Acebutolol

Brand names

• Apo-Acebutolol
• Gen-Acebutolol
• Med-Acebutolol
• Monitan
• Novo-Acebutolol
• Nu-Acebutolol
• Rhotral
• Sectral

Usage

To treat mild to moderate high blood pressure; also used to prevent or control chest pain due to angina.

How it works

Acebutolol slows the rate and force of contraction of the heart by blocking certain nerve impulses. This reduces blood pressure and prevents the heart from overexertion, which may bring on angina.

Side effects

Serious

Severe shortness of breath and rapid heartbeat (symptoms of congestive heart failure), worsening of asthma, severe allergic reaction (skin rash, itching, wheezing, swelling of lips, tongue, and throat). If any of these symptoms develop, seek medical attention immediately.

Common

Cough, diarrhea, decreased sexual ability, depression, drowsiness, dizziness, fatigue, frequent urination, gas, indigestion, nausea, trouble sleeping, cold hands and feet, numbness or tingling in fingers or toes.

Less common

Fever, sore throat, abdominal pain, headache, anxiety, joint or back pain, dry or burning eyes, unusual bleeding or bruising, dark urine, nightmares or unusually vivid dreams.

Possible interactions

Other medicaments:

Acebutolol may increase the effects of:

• other antihypertensive medicaments, excessively lowering the blood pressure. Dose adjustments may be necessary.
• reserpine, causing sedation, depression, slow heart rate and low blood pressure.

Acebutolol taken concurrently with:

• alfentanil (Alfenta) may result in severe slowing of the heart leading to sinus arrest. Use with great caution.
• alpha one adrenergic blockers (such as prazosin) may result in a severe drop in blood pressure (especially when patients stand) in response to a first dose of this medicine. Use with great caution.
• amiodarone (Cordarone) may result in severe slowing of the heart leading to sinus arrest. Use with great caution.
• calcium channel blockers such as mibefradil (Posicor) or verapamil (Calan) may lead to increased risk of abnormal heart rate or rhythm.
• clonidine (Catapres) may cause rebound high blood pressure if clonidine is withdrawn while acebutolol is still being taken.
• digoxin (Lanoxin) may change heart conduction.
• diltiazem (Cardizem) may result in increased acebutolol effects.
• fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil) or venlafaxine (Effexor) may decrease removal of acebutolol from the body (not reported as yet). Caution is advised.
• insulin may cause low blood sugar (hypoglycemia).
• methyldopa (Aldomet) may lead to unexpected increases in blood pressure.
• NSAIDs may result in decreased acebutolol benefits.
• oral antidiabetic medicaments may result in slow recovery from low blood sugar.
• ritonavir (Norvir) and perhaps other protease inhibitors may increase the metabolism of this medicine and blunt therapeutic benefits of acebutolol.

The following medicaments may decrease the effects of acebutolol:

• indomethacin (Indocin) and some other "aspirin substitutes" (NSAIDs) can blunt acebutolol's antihypertensive effect.
• rifabutin (Mycobutin) and other medicaments that may increase (induce) cytochrome P450 enzymes in the liver (the ones that help the body remove medicines like acebutolol) may result in loss of benefits of acebutolol even if every dose of acebutolol is being taken.

Foods:

Follow a sensible low cardiovascular risk diet. Avoid excessive salt intake.

Herbal medicines or minerals:

Ginseng may increase blood pressure, blunting the benefits of this medicine. Hawthorn, saw palmetto, ma huang, goldenseal, yohimbe and licorice may also cause increased blood pressure. Calcium and garlic may help lower blood pressure. Indian snakeroot has a German Commission E monograph indication for hypertension-talk to your doctor. Eleuthero root and ephedra should be avoided by people living with hypertension.

Alcohol:

Alcohol may exaggerate lowering of blood pressure and may increase its mild sedative effect.

Tobacco smoking:

Nicotine may reduce this medicament's effectiveness and can worsen closing of bronchial tubes seen in regular smokers.
Marijuana may increase blood pressure and reduce this medicament's effectiveness.

Driving Hazardous Activities:

Use caution-may cause drowsiness.

Exposure to heat:

Hot environments can exaggerate the effects of this medicament.

Exposure to cold:

Elderly need to prevent hypothermia.

Heavy exercise or exertion:

This medicament can intensify increased blood pressure (hypertensive) response to isometric exercise. Talk to your doctor about how much and how to exercise.

Occurrence of unrelated illness:

Fevers can lower blood pressure and require decreased doses. Nausea or vomiting may interrupt the dosing schedule. Ask your doctor for help.

Discontinuation:

DO NOT stop the medicament suddenly. Dose decreases over 2-3 weeks are recommended. Ask your doctor for help.

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