Antihypertensive Medications. (Featured CME Topic: Hypertension).There are dozens of antihypertensive antihypertensive /an·ti·hy·per·ten·sive/ (-ten´siv) counteracting high blood pressure, or an agent that does this. an·ti·hy·per·ten·sive adj. Reducing high blood pressure. n. agents in use today. They can be grouped into eight different classifications: (1) alpha/beta-adrenergic blocking agents blocking agent n. A drug that blocks transmission of nerve impulses at an autonomic receptor site, autonomic synapse, or neuromuscular junction. , (2) angiotensin-converting enzyme inhibitors Angiotensin-Converting Enzyme Inhibitors Definition Angiotensin-converting enzyme inhibitors (also called ACE inhibitors) are medicines that block the conversion of the chemical angiotensin I to a substance that increases salt and water retention in the , (3) angiotensin II receptor antagonists angiotensin II receptor antagonist Pharmacology Any of a family of agents-eg losartan and valsartan, which block the binding of angiotensin II–A-II to its cognate cell membrane receptors–AT1, AT2, and others; 1st , (4) antiadrenergic antiadrenergic /an·ti·ad·re·ner·gic/ (-ad?re-ner´jik) 1. sympatholytic; opposing the effects of impulses conveyed by adrenergic postganglionic fibers of the sympathetic nervous system. 2. an agent that so acts. agents, (5) beta-adrenergic blocking agents beta-adrenergic blocking agent n. See beta-blocker. , (6) calcium-channel blocking agents, (7) diuretics Diuretics Definition Diuretics are medicines that help reduce the amount of water in the body. Purpose Diuretics are used to treat the buildup of excess fluid in the body that occurs with some medical conditions such as congestive heart , and (8) vasodilators Vasodilators Definition Vasodilators are medicines that act directly on muscles in blood vessel walls to make blood vessels widen (dilate). Purpose Vasodilators are used to treat high blood pressure (hypertension). . The Table lists the generic Generic Describes the characteristics and/or experience of the total universe of a coupon of MBS sector type; that is, in contrast to a specific pool or collateral group, as in a specific CMO issue. and trade names of the drugs currently available in each classification, along with each drug's customary starting dosage dosage /dos·age/ (do´saj) the determination and regulation of the size, frequency, and number of doses. dos·age n. 1. Administration of a therapeutic agent in prescribed amounts. and usual dosage range, as well as pertinent PERTINENT, evidence. Those facts which tend to prove the allegations of the party offering them, are called pertinent; those which have no such tendency are called impertinent, 8 Toull. n. 22. By pertinent is also meant that which belongs. Willes, 319. comments, if any. References (1.) DRUGDEX System. Hutchison Hutchison may refer to: People with the surname Hutchison:
Anderson, river, c.465 mi (750 km) long, rising in several lakes in N central Northwest Territories, Canada. It meanders north and west before receiving the Carnwath River and flowing north to Liverpool Bay, an arm of the Arctic ML (eds). MICROMEDEX Inc., Englewood Englewood (ĕng`gəlw  d).1 City (1990 pop. 29,387), Arapahoe co., N central Colo., on the South Platte River, a residential and industrial suburb of Denver; inc. 1903. , Colo (Edition expires December December: see month. (2000) (2.) Drug Facts and Comparisons. Hebel Hebel can refer to:
Louis, 1682–1712, titular duke of Burgundy; grandson of King Louis XIV of France. He became heir to the throne on the death (1711) of his father, Louis the Great Dauphin. , 2001
TABLE. Antihypertensive Medications (1,2)
Alpha/Beta-Adrenergic Blocking Agents
Classification/Drug Trade Names Starting Dosage
Carvedilol Coreg 6.25 mg BID
Labetalol (*) Normodyne, 100 mg BID
Trandate
Classification/Drug Usual Dosage Range
Carvedilol 6.25-25 mg BID
Labetalol (*) 200-400 mg BID
Classification/Drug Comments
Carvedilol Should be taken with food.
Do not stop abruptly.
Labetalol (*) Do not stop abruptly.
