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Action/Kinetics:
Sublingual, chewable. Onset: 2-5 min;
duration: 1-3 hr.
Oral Capsules/Tablets. Onset: 20-40 min;
duration: 4-6 hr.
Extended-release. Onset: up to 4 hr;
duration: 6-8 hr.
Additional Uses:
Diffuse esophageal spasm. Oral tablets are only for prophylaxis while sublingual and chewable forms may be used to terminate acute attacks of angina.
Special Concerns:
Use with caution during lactation. Safety and efficacy have not been established in children.
Additional Side Effects:
Vascular headaches occur especially frequently.
Additional Drug Interactions:
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Acetylcholine / Acetylcholine effect antagonized
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Norepinephrine / Norepinephrine effect antagonized
How Supplied:
Chew Tablet: 5 mg;
Capsule, Extended Release: 40 mg;
Tablet, Extended Release: 40 mg;
Sublingual tablet: 2.5 mg, 5 mg, 10 mg;
Tablet: 2.5 mg, 5 mg, 20 mg, 30 mg, 40 mg
Dosage
?Tablets
Antianginal.
Initial: 5-20 mg q 6 hr;
maintenance: 10-40 mg q 6 hr (usual: 20-40 mg q.i.d.
?Chewable Tablets
Antianginal, acute attack.
Initial: 5 mg q 2-3 hr. The dose can be titrated upward until angina is relieved or side effects occur.
Prophylaxis.
5-10 mg q 2-3 hr.
?Extended-Release Capsules
Antianginal.
Initial: 40 mg;
maintenance: 40-80 mg q 8-12 hr.
?Extended-Release Tablets
Antianginal.
Initial: 40 mg;
maintenance: 40-80 mg q 8-12 hr.
?Sublingual
Acute attack.
2.5-5 mg q 2-3 hr as required. The dose can be titrated upward until angina is relieved or side effects occur.
Prophylaxis.
5-10 mg q 2-3 hr.
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