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Uses

Hypertension

Management of hypertension, alone or in combination with other antihypertensive agents. Not indicated for the treatment of hypertensive emergencies.

Angina

Management of chronic stable angina pectoris.

A component of the standard therapeutic measures in the management of unstable angina or non-ST-segment elevation/non-Q-wave MI†.

Supraventricular Tachyarrhythmias

Treatment of hemodynamically stable narrow-complex supraventricular tachyarrhythmias (e.g., junctional tachycardia, paroxysmal supraventricular tachycardia, ectopic or multifocal atrial tachycardia), following use of vagal stimulation and/or IV adenosine (drug of choice), in patients with preserved left ventricular function; used to slow ventricular rate when therapy with cardiac glycoside is unsuccessful or contraindicated.

Paroxysmal atrial tachycardias, especially those caused by catecholamines or cardiac glycosides, or those associated with the Wolff-Parkinson-White syndrome.

Treatment of persistent atrial extrasystoles and noncompensatory sinus tachycardia that impair the well-being of the patient and do not respond to conventional therapy.

Slowing of rapid ventricular response in acute atrial fibrillation associated with AMI when heart rate is ≥120 bpm and clinical left ventricular dysfunction (e.g., overt heart failure), bronchospastic disease, or other contraindications are not present.

May be especially useful in conjunction with a cardiac glycoside to slow ventricular rates in the treatment of atrial flutter and fibrillation in patients whose arrhythmia is not controlled by adequate doses of a cardiac glycoside alone.

Ventricular Arrhythmias

Treatment of hemodynamically stable, polymorphic ventricular tachycardia† associated with myocardial ischemia or infarction in patients with normal cardiac function and baseline QT interval; considered an alternative agent to other IV β-adrenergic blocking agents and rarely used. May be used cautiously IV, with constant ECG monitoring, when cardioversion techniques or other drugs are not indicated or are ineffective and when a matter of minutes in controlling the arrhythmia may mean life or death.

Treatment of tachyarrhythmias during cardiovascular surgery†, including decreasing ventricular fibrillation time during cardiopulmonary bypass surgery†.

Treatment of persistent ventricular premature contractions that impair the well-being of the patient and do not respond to conventional therapy.

Tachyarrhythmias Associated with Cardiac Glycoside Intoxication or Catecholamine Excess

Management of supraventricular or ventricular tachyarrhythmias associated with cardiac glycoside toxicity when AV block is not present.

Management of resistant tachyarrhythmias associated with catecholamine excess during anesthesia; use with extreme caution and constant ECG and central venous pressure monitoring. More effective and less hazardous therapy, such as lessening the depth of anesthesia or improving ventilation, is preferred.

Hypertrophic Subaortic Stenosis

Management of exertional or other stress-induced angina, vertigo, syncope, and palpitation in patients with hypertrophic subaortic stenosis; clinical improvement may be temporary.

Pheochromocytoma

Management of symptoms resulting from excessive β-receptor stimulation in patients with inoperable or metastatic pheochromocytoma, as an adjunct to α-adrenergic blocking agents. Initiate therapy with an α-adrenergic blocking agent prior to treatment of pheochromocytoma. (See Pheochromocytoma under Cautions.)

Management of tachycardia prior to or during surgery in patients with pheochromocytoma, as an adjunct to α-adrenergic blocking agents. Initiate therapy with an α-adrenergic blocking agent prior to treatment of pheochromocytoma. (See Pheochromocytoma under Cautions.)

Thyrotoxicosis

Short-term (2–4 weeks) adjunctive therapy of tachycardia and supraventricular arrhythmias in patients with thyrotoxicosis when these symptoms are distressful or hazardous, or when immediate therapy is necessary.

Vascular Headache

Prophylaxis of common migraine headache; not recommended for the treatment of a migraine attack that has already started.

AMI

Secondary prevention following AMI to reduce the risk of reinfarction† and mortality.

Management of acute tachyarrhythmias complicating AMI† even when left ventricular failure caused by the arrhythmia is present.

Essential Tremor

Management of essential (familial, hereditary) tremor.

Not indicated for tremor associated with Parkinsonism.