03. Beta Blocker Conversion Table
|Drug||Recommended dosing frequency||Sample dose equivalency||Maximum total daily dose||Dose reduction|
|Beta-1 Selective||Beta-1 Selective||Beta-1 Selective||Beta-1 Selective|
|Acebutolol||BID||100mg BID||1,200mg||CrCl <50|
|Atenolol||Daily||50mg Daily||100mg||CrCl <35|
|Bisoprolol||Daily||5mg Daily||20mg||CrCl <40, cirrhosis, heart failure (10mg …|
Aug 14 2022
What is the best beta blocker on the market?
- Inderal (propranolol)
- Trandate (labetalol)
- Corgard (nadolol)
- Coreg (carvedilol)
What is the lowest dose of beta blocker?
Starting: 3.125 mg twice a day for 2 weeks. Maintenance: 6.25 – 25 mg twice a day. Max: 25 mg twice a day. Increase dose at intervals of 2 weeks. Take with food to slow the rate of absorption and decrease the risk of orthostatic effects.
Is metoprolol better than propranolol?
Metoprolol is less popular for anxiety and is typically used more for high blood pressure. And the side effects can be more frequent than Propranolol, although overall, still quite insignificant and rare.
How much does beta blocker lower blood pressure?
The data showed that the addition of a beta-blocker to thiazide diuretics or calcium channel blockers reduced BP by 8/6 mmHg when given at doses 2 times the recommended starting dose.
How do you convert beta-blockers?
For this non-overlapping or abrupt switching, the current β blocker should be discontinued approximately 12 hours before the first dose of carvedilol. As mentioned, most patients can be initially switched to 6.25 mg or 12.5 mg b.i.d. and then up-titrated at 1–2 week intervals (Table I).
How are beta-blockers dosed?
For atrial fibrillation, the starting dose of the beta-blocker depends on the patient’s heart rate and co-morbidities, e.g. a starting dose of 23.75 mg metoprolol succinate may be appropriate for a patient with moderately elevated heart rate, but 47.5 mg may be required for a patient with a significantly elevated heart …
What is equivalent to bisoprolol?
Table 3 Equivalent dose of carvedilol with other beta-blockersDoseCarvedilol SR8 mg qd64 mg qdBisoprolol1.25 mg qd10 mg qdNebivolol1.25 mg qd10 mg qdMetoprolol succinate25 mg qd200 mg qd1 more row
How many mg of beta-blockers should I take?
high blood pressure – the starting dose is usually 80mg, taken twice a day. If this dose is not working well enough to reduce your blood pressure, your doctor may increase it to a maximum of 160mg twice a day. migraine or angina (chest pain) – 40mg, taken 2 or 3 times a day.
What heart rate is too low on beta-blockers?
Beta-blockers are contraindicated in a variety of conditions, including severe asthma as their action disrupts natural bronchodilation7. In adults, bradycardia is arbitrarily said to be any heart rate below 60 beats per minute8 and may be associated with other arrhythmia such as compensatory ventricular escape beats9.
What is the safest beta blocker?
A number of beta blockers, including atenolol (Tenormin) and metoprolol (Toprol, Lopressor), were designed to block only beta-1 receptors in heart cells. Since they don’t affect beta-2 receptors in blood vessels and the lungs, cardioselective beta blockers are safer for people with lung disorders.
What is equivalent to metoprolol?
Some metoprolol alternatives include Toprol XL, Coreg, Ernesto, Zestril, and Calan.
Is there a better beta blocker than bisoprolol?
Conclusions: These data show that peak beta-blocking effects of bisoprolol appear stronger than those of nebivolol and carvedilol. On the other hand, nebivolol exerts the highest trough-to-peak-ratio. However, beta-blocking effects of all the three drugs are similar at trough.
Are ramipril and bisoprolol the same?
Ramipril is used to treat hypertension and congestive heart failure. Ramipril works by relaxing the smooth muscles of small blood vessels, which in turn reduces blood pressure (BP). Bisoprolol’s effects include a reduction of heart rate, cardiac output, BP and possibly reflex orthostatic hypotension.
Is it safe to stop taking bisoprolol?
Talk to your doctor if you want to stop taking bisoprolol. Stopping bisoprolol can make your blood pressure rise, and this may increase your risk of heart attack and stroke. If you’re bothered by side effects, your doctor may be able to prescribe a different medicine to lower you blood pressure.
Is there an alternative to beta blockers?
However, if you have problems with beta blockers, there are alternative drugs available. If you have angina or AF, for example, other drugs that slow the heart rate, such as diltiazem or verapamil, may be substituted.
How long can I take bisoprolol fumarate?
To reduce the chances of having another heart attack, it is recommended that all patients who have already had one take a beta-blocker, such as bisoprolol. The evidence suggests you benefit from the drug if taken for the first 12 months after your heart attack.
