Classifications: beta-adrenergic antagonist; antihypertensive; Therapeutic: antihypertensive
Pregnancy Category: B
5 mg, 10 mg tablets
Nonselective beta-adrenergic antagonist. Hypotensive mechanism results from its competitively blocking the beta-adrenergic
receptors primarily in myocardium, and beta receptors within bronchial and smooth muscle. Lowers blood pressure by also
decreasing peripheral vascular resistance.
Exerts vasodilation as well as hypotensive effects.
Management of hypertension concurrently with a thiazide diuretic or as single agent. Used in patient who has failed to respond
to diet, exercise, and weight reduction.
Stress and exercise-induced chronic stable angina pectoris.
Bronchospastic diseases; severe bradycardia, cardiogenic shock, AV block, sick sinus syndrome; cardiac failure; pulmonary
failure; lactation. Safety in children is not established.
Nonallergic bronchospasm; COPD; CHF; diabetes mellitus; hyperthyroidism; myasthenia gravis; impaired liver and kidney function;
pregnancy (category B).
Route & Dosage
Adult: PO 5 mg b.i.d., may increase by 10 mg/d q23wk if needed up (max: 60 mg/d in 23 divided doses)
Geriatric: PO Start with 5 mg q.d.
Adult: PO 1540 mg/d in 34 divided doses
- Give drug at same time of day each day with respect to time of food intake for most predictable results.
- Withdraw or discontinue treatment gradually over a period of 12 wk.
Adverse Effects (≥1%)CNS: Fatigue,
, drowsiness, confusion, fainting, decreased libido. CV: Bradycardia,
hypotension, CHF. GI:
Nausea, diarrhea, constipation,
flatulence. Respiratory: Bronchospasm, pulmonary
. Body as a Whole:
Back or joint pain. Sensitivity reactions seen as antinuclear antibodies
(ANA) (1030% of patients). Hematologic: Agranulocytosis. Urogenital:
Impotence. Metabolic: Hypoglycemia
(may mask symptoms
of a hypoglycemic reaction).
and other hypotensive agents
increase hypotensive effect; effects of albuterol, metaproterenol, terbutaline, pirbuterol
s blunt hypotensive effect; decreases hypoglycemic effect of glyburide; amiodarone
increases risk of bradycardia and sinus arrest.
Rapidly from GI tract; 5095% reaches systemic circulation (first pass metabolism
3 h. Peak:
12 h. Duration:
24 h. Distribution:
Distributed into breast milk. Metabolism:
4060% in liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Monitor HR and BP. Report bradycardia and hypotension. Dosage adjustment may be indicated.
- Note: Hypotensive effect may begin within 7 d but is not at maximum therapeutically until about 2 wk after beginning of treatment.
- Lab test: Periodic CBC with differential, kidney function tests, and blood glucose.
Patient & Family Education
- Pindolol masks the dizziness and sweating symptoms of hypoglycemia. Monitor blood glucose for loss of glycemic control.
- Adhere to the prescribed drug regimen; if a change is desired, consult physician first. Abrupt withdrawal of drug might
precipitate a thyroid crisis in a patient with hyperthyroidism, and angina in the patient with ischemic heart disease, leading
to an MI.