                acebutolol and timolol both increase anti-hypertensive channel blocking. Avoid or Use Alternate Drug.

              • umeclidinium bromide/vilanterol inhaled

                acebutolol, umeclidinium bromide/vilanterol inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .

              • vilanterol/fluticasone furoate inhaled

                acebutolol, vilanterol/fluticasone furoate inhaled. pharmacodynamic antagonism. Avoid or Use Alternate Drug. If a beta-blocker must be used in patients with COPD taking a beta-agonist, consider using a beta-blocker that is beta-1 selective .

              Monitor Closely (169)

              • aceclofenac

                acebutolol and aceclofenac both increase serum potassium. Use Caution/Monitor.

                aceclofenac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • acemetacin

                acebutolol and acemetacin both increase serum potassium. Use Caution/Monitor.

                acemetacin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • albuterol

                acebutolol increases and albuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of albuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • aldesleukin

                aldesleukin increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • alfuzosin

                alfuzosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. The severity and duration of hypotension following the first dose of Alfuzosin may be enhanced.

              • aluminum hydroxide

                aluminum hydroxide decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • amifostine

                amifostine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration with blood pressure lowering agents may increase the risk and severity of hypotension associated with amifostine. When amifostine is used at chemotherapeutic doses, withhold blood pressure lowering medications for 24 hr prior to amifostine; if blood pressure lowering medication cannot be withheld, do not administer amifostine.

              • amiloride

                acebutolol and amiloride both increase serum potassium. Modify Therapy/Monitor Closely.

              • amiodarone

                amiodarone, acebutolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of cardiotoxicity with bradycardia.

              • amlodipine

                acebutolol and amlodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • amobarbital

                amobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of amobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • arformoterol

                acebutolol increases and arformoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of arformoterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • asenapine

                asenapine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • aspirin

                acebutolol and aspirin both increase serum potassium. Use Caution/Monitor.

                aspirin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • aspirin rectal

                acebutolol and aspirin rectal both increase serum potassium. Use Caution/Monitor.

                aspirin rectal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                acebutolol and aspirin/citric acid/sodium bicarbonate both increase serum potassium. Use Caution/Monitor.

              • atazanavir

                atazanavir increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypotension, bradycardia, AV block, and prolonged PR interval. Consider lowering beta blocker dose.

              • atenolol

                acebutolol and atenolol both increase serum potassium. Use Caution/Monitor.

              • avanafil

                avanafil increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • bendroflumethiazide

                acebutolol increases and bendroflumethiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • betaxolol

                acebutolol and betaxolol both increase serum potassium. Use Caution/Monitor.

              • bismuth subsalicylate

                bismuth subsalicylate, acebutolol. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Blockage of renal prostaglandin synthesis; may cause severe hypertension.

              • bisoprolol

                acebutolol and bisoprolol both increase serum potassium. Use Caution/Monitor.

              • bumetanide

                acebutolol increases and bumetanide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • butabarbital

                butabarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butabarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • butalbital

                butalbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of butalbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • calcium acetate

                calcium acetate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.

              • calcium carbonate

                calcium carbonate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.

                calcium carbonate decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • calcium chloride

                calcium chloride decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.

              • calcium citrate

                calcium citrate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.

              • calcium gluconate

                calcium gluconate decreases effects of acebutolol by unspecified interaction mechanism. Use Caution/Monitor.

              • candesartan

                candesartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, candesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • carbenoxolone

                acebutolol increases and carbenoxolone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carbidopa

                carbidopa increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Therapy with carbidopa, given with or without levodopa or carbidopa-levodopa combination products, is started, dosage adjustment of the antihypertensive drug may be required.

              • carvedilol

                acebutolol and carvedilol both increase serum potassium. Use Caution/Monitor.

              • celecoxib

                acebutolol and celecoxib both increase serum potassium. Use Caution/Monitor.

                celecoxib decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • celiprolol

                acebutolol and celiprolol both increase serum potassium. Use Caution/Monitor.

