General Toxicity Notes
Blood pressure is the best guide to dose and interval. Hyperkalemia in ESRD.
Half-Life (Normalesrd) Hours
19/26-45
Plasma Protein Binding %
28
Volume Of Distribution L/Kg
1.9-2.5
Dose For Normal Renal Function
40 mg q24h
Second Dose
Second Dose: 40-240 mg q24h
Adjustment For Renal Failure Method
I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
q24h [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
q24-48h [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
q40-60h [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Dose after dialysis, [A]
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10, [A]
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Dose for GFR 10-50, titrate, [D]
References
Frishman WH. Nadolol: a new beta-adrenoceptor antagonist. N Engl J Med. 1981; 305: 678-82. [PMID: 6115316] / Herrera J, Vukovich RA, Griffith DL. Elimination of nadolol by patients with renal impairment. Br J Clin Pharmacol. 1979; 7 Suppl 2: 227S-231S. [PMID: 37878] / Michaels RS, Duchin KL, Akbar S, Meister J, Levin NW. Nadolol in hypertensive patients maintained on long-term hemodialysis. Am Heart J. 1984; 108: 1091-4. [PMID: 6148869] / Seyffart G. Drug Dosage in Renal Insufficiency. Dordrecht, The Netherlands: Kluwer Academic; 1991.
Toxicity Notes
Start with prolonged interval and titrate.