Atenolol

• Tablets 25mg, 50mg, 100mg (£0.89 = 100mg daily)
• Oral solution sugar free 25mg in 5ml (£19.56 = 100mg daily)
• Injection 500 micrograms in 1ml, 10ml amp

Indications

• Angina

Dose

• Angina, 100mg daily in 1 or 2 doses
• Arrhythmias, 50–100mg daily

Bisoprolol

• Tablets 1.25mg, 2.5mg, 3.75mg, 5mg, 7.5mg, 10mg (£0.74 = 10mg daily)

Indications

• Hypertension (resistant hypertension only)
• Angina
• Heart failure

Dose

• Hypertension and angina, usually 10mg once daily (5mg may be adequate in some patients); maximum 20mg daily
• Adjunct in heart failure, initially 1.25mg once daily (in the morning) for 1 week then, if well tolerated, increased to 2.5mg once daily for 1 week, then 3.75mg once daily for 1 week, then 5mg once daily for 4 weeks, then 7.5mg once daily for 4 weeks, then 10mg once daily; maximum 10mg daily

Carvedilol

• Tablets 3.125mg, 6.25mg, 12.5mg, 25mg (£1.27 = 25mg x 28 tablets)

Indications

• Heart failure

Dose

• Adjunct in heart failure, initially 3.125mg twice daily, increased at intervals of at least 2 weeks to 6.25mg twice daily, then to 12.5mg twice daily, then to 25mg twice daily; increase to highest dose tolerated, maximum 25mg twice daily in patients with severe heart failure or body-weight less than 85kg and 50mg twice daily in patients over 85kg

Metoprolol

• Tablets 50mg, 100mg (£10.11 = 50mg three times a day)
• Injection 5mg in 5ml

Indications

• Angina
• Post myocardial infarction beta-blocker (see note below)

Notes

1. Use of beta-blockers post MI is well established. Only agents without intrinsic sympathomimetic activity, e.g. metoprolol, propranolol and timolol, have been shown to have a beneficial effect on mortality. Atenolol, although commonly used post MI, has not been extensively trialled in this setting.

Propranolol

• Tablets 10mg, 40mg, 80mg, 160mg (£1.38 = 80mg twice daily)
• Modified-release capsules 80mg, 160mg (£4.95 = 80mg daily)

Indications

• Propranolol may be appropriately used in a number of conditions including:
  • Prophylaxis of migraine
  • Arrhythmias
  • Tremor
  • Portal hypertension

Labetalol

• Tablets 100mg, 200mg, 400mg (£4.35 = 100mg twice daily)
• Injection 5mg in 1ml, 20ml amp

Indications

• Hypertension in pregnancy

Dose

• Oral: initially 100mg twice daily with food, increased at intervals of 14 days to usual dose of 200mg twice daily; up to 800mg daily in 2 divided doses (3–4 divided doses if higher); maximum 2.4g daily

Notes

1. Should only be used during the first trimester of pregnancy if the potential benefits are likely to outweigh the possible risk to the foetus
2. Labetalol is contra-indicated in asthma

Nebivolol

• Tablets 5mg (£1.40 = 5mg daily)

Indications

• Heart failure (see note below)

Notes

1. Nebivolol has been included for patients found intolerant of other beta blockers. It is only licensed for use in the management of stable mild to moderate heart failure in patients aged over 70 years.
2. Nebivolol 5mg tablets are scored meaning tablets can be halved or quartered.
3. Nebivolol 2.5mg tablets are available but cost over 35 times more than the 5mg tablets.

Sotalol

• Tablets 40mg, 80mg, 160mg (£1.86 = 80mg twice daily)

Indications

• Arrhythmias

Esmolol

• Injection 10mg in 1ml, 10ml vial, 250ml infusion bag