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• DISCONTINUING THERAPY: Hypersensitivity to catecholamines has been observed in patients withdrawn from beta-blocker therapy; exacerbation of angina and, in some cases, myocardial infarction have occurred after abrupt discontinuation of such therapy.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.

Dialysis

Data not available

Other Comments

Monitoring:

• Metabolic: Serum electrolytes periodically

• Caution patients against interruption or cessation of therapy without a physician's advice.