Drug Detail:Corzide 40/5 (Bendroflumethiazide and nadolol [ ben-droe-floo-meth-eye-a-zide-and-nad-oh-lol ])
Drug Class: Beta blockers with thiazides
Usual Adult Dose for Hypertension
Initial dose: Bendroflumethiazide 5 mg-Nadolol 40 mg orally once a day
Maintenance dose: Bendroflumethiazide 5 mg-Nadolol 40 to 80 mg orally once a day
Use: Treatment of hypertension if the fixed dose combination represents an appropriate dose for the individual patient.
Renal Dose Adjustments
CrCl greater than 50 mL/min/1.73 m2: Administer every 24 hours
CrCl 31 to 50 mL/min/1.73 m2: Administer every 24 to 36 hours
CrCl 10 to 30 mL/min/1.73 m2: Administer every 24 to 48 hours
CrCl less than 10 mL/min/1.73 m2: Administer every 40 to 60 hours
If progressive renal impairment becomes evident (as indicated by an increasing nonprotein nitrogen or BUN): Consider withholding or discontinuing diuretic therapy
Liver Dose Adjustments
Use with caution
Precautions
US BOXED WARNING:
- DISCONTINUING THERAPY: Hypersensitivity to catecholamines has been observed in patients withdrawn from beta-blocker therapy; exacerbation of angina and, in some cases, myocardial infarction have occurred after abrupt discontinuation of such therapy. When discontinuing chronically administered nadolol, particularly in patients with ischemic heart disease, the dosage should be gradually reduced over a period of 1 to 2 weeks and the patient should be carefully monitored. If angina markedly worsens or acute coronary insufficiency develops, nadolol administration should be reinstituted promptly, at least temporarily, and other measures appropriate for the management of unstable angina should be taken. Patients should be warned against interruption or discontinuation of therapy without the physician's advice. Because coronary artery disease is common and may be unrecognized, it may be prudent not to discontinue nadolol therapy abruptly even in patients treated only for hypertension.
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Monitoring:
- Metabolic: Serum electrolytes periodically
Patient advice:
- Caution patients against interruption or cessation of therapy without a physician's advice.