acebutolol hydrochloride: clinical use

Prescribing considerations

• Assess renal function because acebutolol and diacetolol may accumulate with impairment.
• Avoid abrupt withdrawal, especially in ischaemic heart disease.
• Use particular caution with obstructive airways disease, compensated heart failure, first-degree atrioventricular block, diabetes, peripheral vascular disease, psoriasis, thyrotoxicosis, myasthenia gravis and depression.
• Inform the anaesthetist before surgery; beta blockade alters cardiovascular responses to anaesthesia and anaphylaxis.

Contraindications and cautions

• Cardiogenic shock, decompensated heart failure or marked bradycardia.
• Second- or third-degree heart block, sick sinus syndrome or Prinzmetal angina.
• Severe asthma or COPD and severe peripheral circulatory disease.
• Untreated phaeochromocytoma or metabolic acidosis.
• History of anaphylaxis, hypersensitivity to beta blockers or product ingredients, breastfeeding, or concurrent floctafenine or sultopride.

Monitoring

• Blood pressure and resting heart rate.
• ECG and clinical status when conduction disease, arrhythmia or interacting cardiac medicines are relevant.
• Renal function, particularly in older people or renal impairment.
• Respiratory function if used despite mild bronchospastic disease.
• Blood glucose awareness and self-monitoring in people treated for diabetes.

Clinical pharmacology

Acebutolol is a relatively beta-1-selective antagonist with intrinsic sympathomimetic activity. Hepatic metabolism forms active diacetolol; elimination uses renal and non-renal pathways.

Formulation and product differences

• The selected product is a film-coated, scored tablet that may be divided equally.
• It contains lactose and is unsuitable for certain rare hereditary disorders affecting galactose or lactose handling.
• Swallow with water rather than chewing or crushing.

Tablet

Route: Oral

Strengths: 400 mg