Table of Contents

ANTI-HYPERTENSIVES

ORALS

Drugs by Class Properties Initial Dose Dosage Range (mg)
β-Adrenergic Antagonists
Atenolol Selective 50 mg PO daily 25-100
Betaxolol Selective 10 mg PO daily 5-40
Bisoprolol Selective 5 mg PO daily 2.5-20
Metoprolol Selective 50 mg PO bid 50-450
Metoprolol XL Selective 50-100 mg PO daily 50-400
Nebivolol Selective with vasodilatory properties 5 mg PO daily 5-40
Nadolol Nonselective 40 mg PO daily 20-240
Propranolol Nonselective 40 mg PO bid 40-240
Propranolol LA Nonselective 80 mg PO daily 60-240
Timolol Nonselective 10 mg PO bid 20-40
Pindolol ISA 5 mg PO daily 10-60
Labetalol α- and β-antagonist properties 100 mg PO bid 200-1200
Carvedilol α- and β-antagonist properties 6.25 mg PO bid 12.5-50
Carvedilol CR α- and β-antagonist properties 10 mg PO daily 10-80
Acebutolol ISA, selective 200 mg PO bid, 400 mg PO daily 200-1200
Calcium Channel Antagonists
Amlodipine DHP 5 mg PO daily 2.5-10
Diltiazem 30 mg PO qid 90-360
Diltiazem LA 180 mg PO daily 120-540
Diltiazem CD 180 mg PO daily 120-480
Diltiazem XR 180 mg PO daily 120-540
Diltiazem XT 180 mg PO daily 120-480
Isradipine DHP 2.5 mg PO bid 2.5-10
Nicardipine DHP 20 mg PO tid 60-120
Nifedipine DHP 10 mg PO tid 30-120
Nifedipine XL (or CC) DHP 30 mg PO daily 30-90
Nisoldipine DHP 20 mg PO daily 20-40
Verapamil 80 mg PO tid 80-480
Verapamil SR 120 mg PO daily 120-480
Angiotensin-Converting Enzyme Inhibitors
Benazepril 10 mg PO bid 10-40
Captopril 25 mg PO bid-tid 50-450
Enalapril 5 mg PO daily 2.5-40
Fosinopril 10 mg PO daily 10-40
Lisinopril 10 mg PO daily 5-40
Moexipril 7.5 mg PO daily 7.5-30
Quinapril 10 mg PO daily 5-80
Ramipril 2.5 mg PO daily 1.25-20
Trandolapril 1-2 mg PO daily 1-4
Perindopril 4 mg PO daily 2-16
Angiotensin II Receptor Blockers
Azilsartan 40 mg PO daily 40-80
Candesartan 8 mg PO daily 8-32
Eprosartan 600 mg PO daily 600-800
Irbesartan 150 mg PO daily 150-300
Olmesartan 20 mg PO daily 20-40
Losartan 50 mg PO daily 25-100
Telmisartan 40 mg PO daily 20-80
Valsartan 80 mg PO daily 80-320
Direct Renin Inhibitors
Aliskiren 150 mg PO daily 150-300
Diuretics
Chlorthalidone Thiazide diuretic 25 mg PO daily 12.5-50
Hydrochlorothiazide Thiazide diuretic 12.5 mg PO daily 12.5-50
Hydroflumethiazide Thiazide diuretic 50 mg PO daily 50-100
Indapamide Thiazide diuretic 1.25 mg PO daily 2.5-5
Methyclothiazide Thiazide diuretic 2.5 mg PO daily 2.5-5
Metolazone Thiazide diuretic 2.5 mg PO daily 1.25-5
Bumetanide Loop diuretic 0.5 mg PO daily (or IV) 0.5-5
Ethacrynic acid Loop diuretic 50 mg PO daily (or IV) 25-100
Furosemide Loop diuretic 20 mg PO daily (or IV) 20-320
Torsemide Loop diuretic 5 mg PO daily (or IV) 5-10
Amiloride Potassium-sparing diuretic 5 mg PO daily 5-10
Triamterene Potassium-sparing diuretic 50 mg PO bid 50-200
Eplerenone Aldosterone antagonist 25 mg PO daily 25-100
Spironolactone Aldosterone antagonist 25 mg PO daily 25-100
α-Adrenergic Antagonists
Doxazosin 1 mg PO daily 1-16
Prazosin 1 mg PO bid-tid 1-20
Terazosin 1 mg PO at bedtime 1-20
Centrally Acting Adrenergic Agents
Clonidine 0.1 mg PO bid 0.1-1.2
Clonidine patch TTS 1/wk (equivalent to 0.1 mg/d release) 0.1-0.3
Guanfacine 1 mg PO daily 1-3
Guanabenz 4 mg PO bid 1-64
Methyldopa 250 mg PO bid-tid 250-2000
Direct-Acting Vasodilators
Hydralazine 10 mg PO qid 50-300
Minoxidil 5 mg PO daily 2.5-100
Miscellaneous
Reserpine 0.5 mg PO daily 0.01-0.25

PARENTAL

Drug Administration Onset Duration of Action Dosage Adverse Effects and Comments
Fenoldopam IV infusion <5 min 30 min 0.1-0.3 µg/kg/min Tachycardia, nausea, vomiting
Sodium nitroprusside IV infusion Immediate 2-3 min 0.5-10 µg/kg/min (initial dose, 0.25 µg/kg/min for eclampsia and renal insufficiency) Hypotension, nausea, vomiting, apprehension; risk of thiocyanate and cyanide toxicity is increased in renal and hepatic insufficiency, respectively; levels should be monitored; must shield from light
Diazoxide IV bolus 15 min 6-12 h 50-100 mg q5-10min, up to 600 mg Hypotension, tachycardia, nausea, vomiting, fluid retention, hyperglycemia; may exacerbate myocardial ischemia, heart failure, or aortic dissection
Labetalol IV bolus IV infusion 5-10 min 3-6 h 20-80 mg q5-10min, up to 300 mg 0.5-2 mg/min Hypotension, heart block, heart failure, bronchospasm, nausea, vomiting, scalp tingling, paradoxical pressor response; may not be effective in patients receiving α- or β-antagonists
Nitroglycerin IV infusion 1-2 min 3-5 min 5-250 µg/min Headache, nausea, vomiting. Tolerance may develop with prolonged use.
Esmolol IV bolus IV infusion 1-5 min 10 min 500 µg/kg/min for first 1 min 50-300 µg/kg/min Hypotension, heart block, heart failure, bronchospasm
Phentolamine IV bolus 1-2 min 3-10 min 5-10 mg q5-15min Hypotension, tachycardia, headache, angina, paradoxical pressor response
Hydralazine (for treatment of eclampsia) IV bolus 10-20 min 3-6 h 10-20 mg q20min (if no effect after 20 mg, try another agent) Hypotension, fetal distress, tachycardia, headache, nausea, vomiting, local thrombophlebitis. Infusion site should be changed after 12 h.
Methyldopate (for treatment of eclampsia) IV bolus 30-60 min 10-16 h 250-500 mg Hypotension
Nicardipine IV infusion 1-5 min 3-6 h 5 mg/h, increased by 1.0-2.5 mg/h q15min, up to 15 mg/h Hypotension, headache, tachycardia, nausea, vomiting
Enalaprilat IV bolus 5-15 min 1-6 h 0.6255 mg q6h Hypotension