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Beta-blocker

Acebutolol

Brand names: Sectral

Acebutolol is a cardioselective beta-blocker with partial agonist (intrinsic sympathomimetic) activity used in hypertension and angina and to control certain arrhythmias.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Hypertension: initial 400 mg
Route: Oral
Frequency: Once daily (twice daily in some patients); usual optimal 400-800 mg/day
Max: 1200 mg daily (administered b.i.d.) for more severe hypertension
Some patients maintained on as little as 200 mg/day. Ventricular arrhythmia: initial 400 mg/day as 200 mg b.i.d., increased gradually to usually 600-1200 mg/day. If discontinuing, reduce gradually over about two weeks. Elderly: approx. 2-fold increased bioavailability — may need lower maintenance doses; avoid doses above 800 mg/day.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Persistently severe bradycardia
  • Second- and third-degree heart block
  • Overt cardiac failure
  • Cardiogenic shock

Side effects

  • Hypotension, bradycardia, heart failure
  • Anxiety, hyper/hypoesthesia, impotence
  • Pruritus
  • Vomiting, abdominal pain
  • Liver abnormalities (raised SGOT/SGPT/LDH, occasionally bilirubin/ALP)

Clinical monograph

How it works

It selectively blocks beta-1 adrenoceptors, reducing heart rate, myocardial contractility and cardiac output while exhibiting partial agonist activity.

Prescribing in practice

  • Do not stop abruptly in patients with ischaemic heart disease, as sudden withdrawal can precipitate worsening angina, arrhythmia or myocardial infarction; taper gradually.
  • Contraindicated in asthma and uncontrolled heart failure, and used with caution in second- or third-degree heart block and severe bradycardia.
  • May mask the adrenergic warning signs of hypoglycaemia, so use with care in patients with diabetes.

Monitoring

Monitor heart rate, blood pressure and clinical response, watching for bradycardia, hypotension and signs of heart failure.

Counselling the patient

  • Take it regularly and do not stop suddenly without medical advice.
  • Report severe dizziness, breathlessness, wheeze or a very slow pulse to your prescriber.

Evidence & guidelines

The cardiovascular benefits of beta-blockade are well established, and acebutolol's use is supported by the SPC and standard practice.

Reference: SmPC Sectral; ESC Hypertension Guidelines 2018; NICE NG136; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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