📋 Indications & Clinical Dosage
*Mild to moderate hypertension:*
Adult: Initially 10 mg once daily; increased if necessary to 20 mg daily, dose can be adjusted after 2 weeks.
Children: Not recommended.
⛔ Contraindications
Acute porphyria, unstable angina, uncontrolled heart failure, within 1 month of myocardial infarction, renal impairment, aortic stenosis, severe hepatic impairment.
⚠️ Precautions & Warnings
Left ventricular dysfunction, sick sinus syndrome (without pacemaker), and hepatic
impairment. Overdose may cause severe hypotension, secondary to profound peripheral vasodilatation.
🔄 Drug Interactions
Beta-blockers, digoxin, phenytoin, carbamazepine, rifampicin, cimetidine, azole antifungals, erythromycin, fluoxetine, terfenadine, astemizole, grapefruit juice.
⚠️ Adverse Reactions / Side Effects
Flushing, peripheral oedema, palpitation, tachycardia, headache, asthenia; drowsiness, myalgia, polyuria, rash, dizziness, GI disturbances. Rare: Gingival hyperplasia, hypotension, myocardial infarction
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Contraindicated in pregnancy.
Lactation / Breastfeeding:
Not recommended.
📚 Official Regulatory & Clinical References
- Drug Regulatory Authority of Pakistan (DRAP): Drug Registration, S.R.O. Price Gazettes & National Essential Medicines List (NEML).
- World Health Organization (WHO): Collaborating Centre for Drug Statistics Methodology (ATC/DDD Index).
- Formulary Standards: British National Formulary (BNF) & Pakistan National Formulary (PNF) guidelines.