Usual Adult Dose for Angina Pectoris

Initial dose: 40 mg orally once a day; may be increased by 40 to 80 mg every 3 to 7 days until optimum response is obtained or pronounced heart rate reduction occurs
Maintenance dose: 40 to 80 mg orally once a day; up to 240 mg once a day may be required
Maximum dose: 240 mg/day

Usual Adult Dose for Hypertension

Initial dose: 40 mg orally once a day; may be increased in 40 to 80 mg increments until optimum blood pressure reduction is achieved
Maintenance dose: 40 to 80 mg orally once a day; up to 320 mg once a day may be required

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

Liver Dose Adjustments

Data not available

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• DISCONTINUING THERAPY: Hypersensitivity to catecholamines has been observed in patients withdrawn from beta-blocker therapy; exacerbation of angina and, in some cases, myocardial infarction have occurred after abrupt discontinuation of such therapy.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

Storage requirements: Protect from light.

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