Angiotensin-Converting Enzyme Inhibitors
Classification/Drug Trade Names Starting Dosage
Benazepril Lotensin 10 mg QD
Captopril (*) Capoten 25 mg BID-TID
Enalapril Vasotec 5 mg QD
Fosinopril Monopril 10 tng QD
Lisinopril Prinivil, Zestril 10 mg QD
Moexipril Univasc 7.5 mg QD
Perindopril Aceon 4 mg QD
Quinapril Accupril 10-20 mg QD
Ramipril Altace 2.5 mg QD
Trandolapril Mavik 1 mg QD (2 mg
QD in African-
American patients)
Classification/Drug Usual Dosage Range
Benazepril 20-40 mg QD
Captopril (*) 25-150 mg BID-TID
Enalapril 10-40 mg QD or in
divided doses
Fosinopril 20-40 mg QD
Lisinopril 20-40 mg QD
Moexipril 7.5-30 mg QD
Perindopril 4-16 mg QD
Quinapril 20-80 mg QD or in
divided doses
Ramipril 2.5-20 mg QD
Trandolapril 24 mg QD
Classification/Drug Comments
Benazepril
Captopril (*)
Enalapril
Fosinopril
Lisinopril
Moexipril Should be taken 1
hour before meals.
Perindopril
Quinapril
Ramipril Capsule may be opened and
sprinkled on apple sauce
or mixed with apple juice
or water.
Trandolapril
Angiotensin II Receptor Antagonists
Classification/Drug Trade Names Starting Dosage
Candesartan Atacand 16 mg QD
Eprosartan Teveten 600 mg QD
Irbesartan Avapro 150 mg QD
Losartan Cozaar 50 mg QD
Telmisartan Micardis 40 mg QD
Valsartan Diovan 80 mg QD
Classification/Drug Usual Dosage Range
Candesartan 8-32 mg/day in
single or divided
doses
Eprosartan 400-800 mg QD
Irbesartan 150-300 mg QD
Losartan 25-100 mg QD
Telmisartan 20-80 mg QD
Valsartan 80-320 mg QD
Classification/Drug Comments
Candesartan
Eprosartan
Irbesartan
Losartan
Telmisartan
Valsartan
Antiadrenergic Agents
Classification/Drug Trade Names Starting Dosage
Clonidine (*) Catapres, 0.1 mg BID or
Catapres-TTS 0.1 mg/24 hr
Q7 days (TTS)
Doxazosin (*) Cardura 1 mg QD or QHS
Guanabenz (*) Wytensin 4mg BID
Guanadrel Hylorel 5 mg BID
Guanethidine (*) Ismelin 10 mg QD
Guanfacine (*) Tenex 1 mg QHS
Mecamylamine Inversine 2.5 mg BID
Methyldopa (*) Aldomet 250 mg BID-TID
Prazosin (*) Minipress 1 mg BID-TID
Reserpine Various generic 0.5 mg QD for
2 weeks, then
reduce dosage
Terazosin (*) Hytrin 1 mg QHS
Classification/Drug Usual Dosage Range
Clonidine (*) 0.1-1.2 mg BID or
0.1-0.6 mg/24 hr
Q7 days (TTS)
Doxazosin (*) 1-16 mg QD
Guanabenz (*) 4-32 mg BID
Guanadrel 20-75 mg/day in
divided doses
Guanethidine (*) 25-50 mg QD
Guanfacine (*) 1-3 mg QHS
Mecamylamine 2.5-25 mg/day in
divided doses
Methyldopa (*) 500-2,000 mg/day in
divided doses
Prazosin (*) 6-15 mg/day in
divided doses
Reserpine 0.1-0.25 mg QD
Terazosin (*) 1-20 mg/day, may
use divided doses
Classification/Drug Comments
Clonidine (*) Abrupt discontinuance may
result in significant
rebound hypertension.
Doxazosin (*) First dose may cause
significant hypotension.
Guanabenz (*)
Guanadrel Sympathomimetics (as in OTC
cough and cold products)
may reverse effectiveness.
Guanethidine (*) Can cause significant
postural hypotension.
Guanfacine (*) Do not stop abruptly.
Mecamylamine Do not stop abruptly.
