Information
In patients with mild or moderate hypertension. It is usually used in combination with other drugs, particularly thiazide or thiazide-related diuretics. However, it may be tried alone as an initial agent in those patients in whom, in the judgment of the physician, treatment should be started with a beta-blocker rather than a diuretic. Therapy should start using Trasicor (regular formulation), and once the maintenance dose has been established, Slow-Trasicor may be substituted (see Dosage).
The combination of oxprenolol with a thiazide-related diuretic and/or peripheral vasodilator has been found to be compatible and generally more effective than oxprenolol alone. Experience with other antihypertensive agents has not shown evidence of incompatibility.
Oxprenolol is not recommended for the emergency treatment of hypertensive crisis.
Oxprenolol is usually used in conjunction with other antihypertensive agents, particularly thiazide diuretics, but may be used alone (see Indications).
Dosage must always be adjusted according to the individual requirements of the patient, within the following guidelines:
Initial Dosage: Treatment should be initiated with Trasicor (regular formulation), 20 mg 3 times a day, followed by upward titration of the dose 3 times a day, with increases of 60 mg/day at 1 to 2 week intervals until adequate control of blood pressure is obtained.
Maintenance Dosage: Once the optimal dose has been established, the total daily dose of Trasicor (regular formulation) may be given on a b.i.d. schedule, although no comparison studies between the t.i.d. and b.i.d. regimen have been carried out. Alternatively, an equivalent single daily dose of Slow-Trasicor may be substituted, and should be taken in the morning. Slow-Trasicor tablets should be swallowed whole.
The usual effective dose range is 120 to 320 mg/day, and the daily dosage should not exceed 480 mg.
Side Effects
Cardiovascular congestive heart failure (see Warnings), pulmonary edema, cardiac enlargement, secondary effects of decreased cardiac output which include: syncope, vertigo, lightheadedness and postural hypotension, severe bradycardia, lengthening of PR interval, second and third degree AV block, sinus arrest, palpitations, chest pains, peripheral vascular disorders (cold/tingling extremities) Raynaud's phenomenon, claudication, hot flushes.
Respiratory: shortness of breath, wheezing, bronchospasm, status asthmaticus.
CNS: headache, dizziness, anxiety, mental depression, nervousness, irritability, hallucinations, sleep disturbances including nightmares and insomnia, tinnitus, weakness, sedation, vivid dreams, vertigo, paresthesia and slurred speech.
Gastrointestinal: diarrhea, constipation, flatulence, heartburn, anorexia, nausea and vomiting, abdominal pain, dryness of mouth.
Allergic/Dermatological: (see Warnings), rash (psoriasiform and exanthematic), dry skin, pruritus, sweating.
Ophthalmological: keratoconjunctivitis, dry eyes, itching eyes, blurred vision.
Miscellaneous: impotence, decreased libido, nasal stuffiness, weight gain, exertional tiredness.
Clinical Laboratory: elevated transaminases, BUN, alkaline phosphatase and bilirubin have occurred in some patients. Thrombocytopenia and leukopenia, and hypoglycemia have also been reported rarely.