              • chlorothiazide

                acebutolol increases and chlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorthalidone

                acebutolol increases and chlorthalidone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • choline magnesium trisalicylate

                acebutolol and choline magnesium trisalicylate both increase serum potassium. Use Caution/Monitor.

                choline magnesium trisalicylate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • clevidipine

                acebutolol and clevidipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • clonidine

                acebutolol, clonidine. Mechanism: pharmacodynamic synergism. Modify Therapy/Monitor Closely. Selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.

              • cyclopenthiazide

                acebutolol increases and cyclopenthiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dasiglucagon

                acebutolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.

              • desflurane

                desflurane, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • diclofenac

                acebutolol and diclofenac both increase serum potassium. Use Caution/Monitor.

                diclofenac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • diflunisal

                acebutolol and diflunisal both increase serum potassium. Use Caution/Monitor.

                diflunisal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • digoxin

                acebutolol and digoxin both increase serum potassium. Use Caution/Monitor.

                acebutolol increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor. Enhanced bradycardia.

              • diltiazem

                acebutolol and diltiazem both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • dobutamine

                acebutolol increases and dobutamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of dobutamine by pharmacodynamic antagonism. Use Caution/Monitor.

              • dopexamine

                acebutolol increases and dopexamine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of dopexamine by pharmacodynamic antagonism. Use Caution/Monitor.

              • doxazosin

                doxazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. The severity and duration of hypotension following the first dose of doxozosin may be enhanced.

              • drospirenone

                acebutolol and drospirenone both increase serum potassium. Modify Therapy/Monitor Closely.

              • ephedrine

                acebutolol increases and ephedrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of ephedrine by pharmacodynamic antagonism. Use Caution/Monitor.

              • epinephrine

                acebutolol increases and epinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of epinephrine by pharmacodynamic antagonism. Use Caution/Monitor.

              • epinephrine racemic

                acebutolol increases and epinephrine racemic decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of epinephrine racemic by pharmacodynamic antagonism. Use Caution/Monitor.

              • eprosartan

                eprosartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, eprosartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • esmolol

                acebutolol and esmolol both increase serum potassium. Use Caution/Monitor.

              • ethacrynic acid

                acebutolol increases and ethacrynic acid decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ether

                acebutolol, ether. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Both beta blockers and ether depress the myocardium; consider lowering beta blocker dose if ether used for anesthesia.

              • etodolac

                acebutolol and etodolac both increase serum potassium. Use Caution/Monitor.

                etodolac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • etomidate

                etomidate, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • felodipine

                acebutolol and felodipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • fenbufen

                acebutolol and fenbufen both increase serum potassium. Use Caution/Monitor.

              • fenoprofen

                acebutolol and fenoprofen both increase serum potassium. Use Caution/Monitor.

                fenoprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • fingolimod

                acebutolol increases effects of fingolimod by pharmacodynamic synergism. Use Caution/Monitor. Both medications decrease heart rate. Monitor patients on concomitant therapy, particularly in the first 6 hours after fingolimod is initiated or after a treatment interruption of at least two weeks, for bradycardia and atrioventricular block. To identify underlying risk factors of bradycardia and AV block, obtain a new or recent ECG in patients using beta-blockers prior to starting fingolimod.

              • flurbiprofen

                acebutolol and flurbiprofen both increase serum potassium. Use Caution/Monitor.

                flurbiprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • formoterol

                acebutolol increases and formoterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of formoterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • furosemide

                acebutolol increases and furosemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • gentamicin

                acebutolol increases and gentamicin decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • glucagon

                glucagon decreases toxicity of acebutolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.

              • glucagon intranasal

                glucagon intranasal decreases toxicity of acebutolol by sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor. Coadministration of glucagon with beta-blockers may have transiently increased pulse and blood pressure.

              • hawthorn

                hawthorn increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor.

              • hydralazine

                hydralazine increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Additive hypotensive effects.

              • hydrochlorothiazide

                acebutolol increases and hydrochlorothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • ibuprofen

                acebutolol and ibuprofen both increase serum potassium. Use Caution/Monitor.

                ibuprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ibuprofen IV

                ibuprofen IV decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                acebutolol and ibuprofen IV both increase serum potassium. Use Caution/Monitor.

              • indacaterol, inhaled

                indacaterol, inhaled, acebutolol. Other (see comment). Use Caution/Monitor. Comment: Beta-blockers and indacaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.