What is a beta blocker?
Beta-blockers is a topic covered in the Johns Hopkins Diabetes Guide. To view the entire topic, please log in or purchase a subscription. Official website of the Johns Hopkins Antibiotic (ABX), HIV, Diabetes, and Psychiatry Guides, powered by Unbound Medicine.
How often should I give a myocardial infarction medication?
Myocardial infarction: Acute: I.V.: 5 mg every 2 minutes for 3 doses in early treatment of myocardial infarction; thereafter, give 50 mg orally every 6 hours beginning 15 minutes after last I.V. dose and continue for 48 hours; then administer a maintenance dose of 100 mg twice daily.
Is there a dosage adjustment for HD?
HD: no dosage adjustment provided due to no data available in this population.
What are the different forms of beta blockers?
Beta-blockers are available for administration in three main forms: oral, intravenous, and ophthalmic , and the route of administration often depends on the acuity of the illness (parenteral use in arrhythmias), disease type (topical use in glaucoma), and chronicity of the disease.
Which beta receptor blockers are cardio-selective?
Beta-1 receptor-selective blockers like atenolol, bisoprolol, metoprolol, and esmolol only bind to the beta-1 receptors; therefore, they are cardio-selective.  Beta-blockers lower the secretion of melatonin and hence may cause insomnia and sleep changes in some patients. 
What are beta blockers used for?
Indications. Beta-blockers, as a class of drugs, are primarily used to treat cardiovascular diseases and other conditions.  Beta receptors exist in three distinct forms: beta-1 (B1), beta-2 (B2), and beta-3 (B3). Beta-1 receptors located primarily in the heart mediate cardiac activity. Beta-2 receptors, with their diverse location in many organ …
What is the best treatment for beta blocker overdose?
The antidote for beta-blocker overdose is glucagon. It is especially useful in beta-blocker-induced cardiotoxicity. The second line of treatment is cardiac pacing if glucagon fails.
What does alpha 1 do to the heart?
Alpha-1 receptors induce vasoconstriction and increased cardiac chronotropy; this means agonism at the alpha-1 receptors leads to higher blood pressure and an increased heart rate. In contrast, antagonism at the alpha-1 receptor leads to vasodilation and negative chronotropic, which leads to lower blood pressure and decreases heart rate. Some beta-blockers, such as carvedilol, labetalol, and bucindolol, have additional alpha-1 receptor blockage activity in addition to their non-selective beta receptor blockage. This property is clinically useful because beta-blockers that block the alpha-1 receptor have a more pronounced clinical effect on treating hypertension. 
Can beta blockers cause bronchospasm?
Less commonly, bronchospasm presents in patients on beta-blockers. Asthmatic patients are at a higher risk. Patients with Raynaud syndrome are also at risk of exacerbation. Beta-blockers can induce hyperglycemia and mask the hemodynamic signs, usually seen in a hypoglycemic patient, such as tachycardia.
Do beta blockers bind to alpha receptors?
Beta-blockers vary in their specificity towards different receptors, and accordingly, the effects produced depend on the type of receptor(s) blocked as well as the organ system involved. Some beta-blockers also bind to alpha receptors to some degree, allowing them to induce a different clinical outcome when used in specific settings.
What is the most commonly used anxiolytic?
Benzodiazepines are the most commonly used anxiolytics and hypnotics. There are major differences in potency between different benzodiazepines and this difference in potency is important when switching from one benzodiazepine to another.
What is the class of corticosteroids?
Topical corticosteroids range in potency from mild (class VII) to superpotent (class I— Relative Potency of Selected Topical Corticosteroids). Intrinsic differences in potency are attributable to fluorination or chlorination (halogenation) of the compound.
How much should the opioid dose be reduced?
It is recommended that the new dose should be reduced by 30-50% to allow for incomplete cross-tolerance.
Why do we provide an opioid conversion table?
We provide an opioid conversion table for commonly used opioid preparations to help clinicians better understand the relationship between these agents and methadone. Conversion must take into consideration clinical issues that affect translation of equivalents to and from methadone.
Why switch IV to PO?
Switching from intravenous (IV) to oral (PO) therapy as soon as patients are clinically stable can reduce the length of hospitalization and lower associated costs. While intravenous medications may be more bioavailable and have greater effects, some oral drugs produce serum levels comparable to those of the parenteral form. Medications involved in switch therapy include antibiotics, analgesics, antipsychotics, and antivirals.
Is prednisolone 5 mg the same as hydrocortisone 20 mg?
What is the equivalent dose of oral prednisolone to intravenous (IV) hydrocortisone? From the literature, prednisolone 5mg is approximately equivalent to hydrocortisone 20mg in terms of equivalent anti-inflammatory dose.