ADMINISTRATION ROUTES:
PO
ALTERNATIVE NAMES:
Celol, Selectol
ICU INDICATIONS:
- Hypertension
- Acute myocardial infarction
- Secondary prevention in patients with coronary artery disease
- Angina
- Rate control
Note: Celiprolol may be used with caution in patients with asthma or COPD (see WARNINGS)
PRESENTATION AND ADMINISTRATION:
PO:
Celol 200 mg tablets (yellow)
Should be taken on an empty stomach. Absorption is significantly affected by food. Unknown effects with NG feed – consider alternatives.
DOSAGE:
PO:
Begin at 200 mg once daily. Increase to up to 600 mg daily
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
Dose in renal impairment
GFR (ml/min) | DOSE |
---|---|
<10 | 150-300 mg once daily |
10-20 | dose as in normal renal function |
>20-50 | dose as in normal renal function |
Dose in renal replacement therapy
MODALITY | DOSE |
---|---|
CAPD | 150-300 mg once daily |
HD | 150-300 mg once daily |
CVVHDF | dose as in normal renal function |
DOSAGE IN PAEDIATRICS: PO:
5-10 mg/kg once daily
CLINICAL PHARMACOLOGY:
Celiprolol is a cardioselective beta-blocker, whose beta-blocking action results from a selective competitive blockade at the level of the beta-1 receptors; it is a partial agonist at beta-2 receptors. The vasodilative effect of Celiprolol probably results in part from its partial agonist properties at the level of the beta-2 receptors. Celiprolol lacks a membrane stabilising effect. It is devoid of any cardiodepressive effect at the doses used in clinical practice. It does not appear to have bronchoconstrictive effect at therapeutic doses.
CONTRAINDICATIONS:
- Sinus bradycardia
- Heart block greater than first degree
- Cardiogenic shock
- Overt cardiac failure
WARNINGS:
Cardiac Failure
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure.
Discontinuation of therapy
Discontinuation of therapy in a patient with coronary artery disease may lead to rebound angina, arrhythmia or myocardial infarction.
Diabetes and Hypoglycaemia
Beta blockers may mask tachycardia occurring with hypoglycaemia.
Thyrotoxicosis
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm.
Asthma
Due to its beta-1 selective blocking and beta-2 agonist properties, celiprolol may be used with caution in asthmatics out of acute episodes and in patients with compensated chronic obstructive pulmonary disease (see CLINICAL PHARMACOLOGY). It may still precipitate bronchospasm in these patients and should be used with caution.
PRECAUTIONS:
General:
Celiprolol may aggravate peripheral arterial circulatory disorders
Laboratory Tests:
No tests in addition to routine ICU tests are required
Drug/Laboratory Test Interactions:
None known
IMPORTANT DRUG INTERACTIONS IN ICU:
Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine
ADVERSE REACTIONS:
Body as a Whole:
Tiredness, fatigue
Cardiovascular System:
Bradycardia , cold extremities, hypotension, leg pain
Respiratory System:
Wheeziness, dyspnoea
Digestive System:
Diarrhoea, nausea
Nervous System:
Dizziness, vertigo, light-headedness