              • indapamide

                acebutolol increases and indapamide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • indomethacin

                acebutolol and indomethacin both increase serum potassium. Use Caution/Monitor.

                indomethacin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • insulin degludec

                acebutolol, insulin degludec. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).

              • insulin degludec/insulin aspart

                acebutolol, insulin degludec/insulin aspart. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).

              • insulin inhaled

                acebutolol, insulin inhaled. Other (see comment). Modify Therapy/Monitor Closely. Comment: Beta-blockers may either increase or decrease the blood glucose lowering effect of insulin; beta-blockers can prolong hypoglycemia (interference with glycogenolysis) or cause hyperglycemia (insulin secretion inhibited).

              • iodixanol

                acebutolol increases toxicity of iodixanol by unspecified interaction mechanism. Use Caution/Monitor. Use of beta-blockers lowers the threshold for and increases the severity of contrast reactions, and reduces the responsiveness of treatment of hypersensitivity reactions with epinephrine. .

              • irbesartan

                irbesartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, irbesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • isoproterenol

                acebutolol increases and isoproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of isoproterenol by pharmacodynamic antagonism. Use Caution/Monitor.

              • isradipine

                acebutolol and isradipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • ivabradine

                ivabradine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Most patients receiving ivabradine will also be treated with a beta-blocker. The risk of bradycardia increases with coadministration of drugs that slow heart rate (eg, digoxin, amiodarone, beta-blockers). Monitor heart rate in patients taking ivabradine with other negative chronotropes.

              • ketamine

                ketamine, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • ketoprofen

                acebutolol and ketoprofen both increase serum potassium. Use Caution/Monitor.

                ketoprofen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ketorolac

                acebutolol and ketorolac both increase serum potassium. Use Caution/Monitor.

                ketorolac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ketorolac intranasal

                acebutolol and ketorolac intranasal both increase serum potassium. Use Caution/Monitor.

                ketorolac intranasal decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • labetalol

                acebutolol and labetalol both increase serum potassium. Use Caution/Monitor.

              • lasmiditan

                acebutolol increases effects of lasmiditan by pharmacodynamic synergism. Use Caution/Monitor. Lasmiditan has been associated with a lowering of heart rate (HR). In a drug interaction study, addition of a single 200-mg dose of lasmiditan to propranolol decreased HR by an additional 5 bpm compared to propranolol alone, for a mean maximum of 19 bpm.

              • levalbuterol

                acebutolol increases and levalbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of levalbuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • levodopa

                levodopa increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Consider decreasing dosage of antihypertensive agent.

              • lornoxicam

                acebutolol and lornoxicam both increase serum potassium. Use Caution/Monitor.

                lornoxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • losartan

                losartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, losartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • lurasidone

                acebutolol increases effects of lurasidone by Other (see comment). Use Caution/Monitor. Comment: Potential for increased risk of hypotension with concurrent use. Monitor blood pressure and adjust dose of antihypertensive agent as needed.

              • maraviroc

                maraviroc, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of orthostatic hypotension.

              • meclofenamate

                meclofenamate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

                acebutolol and meclofenamate both increase serum potassium. Use Caution/Monitor.

              • mefenamic acid

                acebutolol and mefenamic acid both increase serum potassium. Use Caution/Monitor.

                mefenamic acid decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • mefloquine

                mefloquine increases levels of acebutolol by decreasing metabolism. Use Caution/Monitor. Risk of arrhythmia.

              • meloxicam

                acebutolol and meloxicam both increase serum potassium. Use Caution/Monitor.

                meloxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • metaproterenol

                acebutolol increases and metaproterenol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of metaproterenol by pharmacodynamic antagonism. Use Caution/Monitor.

              • methyclothiazide

                acebutolol increases and methyclothiazide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

              • metolazone

                acebutolol increases and metolazone decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • metoprolol

                acebutolol and metoprolol both increase serum potassium. Use Caution/Monitor.

              • moxisylyte

                moxisylyte and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nabumetone

                acebutolol and nabumetone both increase serum potassium. Use Caution/Monitor.

                nabumetone decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • nadolol

                acebutolol and nadolol both increase serum potassium. Use Caution/Monitor.

