Management of hypertension (alone or in combination with other classes of antihypertensive agents).
One of several preferred initial therapies in hypertensive patients with heart failure, postmyocardial infarction, ischemic heart disease, and/or diabetes mellitus.
Can be used as monotherapy for initial management of uncomplicated hypertension; however, thiazide diuretics are preferred by JNC 7.
Cardiac Arrhythmias
Treatment of frequent ventricular premature complexes (VPCs), including uniform and multiform VPCs and/or coupled VPCs, and R-on-T complexes in patients with primary arrhythmias or arrhythmias secondary to various cardiac disorders (e.g., CAD, MI, valvular disease).
Management of various supraventricular tachyarrhythmias†.
Secondary prevention following AMI† to reduce the risk of reinfarction and mortality.
Dosage and Administration
General
Individualize dosage according to patient response.
β-Adrenergic blocking selectivity diminishes as dosage is increased.
If long-term therapy is discontinued, reduce dosage gradually over a period of about 2 weeks. (See Abrupt Withdrawal of Therapy under Cautions.)
When substituting another β-adrenergic blocking agent for acebutolol, initiate at a comparable dosage without interruption of β-blocker therapy.
Hypertension
Monitor BP carefully during initial titration or subsequent dosage increases. Large or abrupt BP reductions generally should be avoided.
Angina
Adjust dosage of β-adrenergic blocking agents according to clinical response and to maintain a resting heart rate of 55–60 bpm.
Administration
Acebutolol hydrochloride is administered orally. Also been administered IV†, but a parenteral dosage form is currently not commercially available in the US.
Oral Administration
Hypertension
Usually administer as a single daily dose; however, for 24-hour BP control, some patients may require administration of the daily dose in 2 divided doses.
Ventricular Arrhythmias
Twice-daily dosing of the drug appears to be more effective than once-daily dosing for the suppression and prevention of frequent VPCs.
Angina
Once-daily administration may be as effective as divided doses; however, further studies are needed.
Dosage
Available as acebutolol hydrochloride; dosage expressed in terms of acebutolol.
Adults
Hypertension
Oral
Initially, 200–400 mg daily. Usual maintenance dosage is 200–800 mg daily, but some patients may achieve adequate BP control with dosages as low as 200 mg daily. Increase dosage up to 1.2 g daily in two divided doses in patients with more severe hypertension or if adequate reduction of BP does not occur; alternatively, add another hypotensive agent (e.g., thiazide diuretic).
Ventricular Arrhythmias
Oral
Initially, 200 mg twice daily. Increase gradually until optimum effect is achieved. Usual maintenance dosage is 600–1200 mg daily.
Angina
Oral
Initially, 200 mg twice daily. Increase dosage gradually until optimum effect is achieved. Usual maintenance dosage is 800 mg or less daily, but patients with severe angina may require higher dosages.
Prescribing Limits
Adults
Hypertension
Oral
Maximum 1.2 g daily.
Special Populations
Renal Impairment
Active metabolite (diacetolol) eliminated principally by the kidneys; dosage and/or frequency of administration must be modified in response to the degree of renal impairment.
Dosage Reductions in Patients with Renal Impairment
Reduction in Usual Daily Dosage
Clcr(mL/min)
50%
25–49 mL/minute
75%
<25 mL/minute
Acebutolol and diacetolol removed by hemodialysis; individualize dosage carefully in patients with severe renal impairment who undergo chronic intermittent hemodialysis.
Geriatric Patients
Consider reduction in maintenance dosage. Avoid dosages >800 mg daily.
Media Gallery
Drug Info Tools
