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Which drug? Indication First-line Caution Uncomplicated HTN ACEi/ARB, CCB, or thiazide-like diuretic (consider patient factors) HFrEF Guideline-directed: ARNI (or ACEi/ARB) + evidence-based BB + MRA + SGLT2i Avoid non-DHP CCBs (verapamil, diltiazem): negative inotropic CKD + albuminuria ACEi/ARB Pregnancy Labetalol; nifedipine MR. Methyldopa is an alternative ACEi, ARB, MRA contraindicated AF rate control BB or non-DHP CCB (diltiazem, verapamil) where appropriate Avoid non-DHP CCBs in HFrEF
Antihypertensives Class Medication (Brand) Dose ACE inhibitor Lisinopril (Zestril) 5–20 mg OD Ramipril (Tritace) 1.25–10 mg OD Perindopril (Coversyl) 2–8 mg OD Captopril (Capoten) 12.5–50 mg BD or TDS ARB Valsartan (Diovan) 80–160 mg OD Telmisartan (Micardis) 20–80 mg OD Candesartan (Atacand) 8–32 mg OD CCB (DHP)Amlodipine (Norvasc, Istin) 5–10 mg OD Nifedipine LA (Adalat LA) 30–60 mg OD Lercanidipine (Lercadip) 5–20 mg OD Thiazide-like diuretic Indapamide (Natrilix) 1.25–2.5 mg OD Loop diuretic Furosemide (Lasix) HTN/oedema: 20–80 mg PO / IV Aldosterone antagonist Spironolactone (Aldactone) 25–100 mg OD Beta blockers (also anti-anginal / rate control)Bisoprolol (Concor) 2.5–5 mg OD Metoprolol (Lopressor) 50–100 mg BD Carvedilol (Dilatrend) 6.25–25 mg BD Atenolol (Tenormin) 25–100 mg OD–BD Labetalol (Trandate) 100–400 mg BD Central acting agent Methyldopa (Aldomet) 250–500 mg BD / TDS Direct vasodilator Hydralazine (Apresoline) 100–200 mg/day in 3–4 divided doses Combination Amlodipine + Valsartan (Exforge) 5/160, 10/160 mg OD Combination Exforge HCT (+ Hydrochlorothiazide) 5/160/12.5, 10/160/12.5 mg OD Combination Amlodipine + Telmisartan (Twynsta) 40/5, 80/5, 80/10 mg OD Combination Amlodipine + Perindopril (Coveram) 5/5, 5/10, 10/10 mg OD Combination Telmisartan + HCTZ (Micardis Plus) 80/12.5 mg OD Combination Valsartan + HCTZ (Co-Diovan) 80/12.5, 160/25 mg OD
Anti-anginal Class Medication (Brand) Dose Notes Long-acting nitrate Isosorbide mononitrate (Monorem, Imdur) 30–60 mg OD Keep a nitrate-free interval; headache Short-acting nitrate GTN (glyceryl trinitrate) SL 0.4–0.5 mg PRN; IV infusion for ACS / pulmonary oedema Avoid if hypotensive or recent PDE5 inhibitor Metabolic Trimetazidine (Vastarel MR) 35 mg BD Add-on Metabolic Ranolazine (Ranexa) 375–750 mg BD QT prolongation If-channel inhibitor Ivabradine (Procoralan) 5–7.5 mg BD Sinus rhythm, HR ≥ 70 K-channel activator Nicorandil 10–20 mg BD Confirm local availability
First-line anti-anginals are beta blockers and CCBs (see above); agents here are add-on or alternatives.
Anti-arrhythmic Drug (Brand) Dose Use / notes Amiodarone (Cordarone)Arrest: 300 mg IV bolus. Non-arrest: 300 mg IV over 20–60 min → 900 mg / 24 h; PO load 200 mg TDS then taper Broad (AF, VT); thyroid / lung / LFT monitoring; central line for infusion Adenosine (Adenocor)6 mg rapid IV push → 12 mg → 12 mg SVT; transient; warn flushing / chest tightness; continuous ECG Digoxin (Lanoxin)Load 500 mcg, then 250 mcg to ~1 mg / 24 h; maintenance 62.5–250 mcg OD Rate control in AF; renal dose, check levels Verapamil (Isoptin)IV 5–10 mg slow; PO 40–120 mg TDS Rate control; avoid in HFrEF and with IV beta blocker Flecainide (Tambocor)50–150 mg BD (or IV) AF cardioversion; only if structurally normal heart
Educational reference for clinicians. Doses are typical adult starting points. Cross-check allergies, interactions, current local policy, the formulary, and renal/hepatic function before prescribing.
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Last updated · August 2026
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