              • naproxen

                acebutolol and naproxen both increase serum potassium. Use Caution/Monitor.

                naproxen decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • nebivolol

                acebutolol and nebivolol both increase serum potassium. Use Caution/Monitor.

              • nicardipine

                acebutolol and nicardipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nifedipine

                acebutolol and nifedipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nisoldipine

                acebutolol and nisoldipine both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • nitroglycerin rectal

                nitroglycerin rectal, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Beta-blockers blunt the reflex tachycardia produced by nitroglycerin without preventing its hypotensive effects. If beta-blockers are used with nitroglycerin in patients with angina pectoris, additional hypotensive effects may occur.

              • norepinephrine

                acebutolol increases and norepinephrine decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of norepinephrine by pharmacodynamic antagonism. Use Caution/Monitor.

              • olmesartan

                olmesartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, olmesartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • olodaterol inhaled

                acebutolol, olodaterol inhaled. Either decreases effects of the other by Mechanism: pharmacodynamic antagonism. Use Caution/Monitor. Beta-blockers and olodaterol may interfere with the effect of each other when administered concurrently. Beta-blockers may produce severe bronchospasm in COPD patients. Therefore, patients with COPD should not normally be treated with beta-blockers. However, under certain circumstances, e.g. as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-blockers in patients with COPD. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.

              • oxaprozin

                acebutolol and oxaprozin both increase serum potassium. Use Caution/Monitor.

                oxaprozin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • parecoxib

                acebutolol and parecoxib both increase serum potassium. Use Caution/Monitor.

                parecoxib decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • penbutolol

                acebutolol and penbutolol both increase serum potassium. Use Caution/Monitor.

              • pentobarbital

                pentobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of pentobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • phenobarbital

                phenobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of phenobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • phenoxybenzamine

                phenoxybenzamine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • phentolamine

                phentolamine and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • pindolol

                acebutolol and pindolol both increase serum potassium. Use Caution/Monitor.

              • pirbuterol

                acebutolol increases and pirbuterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of pirbuterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • piroxicam

                acebutolol and piroxicam both increase serum potassium. Use Caution/Monitor.

                piroxicam decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • ponesimod

                ponesimod and acebutolol both increase immunosuppressive effects; risk of infection. Use Caution/Monitor. Beta-blockers may have additive effects on lowering HR. Consider resting HR before initiating ponesimod in patients on stable dose of beta-blocker. Refer to the ponesimod prescribing information for more dosing information.

              • potassium acid phosphate

                acebutolol and potassium acid phosphate both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium chloride

                acebutolol and potassium chloride both increase serum potassium. Modify Therapy/Monitor Closely.

              • potassium citrate

                acebutolol and potassium citrate both increase serum potassium. Use Caution/Monitor.

              • prazosin

                prazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. The severity and duration of hypotension following the first dose of prazosin may be enhanced.

              • primidone

                primidone decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • propofol

                propofol, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • propranolol

                acebutolol and propranolol both increase serum potassium. Use Caution/Monitor.

              • sacubitril/valsartan

                sacubitril/valsartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, sacubitril/valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • salicylates (non-asa)

                acebutolol and salicylates (non-asa) both increase serum potassium. Use Caution/Monitor.

                salicylates (non-asa) decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • salmeterol

                acebutolol increases and salmeterol decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of salmeterol by pharmacodynamic antagonism. Use Caution/Monitor.

              • salsalate

                acebutolol and salsalate both increase serum potassium. Use Caution/Monitor.

                salsalate decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • secobarbital

                secobarbital decreases levels of acebutolol by increasing metabolism. Use Caution/Monitor. Consider a higher beta-blocker dose during coadministration of secobarbital. Atenolol, sotalol, nadolol less likely to be affected than other beta blockers.

              • sevelamer

                sevelamer decreases levels of acebutolol by increasing elimination. Use Caution/Monitor.

              • sevoflurane

                sevoflurane, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • sildenafil

                acebutolol increases effects of sildenafil by additive vasodilation. Use Caution/Monitor. Sildenafil has systemic vasodilatory properties and may further lower blood pressure in patients taking antihypertensive medications. Monitor blood pressure response to sildenafil in patients receiving concurrent blood pressure lowering therapy.

