Select therapeutic use:

Angina:

Indications for KAPSPARGO SPRINKLE:

Long-term management of angina pectoris.

Adult:

Swallow whole. If difficulty swallowing cap, may open and sprinkle contents over a teaspoonful of soft food (eg, applesauce, yogurt, pudding) and consume mixture within 60mins; or, can give via NG tube (mix contents with 15mL of water first). Individualize. Initially 100mg once daily. May increase at 1-week intervals; max 400mg/day. Reduce dose gradually over 1–2 weeks.

Children:

Not established.

Contraindications:

Severe bradycardia. 2nd or 3rd degree heart block. Cardiogenic shock. Decompensated heart failure. Sick sinus syndrome (unless paced).

Warnings/Precautions:

Worsening heart failure; increase diuretic and stabilize before up-titration; reduce or discontinue dose if necessary. Ischemic heart or peripheral vascular disease. Bronchospastic disease. Pheochromocytoma (initiate with an alpha-blocker first). Surgery. May mask signs of hypoglycemia. Hyperthyroidism. Avoid abrupt cessation. Hepatic impairment. Elderly. Neonates. Pregnancy (esp. during 3rd trimester). Nursing mothers.

Pharmacologic Class:

Beta-blocker.

Interactions:

May potentiate catecholamine depleting drugs (eg, reserpine, MAO inhibitors); monitor. Increased risk of bradycardia with digitalis glycosides, clonidine, diltiazem, verapamil. Increased rebound hypertension with clonidine withdrawal. May be potentiated by strong CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone). Avoid alcohol. May block epinephrine.

Adverse Reactions:

Tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, rash; worsening angina, heart failure, AV block.

Generic Availability:

NO

How Supplied:

Ext-rel caps—30

CHF and arrhythmias:

Indications for KAPSPARGO SPRINKLE:

Heart failure, to reduce risk of cardiovascular mortality and heart failure hospitalization.

Adult:

Swallow whole. If difficulty swallowing cap, may open and sprinkle contents over a teaspoonful of soft food (eg, applesauce, yogurt, pudding) and consume mixture within 60mins; or, can give via NG tube (mix contents with 15mL of water first). Individualize. Initially 25mg once daily for 2 weeks. May double dose as tolerated every 2 weeks; max 200mg/day. Reduce dose if symptomatic bradycardia occurs.

Children:

Not established.

Contraindications:

Severe bradycardia. 2nd or 3rd degree heart block. Cardiogenic shock. Decompensated heart failure. Sick sinus syndrome (unless paced).

Warnings/Precautions:

Worsening heart failure; increase diuretic and stabilize before up-titration; reduce or discontinue dose if necessary. Ischemic heart or peripheral vascular disease. Bronchospastic disease. Pheochromocytoma (initiate with an alpha-blocker first). Surgery. May mask signs of hypoglycemia. Hyperthyroidism. Avoid abrupt cessation. Hepatic impairment. Elderly. Neonates. Pregnancy (esp. during 3rd trimester). Nursing mothers.

Pharmacologic Class:

Beta-blocker.

Interactions:

May potentiate catecholamine depleting drugs (eg, reserpine, MAO inhibitors); monitor. Increased risk of bradycardia with digitalis glycosides, clonidine, diltiazem, verapamil. Increased rebound hypertension with clonidine withdrawal. May be potentiated by strong CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone). Avoid alcohol. May block epinephrine.

Adverse Reactions:

Tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, rash; worsening angina, heart failure, AV block.

Generic Availability:

NO

How Supplied:

Ext-rel caps—30

Hypertension:

Indications for KAPSPARGO SPRINKLE:

Hypertension.

Adult:

Swallow whole. If difficulty swallowing cap, may open and sprinkle contents over a teaspoonful of soft food (eg, applesauce, yogurt, pudding) and consume mixture within 60mins; or, can give via NG tube (mix contents with 15mL of water first). Initially 25–100mg once daily, alone or with other antihypertensives. May increase at 1-week intervals; max 400mg/day.

Children:

<6yrs: not established. Swallow whole. If difficulty swallowing cap, may open and sprinkle contents over a teaspoonful of soft food (eg, applesauce, yogurt, pudding) and consume mixture within 60mins; or, can give via NG tube (mix contents with 15mL of water first). ≥6yrs: initially 1mg/kg once daily (max 50mg dose). May increase at 1-week intervals; max 2mg/kg once daily.

Contraindications:

Severe bradycardia. 2nd or 3rd degree heart block. Cardiogenic shock. Decompensated heart failure. Sick sinus syndrome (unless paced).

Warnings/Precautions:

Worsening heart failure; increase diuretic and stabilize before up-titration; reduce or discontinue dose if necessary. Ischemic heart or peripheral vascular disease. Bronchospastic disease. Pheochromocytoma (initiate with an alpha-blocker first). Surgery. May mask signs of hypoglycemia. Hyperthyroidism. Avoid abrupt cessation. Hepatic impairment. Elderly. Neonates. Pregnancy (esp. during 3rd trimester). Nursing mothers.

Pharmacologic Class:

Beta-blocker.

Interactions:

May potentiate catecholamine depleting drugs (eg, reserpine, MAO inhibitors); monitor. Increased risk of bradycardia with digitalis glycosides, clonidine, diltiazem, verapamil. Increased rebound hypertension with clonidine withdrawal. May be potentiated by strong CYP2D6 inhibitors (eg, quinidine, fluoxetine, paroxetine, propafenone). Avoid alcohol. May block epinephrine.

Adverse Reactions:

Tiredness, dizziness, depression, shortness of breath, bradycardia, hypotension, diarrhea, pruritus, rash; worsening angina, heart failure, AV block.

Generic Availability:

NO

How Supplied:

Ext-rel caps—30