Rotenol 50 mg Tablet

Cardioselective beta-blocker for:

• High blood pressure
• Angina (chest pain)
• Irregular heart rhythms (supraventricular arrhythmias, fast heart rate)
• Early treatment after a heart attack
• Sometimes for migraine prevention and anxiety symptoms (off-label)

Hypertension: 25–50 mg once daily (maximum usually 100 mg; higher doses rarely add benefit).

Angina: 50–100 mg daily in 1–2 doses.

Arrhythmia: 50–100 mg once daily.

Kidney impairment: CrCl 15–35: maximum 50 mg daily; below 15: maximum 25 mg daily (or 50 mg on alternate days).

Children (arrhythmia, specialist): 0.5–2 mg/kg daily.

• Take at the same time each day.
• Do not stop suddenly (risk of angina or heart attack) — reduce over 1–2 weeks.

• Slow heart rate (below 50/min), 2nd or 3rd degree heart block, sick sinus syndrome
• Cardiogenic shock, uncontrolled heart failure
• Severe low blood pressure, severe peripheral circulation disorders
• Untreated phaeochromocytoma, metabolic acidosis
• Severe asthma or bronchospasm

Common: tiredness, cold hands and feet, slow heartbeat, stomach upset, dizziness.

Less common: sleep disturbance, vivid dreams, low mood, erectile difficulty, worsening of psoriasis.

Rare but serious: heart block, worsening heart failure, bronchospasm in asthma, masking of low blood sugar signs, rash, dry eyes.

• Asthma/COPD: caution, use the lowest dose.
• Diabetes: may hide hypoglycaemia (except sweating).
• Before surgery tell the anaesthetist.
• Thyrotoxicosis: may mask signs.
• Check pulse regularly.

Not recommended in pregnancy (associated with low birth weight) — labetalol or others preferred. Avoid while breastfeeding (accumulates in milk; slow heart rate in baby).

• Verapamil, diltiazem (heart block, very slow pulse) — avoid together
• Clonidine (rebound hypertension if clonidine is stopped first)
• Amiodarone, digoxin (slow pulse)
• Insulin, diabetes tablets (hidden hypoglycaemia)
• NSAIDs (reduced effect)
• Adrenaline (severe hypertension)

Slow heartbeat, low blood pressure, heart failure, bronchospasm. Emergency treatment.

Store below 30°C, protected from light and moisture.