              • silodosin

                silodosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Increased risk of dizziness and orthostatic hypotension when silodosin is administered concurrently with antihypertensives.

              • siponimod

                siponimod, acebutolol. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Caution when siponimod is initiated in patients receiving beta-blocker treatment because of additive effects on lowering heart rate. Temporary interruption of beta-blocker may be needed before initiating siponimod. Beta-blocker treatment can be initiated in patients receiving stable doses of siponimod.

              • sodium bicarbonate

                sodium bicarbonate decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • sodium citrate/citric acid

                sodium citrate/citric acid decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • sotalol

                acebutolol and sotalol both increase serum potassium. Use Caution/Monitor.

              • spironolactone

                acebutolol and spironolactone both increase serum potassium. Modify Therapy/Monitor Closely.

              • succinylcholine

                acebutolol and succinylcholine both increase serum potassium. Use Caution/Monitor.

              • sulfasalazine

                acebutolol and sulfasalazine both increase serum potassium. Use Caution/Monitor.

                sulfasalazine decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • sulindac

                acebutolol and sulindac both increase serum potassium. Use Caution/Monitor.

                sulindac decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • tadalafil

                tadalafil increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypotension.

              • telmisartan

                telmisartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, telmisartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • terazosin

                terazosin and acebutolol both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely. Additive hypotensive effects may occur when terazosin is used in combination with acebutolol.

              • terbutaline

                acebutolol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

                acebutolol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor.

              • theophylline

                acebutolol, theophylline. Other (see comment). Use Caution/Monitor. Comment: Beta blockers (esp. non selective) antagonize theophylline effects, while at the same time increasing theophylline levels and toxicity (mechanism: decreased theophylline metabolism). Smoking increases risk of interaction.

              • timolol

                acebutolol and timolol both increase serum potassium. Use Caution/Monitor.

              • tolfenamic acid

                acebutolol and tolfenamic acid both increase serum potassium. Use Caution/Monitor.

                tolfenamic acid decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • tolmetin

                acebutolol and tolmetin both increase serum potassium. Use Caution/Monitor.

                tolmetin decreases effects of acebutolol by pharmacodynamic antagonism. Use Caution/Monitor. Long term (>1 wk) NSAID use. NSAIDs decrease prostaglandin synthesis.

              • tolvaptan

                acebutolol and tolvaptan both increase serum potassium. Use Caution/Monitor.

              • torsemide

                acebutolol increases and torsemide decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • triamterene

                acebutolol and triamterene both increase serum potassium. Modify Therapy/Monitor Closely.

              • valsartan

                valsartan and acebutolol both increase serum potassium. Use Caution/Monitor.

                acebutolol, valsartan. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Risk of fetal compromise if given during pregnancy.

              • verapamil

                acebutolol and verapamil both increase anti-hypertensive channel blocking. Modify Therapy/Monitor Closely.

              • xipamide

                xipamide increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor.

              Minor (30)

              • adenosine

                acebutolol, adenosine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Bradycardia.

              • agrimony

                agrimony increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • brimonidine

                brimonidine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • cevimeline

                cevimeline increases effects of acebutolol by unspecified interaction mechanism. Minor/Significance Unknown.

              • ciprofloxacin

                ciprofloxacin increases levels of acebutolol by decreasing metabolism. Minor/Significance Unknown. May also rarely decrease beta blocker levels.

              • cocaine

                acebutolol increases effects of cocaine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of angina.

              • cornsilk

                cornsilk increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • dihydroergotamine

                dihydroergotamine, acebutolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.

              • dihydroergotamine intranasal

                dihydroergotamine intranasal, acebutolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive vasospasm.

              • dipyridamole

                dipyridamole, acebutolol. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Risk of bradycardia.

              • escitalopram

                escitalopram increases levels of acebutolol by decreasing metabolism. Minor/Significance Unknown.

              • fenoldopam

                fenoldopam increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown. Additive hypotensive effects.

              • forskolin

                forskolin increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • guanfacine

                acebutolol, guanfacine. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Selective beta blocker administration during withdrawal from centrally acting alpha agonists may result in rebound hypertension.

