Drug | Alpha blockade | Beta-1 selectivity | ISA | MSA | Lipophilicity | Usual dose* | Half life, hours¶ | Elimination |
Acebutolol | No | Yes | Yes | Yes | Low | 100 to 400 mg twice per day | 3 to 4 | Hepatic (primary) Renal (secondary) |
Atenolol | No | Yes | No | No | Low | 50 to 200 mg once daily | 6 to 9 | Renal |
Betaxolol | No | Yes | No | Yes | Low | 10 to 20 mg once daily | 14 to 22 | Hepatic (primary) Renal (secondary) |
Bisoprolol | No | Yes | No | No | Moderate | 2.5 to 20 mg once daily | 9 to 12 | Renal and hepatic |
Carteolol | No | No | Yes | No | Low | 2.5 to 5 mg once daily | 6 | Renal |
Carvedilol | Yes | No | No | Yes | High | 3.125 to 25 mg twice per day | 7 to 10 | Biliary (primary) Hepatic (secondary) |
Esmolol | No | Yes | No | No | Low | IV only 250 to 500 micrograms/kg over one minute then 25 to 50 micrograms/kg per minute as IV infusion; titrate incrementally up to maximum of 300 microgram/kg per minuteΔ | 9 minutes | Blood esterases |
Labetalol | Yes | No | Yes (Beta2) | Low | Moderate | IV 20 mgΔ Orally 100-400 mg two or three times per day | 3 to 4 | Hepatic |
Metoprolol tartrate | No | Yes | No | Low | Moderate | IV 1.25 to 5 mgΔ Orally 25 to 100 mg two times per day | 3 to 4 (7 to 9 hours in poor metabolizers) | Hepatic via CYP2D6 (polymorphic) |
Metoprolol succinate (extended release) | No | Yes | No | Low | Moderate | Orally 50 to 400 mg once daily | Apparent half-life prolonged by continuous osmotic release over ~20 hours | Hepatic via CYP2D6 (polymorphic) |
Nadolol | No | No | No | No | Low | 40 to 160 mg once daily | 20 to 24 | Renal |
Nebivolol | No | Yes | No | No | High | 5 to 40 mg once daily | 10 to 12 (19 to 32 poor metabolizers) | Hepatic |
Oxprenolol◊ | No | No | Yes | Yes | Moderate | 40 to 80 mg three times per day | 1.5 | Hepatic |
Penbutolol | No | No | Yes | No | High | 10 to 40 mg once daily | 5 | Hepatic |
Pindolol | No | No | Yes | Low | Moderate | 5 to 30 mg twice per day | 3 to 4 | Hepatic (primary) Renal (secondary) |
Propranolol | No | No | No | Yes | High | IV 1 to 5 mgΔ Orally 10 to 80 mg two to four times daily | 3 to 4 | Hepatic |
Sotalol§ | No | No | No | No | Low | 80 to 160 mg twice per day | 12 | Renal |
Timolol | No | No | No | No | Moderate | 10 to 30 mg twice per day | 4 to 5 | Hepatic (primary) Renal (secondary) |
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