Should be taken after meals.
Methyldopa (*) Causes a positive direct
Coombs' test in 10% to
20% of patients.
Prazosin (*) First dose may cause
significant hypotension.
Reserpine Avoid in patients with
a history of depression.
Terazosin (*) First dose may cause
significant hypotension.
Beta-Adrenergic Blocking Agents
Classification/Drug Trade Names Starting Dosage
Acebutolol (*) Sectral 200 mg BID
Atenolol (*) Tenormin 50 mg QD
Betaxolol Kerlone 10 mg QD
Bisoprolol Bezeta 2.5-5 mg QD
Carteolol Cartol 2.5 mg QD
Metoprolol (*) Lopressor, 50 mg BID or
Toprol XL 50-100 mg QD
(XL)
Nadolol (*) Corgard 40 mg QD
Penbutolol Levatol 20 mg QD
Pindolol (*) Visken 5 mg BID
Propranolol (*) Inderal, 40 mg BID or
Inderal LA 80 mg QD (LA)
Timolol (*) Blocadren 10 mg BID
Classification/Drug Usual Dosage Range
Acebutolol (*) 200-600 mg BID
Atenolol (*) 50-200 mg QD
Betaxolol 10-20 mg QD
Bisoprolol 2.5-20 mg QD
Carteolol 2.5-10 mg QD
Metoprolol (*) 100-450 mg/day in
divided doses or
100-400 mg QD
(XL)
Nadolol (*) 40-80 mg QD
(doses up to
320 mg QD may
be used)
Penbutolol 10-40 mg QD
Pindolol (*) 5-30 mg BID
Propranolol (*) 120-240 mg/day in
divided doses or
120-160 mg QD (SR)
Timolol (*) 10-30 mg BID
Classification/Drug Comments
Acebutolol (*)
Atenolol (*)
Betaxolol
Bisoprolol
Carteolol
Metoprolol (*) Blood pressure after
one week of therapy will
be reflective of maximum
effect of that dose for
the particular patient.
Nadolol (*)
Penbutolol Full effect may take weeks.
Pindolol (*)
Propranolol (*)
Timolol (*) Allow at least 7 days
between dose changes.
Calcium-Channel Blocking Agents
Classification/Drug Trade Names Starting Dosage
Amlodipine Norvasc 5 mg QD
Diltiazem Cardizem, 30 mg QID or
Tiamate, 60-120 mg BID (SR)
Cardizem SR, or 180-240 mg QD
Cardizem CD, (CD and XR)
Dilacor XR,
Tiazac
Felodipine Plendil 5 mg QD
Isradipine DyanaCirc, 2.5 mg BID or
DyanaCirc CR 5 mg QD (SR)
Nicardipine (*) Cardene, 20 mg TID or
Cardene SR 30 mg BID (SR)
Nifedipine Adalat CC, 30 mg QD
Procardia XL
Nisoldipine Sular 20 mg QD
Verapamil (*) Calan, 80 mg TID or
Calan SR, 120-240 mg QD
Isoptin, (SR)
Isoptin SR,
Verelan,
Verelan PM
Classification/Drug Usual Dosage Range
Amlodipine 2.5-10 mg QD
Diltiazem 120-480 mg total
daily dose (division
of dose depends
upon formulation)
Felodipine 2.5-10 mg QD
Isradipine 2.5-10 mg BID or
5-20 mg QD (SR)
Nicardipine (*) 20-40 mg TID or
30-60 mg BID (SR)
Nifedipine 30-90 mg QD
Nisoldipine 20-60 mg QD
Verapamil (*) 120-360 mg total
daily dose
(division of dose
depends upon
formulation)
Classification/Drug Comments
Amlodipine May be taken with or
without food. Avoid
grapefruit products.
Diltiazem Should be taken on an
empty stomach. Sustained
release dosage forms
should not be opened,
crushed, or chewed.
Felodipine Should not be crushed or
chewed.Avoid grapefruit
products.
Isradipine Sustained release dosage
forms should not be
crushed or chewed.
Nicardipine (*) Sustained release dosage
forms should not be
crushed or chewed.