              • imaging agents (gadolinium)

                acebutolol, imaging agents (gadolinium). Mechanism: unknown. Minor/Significance Unknown. Increased risk of anaphylaxis from contrast media.

              • levobetaxolol

                levobetaxolol increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • lily of the valley

                acebutolol, lily of the valley. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown.

              • maitake

                maitake increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • melatonin

                melatonin decreases toxicity of acebutolol by pharmacodynamic antagonism. Minor/Significance Unknown. Melatonin may correct beta blocker induced sleep disturbances.

              • metipranolol ophthalmic

                metipranolol ophthalmic increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • neostigmine

                acebutolol, neostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.

              • noni juice

                acebutolol and noni juice both increase serum potassium. Minor/Significance Unknown.

              • octacosanol

                octacosanol increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • physostigmine

                acebutolol, physostigmine. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Additive bradycardia.

              • pilocarpine

                pilocarpine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • reishi

                reishi increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • shepherd's purse

                shepherd's purse, acebutolol. Other (see comment). Minor/Significance Unknown. Comment: Theoretically, shepherd's purse may interfere with BP control.

              • tizanidine

                tizanidine increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypotension.

              • treprostinil

                treprostinil increases effects of acebutolol by pharmacodynamic synergism. Minor/Significance Unknown.

              • yohimbe

                acebutolol decreases toxicity of yohimbe by pharmacodynamic antagonism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Fatigue (11%)

              1-10%

              Dizziness (6%)

              Headache (6%)

              Constipation (4%)

              Diarrhea (4%)

              Dyspnea (4%)

              Dyspepsia (4%)

              Nausea (4%)

              Flatulence (3%)

              Insomnia (3%)

              Abdominal pain (2%)

              Bradycardia (2%)

              Chest pain (2%)

              Dysuria (2%)

              Edema (2%)

              Heart failure (2%)

              Hypotension (2%)

              Impotence (2%)

              Myalgia (2%)

              Pharyngitis (2%)

              Pruritus (2%)

              Rhinitis (2%)

              Vomiting (2%)

              Wheezing (2%)

              <1%

              Hepatotoxicity

              SLE

              Frequency Not Defined

              Bronchospasm, depression, decreased exercise tolerance, Raynaud's phenomenon

              May increase triglyceride levels and insulin resistance, and decrease HDL levels

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              Warnings

              Contraindications

              Hypersensitivity

              Asthma/COPD, severe bradycardia, 2°/3° heart block, cardiogenic shock, overt heart failure, sinus bradycardia, sick sinus syndrome without permanent pacemaker

              Avoid during breastfeeding

              Cautions

              Anesthesia/surgery (myocardial depression); chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures

              Bronchospastic disease, cerebrovascular insufficiency, DM, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease, compromised left ventricular function, elderly, use in pheochromocytoma, IDDM

              Avoid abrupt withdrawal; sudden discontinuation can exacerbate angina and lead to myocardial infarction

              May increase risk of stroke after surgery

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              Pregnancy & Lactation

              Pregnancy Category: B; D in 2nd and 3rd trimesters (expert analysis). Neonates of mothers who have received acebutolol during pregnancy have reduced birth weight, decreased blood pressure, and decreased heart rate.

              Lactation: excreted into milk/not recommended

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Cardioselective for beta-1 at low doses; has intrinsic sympathomimetic activity, ie, can lower BP with less decrease in HR

              Class 2 antiarrhythmic

              Pharmacokinetics

              Peak Plasma Time: 2-3 hr

              Toxic range: acetabutalol >15-20 mcg/mL, & diacetolol (the active metabolite) < 90-150 mcg/mL

              Onset: 1.5-3 hr (initial response); 3-8 hr (peak response)

              Duration: 12-24 hr

              Bioavailability: 40%

              Absorption: 40% (oral)

              Protein Bound: 10-26%

              Vd: 1.2 L/kg

              Metabolism: metabolized in the liver to active met, diacetolol

              Metabolites: diacetolol (active), free amine of acebutolol (inactive)

              Excretion: principally in feces 56%, urine 30-40%, bile 3-8%

              Dialyzable: Yes (HD)

              Less effective than thiazide diuretics in black and geriatric patients Shown to decrease mortality in hypertension and post-myocardial infarction

