Formulary
Acebutolol: Indications, Dosing, Side Effects and Interactions
Acebutolol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Acebutolol: Indications, Dosing, Side Effects and Interactions
Acebutolol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Hypertension**
- **Adult** (By Mouth): Initially 400 mg daily for 2 weeks, alternatively initially 200 mg twice daily for 2 weeks, then increased if necessary to 400 mg twice daily; maximum 1.2 g per day.
**Angina**
- **Adult** (By Mouth): Initially 400 mg daily, alternatively initially 200 mg twice daily; maximum 1.2 g per day.
**Arrhythmias**
- **Adult** (By Mouth): 0.4-1.2 g daily in 2-3 divided doses.
**Severe angina**
- **Adult** (By Mouth): Initially 300 mg 3 times a day; maximum 1.2 g per day.
Cautions
For all beta-adrenoceptor blockers (systemic) Diabetes; first-degree AV block; history of obstructive airways disease (introduce cautiously); myasthenia gravis; portal hypertension (risk of deterioration in liver function); psoriasis; symptoms of hypoglycaemia may be masked; symptoms of thyrotoxicosis may be masked Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: in combination with verapamil or diltiazem (risk of heart block) with bradycardia (heart rate less than 50 beats per minute), or second- or third-degree AV block (contra-indicated; risk of complete heart block, asystole) in diabetes mellitus patients with frequent hypoglycaemic episodes (risk of suppressing hypoglycaemic symptoms) if prescribed a non-selective beta-blocker (including topical beta-blockers) in a history of asthma requiring treatment (contra-indicated in asthma; risk of increased bronchospasm)
Contraindications
For all beta-adrenoceptor blockers (systemic) Asthma; cardiogenic shock; hypotension; marked bradycardia; metabolic acidosis; phaeochromocytoma (apart from specific use with alpha-blockers); Prinzmetal's angina; second-degree AV block; severe peripheral arterial disease; sick sinus syndrome; third-degree AV block; uncontrolled heart failure Contra-indications, further information Bronchospasm Beta-blockers, including those considered to be cardioselective, should usually be avoided in patients with a history of asthma, bronchospasm or a history of obstructive airways disease. However, when there is no alternative, a cardioselective beta-blocker can be given to these patients with caution and under specialist supervision. In such cases the risk of inducing bronchospasm should be appreciated and appropriate precautions taken.
Side effects
For all beta-adrenoceptor blockers (systemic) Common or very common Abdominal discomfort; bradycardia; confusion; depression; diarrhoea; dizziness; dry eye (reversible on discontinuation); dyspnoea; erectile dysfunction; fatigue; headache; heart failure; nausea; paraesthesia; peripheral coldness; rash (reversible on discontinuation); Raynaud's phenomenon; sleep disorders; syncope; visual impairment; vomiting Uncommon Alopecia; atrioventricular block; bronchospasm Rare or very rare Hallucination; psoriasis exacerbated Side-effects, further information With administration by intravenous injection, excessive bradycardia can occur and may be countered with intravenous injection of atropine sulfate. Overdose Therapeutic overdosages with beta-blockers may cause lightheadedness, dizziness, and possibly syncope as a result of bradycardia and hypotension; heart failure may be precipitated or exacerbated. With administration by intravenous injection, excessive bradycardia can occur and may be countered with intravenous injection of atropine sulfate. For details on the management of poisoning, see Beta-blockers, under Emergency treatment of poisoning . Side-effects For acebutolol Common or very common Gastrointestinal disorder Frequency not known Cyanosis; hepatic disorders; intermittent claudication; lung infiltration; lupus-like syndrome; nervous system disorder; pneumonitis; psychosis; sexual dysfunction
Interactions
**Severe interactions:**
- An increased risk of depression has been reported when beta-blockers are co-administered with diltiazem.
- Antiarrhythmics of class I (eg disopyramide) and amiodarone may increase atrial conduction time and induce negative inotropic effects when used in combination with beta-blockers.
- If a beta-blocker is used in combination with clonidine, the gradual withdrawal of beta-blocker should first be considered before the withdrawal of clonidine.
**Other interactions (8):**
- Combinations requiring precautions for use + halogenated volatile anesthetics Reduction of cardiovascular compensation reactions by beta-blockers.
- Inform the anesthesiologist of this treatment (see section 4.4).
- Warn the patient and strengthen, especially at the beginning of treatment, the self-monitoring glycemic (see section 4.4.) In patients with unstable diabetes or insulin-dependent diabetes, the...
- Arterial pressure monitoring and dose adjustment of antihypertensives should be considered if necessary.
- Antiarrhythmics of class I (eg disopyramide) and amiodarone may increase atrial conduction time and induce negative inotropic effects when used in combination with beta-blockers.
- Increased risk of orthostatic hypotension.
Pregnancy
For all beta-adrenoceptor blockers (systemic) Beta-blockers may cause intra-uterine growth restriction, neonatal hypoglycaemia, and bradycardia; the risk is greater in severe hypertension.
Breast feeding
For all beta-adrenoceptor blockers (systemic) With systemic use in the mother, infants should be monitored as there is a risk of possible toxicity due to beta-blockade. However, the amount of most beta-blockers present in milk is too small to affect infants. Breast feeding For acebutolol Acebutolol and water soluble beta-blockers are present in breast milk in greater amounts than other beta-blockers.
Renal impairment
Caution in severe impairment (risk of accumulation). M Dose adjustments Halve dose if eGFR 25-50 mL/minute/1.73 m 2 ; use quarter dose if eGFR less than 25 mL/minute/1.73 m 2 ; do not administer more than once daily. M See Prescribing in renal impairment .
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Acebutolol in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

