celiprolol hydrochloride: clinical use

Prescribing considerations

• Confirm the indication is hypertension and review concurrent rate-limiting, antihypertensive and transporter-interacting medicines.
• Avoid abrupt withdrawal, particularly with coronary insufficiency or ischaemic heart disease.
• Use specialist caution with bronchospastic disease, controlled heart failure, first-degree heart block, Prinzmetal angina, peripheral circulatory disease, treated phaeochromocytoma, diabetes, thyrotoxicosis, psoriasis or previous severe anaphylaxis.
• Renal or hepatic impairment and older age warrant closer assessment.
• Celiprolol is not recommended for children in the selected product information.

Contraindications and cautions

• Hypersensitivity to celiprolol or product excipients
• Cardiogenic shock or uncontrolled heart failure
• Sick-sinus syndrome, significant heart block or severe bradycardia
• Severe hypotension
• Severe renal impairment
• Untreated phaeochromocytoma
• Metabolic acidosis
• Acute asthma; the selected generic product also lists severe bronchial asthma and severe chronic obstructive pulmonary disease
• Late-stage peripheral arterial occlusive disease or Raynaud’s syndrome
• Concomitant theophylline

Monitoring

• Blood pressure and resting pulse, including symptoms of hypotension or bradycardia
• ECG and clinical status with medicines affecting conduction or contractility
• Renal and hepatic function where impairment or older age may affect treatment
• Blood glucose in diabetes; tachycardia from hypoglycaemia may be masked
• Respiratory symptoms in people with a relevant pulmonary history
• Signs of worsening heart failure or peripheral circulatory disease

Clinical pharmacology

Celiprolol is a hydrophilic, incompletely absorbed, beta-1 selective antagonist with partial beta-2 agonist activity. It is only slightly metabolised and is eliminated through bile and urine in broadly similar proportions. Food and transporter interactions materially affect exposure.

Formulation and product differences

• Both selected products are scored film-coated tablets, but their shape, appearance and excipients differ.
• The selected generic formulation contains lactose; lactose is not listed among Celectol’s excipients.
• The products use slightly different wording for separation from food, so follow the relevant product leaflet.

Tablet

Route: Oral

Strengths: 200 mg, 400 mg