Nifedipine Sustained release dosage
forms should not be
crushed or chewed. Avoid
grapefruit products.
Nisoldipine Sustained release dosage
forms should not be crushed
or chewed. Avoid taking
with high fat meal or
grapefruit products.
Verapamil (*) Should be taken with food.
Sustained release dosage
forms should not be
crushed or chewed. Avoid
grapefruit products.
Diuretics
Classification/Drug Trade Names Starting Dosage
Amiloride (*) Midamor 5 mg QD
Benzthiazide (*) Exna 25-50 mg BID
Chlorothiazide (*) Diuril 500-1,000 mg/day
in single or divided
doses
Chlorthalidone (*) Hygroton, 25 mg QD
Thalitone
Furosemide (*) Lasix 40 mg BID
Hydrochlorothiazide (*) Esidrix, 12.5 mg QD
HydroDIURIL,
Oretic
Hydrochlorothiazide (*) Diucardin, 50 mg BID
Saluron
Indapamide (*) Lozol 1.25 mg QD
Metolazone Zaroxolyn, 2.5-5 mg QD or
Mykrox 0.5 mg QD
(Mykrox)
Polythiazide Renese 2-4 mg QD
Spironolactone (*) Aldactone 50-100 mg/day in
single or divided
doses
Torsemide Demadex 5 mg QD
Trichlormethiazide (*) Metahydrin, 2-4 mg QD
Naqua,
Diurese
Classification/Drug Usual Dosage Range
Amiloride (*) 5-20 mg QD
Benzthiazide (*) 50-150 mg/day
in divided doses
Chlorothiazide (*) 500-2,000 mg/day
in single or divided
doses
Chlorthalidone (*) 25-100 mg QD
Furosemide (*) 40 mg BID
Hydrochlorothiazide (*) 25-100 mg QD
Hydrochlorothiazide (*) 50-200 mg/day
(divide doses
>100 mg/day)
Indapamide (*) 1.25 mg QD
Metolazone 5.20 mg QD or
0.5-1 mg QD
(Mykrox)
Polythiazide 2-4 mg QD
Spironolactone (*) 50-400 mg/day in
single or divided
doses
Torsemide 2.5-10 mg QD
Trichlormethiazide (*) 2-4 mg QD
Classification/Drug Comments
Amiloride (*)
Benzthiazide (*)
Chlorothiazide (*)
Chlorthalidone (*)
Furosemide (*)
Hydrochlorothiazide (*)
Hydrochlorothiazide (*)
Indapamide (*)
Metolazone Different brands are
not interchangeable.
Doses must be indi-
vidualized.
Polythiazide
Spironolactone (*)
Torsemide
Trichlormethiazide (*)
Vasodilators
Classification/Drug Trade Names Starting Dosage
Hydralozine (*) Apresoline 10 mg QID
Minoxidil (*) Loniten 5 mg QD
Classification/Drug Usual Dosage Range
Hydralozine (*) 40-300 mg total
daily dose (BID
dosing may be
effective)
Minoxidil (*) 10-40 mg QD (may
use up to maximum
of 100 mg QD)
Classification/Drug Comments
Hydralozine (*) Food increases
absorption.
Minoxidil (*) Should never be a
first-line agent. Should
be given with diuretics
and beta-blockers.
(*)Available in generic formulations.
Mrs. Gordon (Member): 5/16/2008 9:28 AM
Hi There,
I am pregnant with high blood pressure. I am taking Labetalol 200mg 3 times per day and methyldopa 250mg 3 times as well. Is it safe for me to eat grapfruit with these medications?
Glenice (Member): 11/3/2009 6:36 AM
hi! is there anyone who can help me? i want to find out if its alright to take felodipine 2.5mg even if im taking micardis 40mg as my maintenance?
ibrahim harb (Member): 5/24/2010 8:12 AM
hi
its safe 2 eat grapfruit, it dosent harm if ur BP controled will just keep on micadis, make felodipine as stat dose if ur BP elevated even u took the micadis, and make sure u dont hv heart disease , else ask a doctor
I am wondering how many mg of Inderal it would take to equal 20 (I think it's 20 mg) of Lopressor?
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