              Half-Life

              • Parent drug (acebutalol): 3-4 hr
              • Active metabolite (diacetolol): 8-13 hr
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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              acebutolol oral
              -
              200 mg capsule
              acebutolol oral
              -
              400 mg capsule
              acebutolol oral
              -
              200 mg capsule
              acebutolol oral
              -
              400 mg capsule

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              acebutolol oral

              ACEBUTOLOL - ORAL

              (A-se-BUE-toe-lol)

              COMMON BRAND NAME(S): Sectral

              WARNING: Do not stop taking this medication without consulting your doctor. Some conditions may become worse when you suddenly stop this drug. Some people who have suddenly stopped taking similar drugs have had chest pain, heart attack, and irregular heartbeat. If your doctor decides you should no longer use this drug, your doctor may direct you to gradually decrease your dose over 1 to 2 weeks.When gradually stopping this medication, it is recommended that you temporarily limit physical activity to decrease strain on the heart. Get medical help right away if you develop chest pain/tightness/pressure, chest pain spreading to the jaw/neck/arm, unusual sweating, trouble breathing, or fast/irregular heartbeat.

              USES: Acebutolol is used to treat high blood pressure and irregular heartbeat (arrhythmia). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Treating irregular heartbeat helps the heart work better and with less strain. Irregular heartbeats can be serious and may sometimes even lead to a heart attack.This medication belongs to a class of drugs known as beta blockers. It works by blocking the action of certain natural substances in your body, such as epinephrine, on the heart and blood vessels. This effect lowers heart rate, blood pressure, and strain on the heart.

              HOW TO USE: See also Warning section.Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. The dosage is based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time(s) each day.For the treatment of high blood pressure, it may take several weeks before you get the full benefit of this drug. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick.Tell your doctor if your condition does not improve or if it worsens (for example, if your routine blood pressure readings remain high or increase).

              SIDE EFFECTS: See also Warning and Precautions sections.Tiredness, dizziness, lightheadedness, nausea, upset stomach, slow heartbeat, or trouble sleeping may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.This drug may reduce blood flow to your hands and feet, causing them to feel cold. Smoking may worsen this effect. Dress warmly and avoid tobacco use.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: symptoms of asthma (for example, feelings of tightness in the chest, shortness of breath, cough, wheezing), blue fingers/toes, fainting, very slow heartbeat, new or worsening symptoms of heart failure (such as shortness of breath, swelling ankles/feet, unusual tiredness, unusual/sudden weight gain), mental/mood changes (such as confusion, depression, memory problems), vision changes, symptoms of liver disease (such as dark urine, persistent nausea, vomiting, stomach/abdominal pain, yellowing eyes/skin).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking acebutolol, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood circulation problems (such as Raynaud's disease, peripheral vascular disease), breathing problems (such as asthma, chronic bronchitis, emphysema), heart problems (such as heart failure, previous heart attack, heart rhythm problems), kidney problems, liver problems, mental/mood disorders (such as depression), a certain muscle disease (myasthenia gravis), overactive thyroid disease (hyperthyroidism), serious allergic reactions, including those needing treatment with epinephrine.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).If you have diabetes, this product may mask the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar, such as dizziness and sweating, are unaffected by this drug. This product may also make it harder to control your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.Children may be at greater risk for low blood sugar (hypoglycemia), especially if they are vomiting or not eating regularly. To help prevent low blood sugar, feed children on a regular schedule. If your child cannot eat regularly, is vomiting, or has symptoms of low blood sugar (such as sweating, seizures), stop this medication and tell the doctor right away.During pregnancy, this medication should be used only when clearly needed. Babies born to mothers taking this drug during pregnancy may have a low birth weight and require monitoring for problems such as low blood pressure and slow heartbeat. Discuss the risks and benefits with your doctor.This drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: fingolimod.Some products have ingredients that could raise your heart rate or blood pressure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: unusually slow heartbeat, fainting, severe weakness.

              NOTES: Do not share this medication with others.Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.Check your blood pressure and pulse (heart rate) regularly while taking this medication. Learn how to check your blood pressure and pulse at home, and share the results with your doctor.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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              • View the formulary and any restrictions for each plan.
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              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.