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Uses: Mild to moderate hypertension. Management of angina pectoris.


1. Second or third degree atrioventricular block. 2. Severe bradycardia. 3. Uncontrolled or digitalis/diuretic-refractory heart failure. 4. Cardiogenic shock. 5. Acute episodes of asthma. 6. Untreated pheochromocytoma. 7. Hypersensitivity to celiprolol or to the components of the formulation. 8. Sick sinus syndrome (including sino-atrial block)

Adverse reactions:

A variety of adverse effects observed with other beta-adrenergic blocking agents should be considered as potential adverse effects of celiprolol, although less likely to occur: asthenia, dizziness, nightmares, sleep disturbances, Raynaud’s disease. The most frequent adverse events reported are the following ones: Skin and appendages: cutaneous effects including psoriasisform rashes. Collagen disorders: antinuclear antibodies have been observed: Exceptional and reversible lupus syndrome. Peripheral and central nervous system: tremor, paresthesia. Vision disorders: xerophthalmias, impaired vision. Psychiatric disorders: depression, libido decrease. Gastro-intestinal system: diarrhoea and vomiting, nausea, gastralgia. Liver and biliary system: increases in transaminases. Metabolism and nutrition: hypoglycemia, hyperglycemia. Cardiovascular system: bradycardia, palpitations, hypotension, cold extremities, cardiac failure and arrhytmias. Respiratory system: bronchospasm, asthmatic dyspnoea and interstitial pneumonitis have been rarely reported. Reproduction System, Male: impotence. Body as a whole: headaches, hot flushes.


General Anesthesia: this medicine therapy must be reported to the anesthetist prior to general anesthesia. If it is decided to withdraw the drug before surgery, 48 hours should be allowed to elapse between the last dose and anesthesia. Special care should be exercised when using anaesthetic agents such as ether, cyclopropane or thrichloroethylene which cause myocardial depression, where this medicine treatment is continued. Celiprolol should be used with caution when co-administered with amiodarone. Blood pressure should be closely monitored in case of co-administration of celiprolol and dihydropyridine derivatives such as nifedipine. The risk of hypotension may be increased. There is also a risk of cardiac failure in patients with a latent or uncontrolled cardiac insufficiency. Associations not recommended: Verapamil: verapamil and celiprolol both slow A-V conduction and depress myocardial contractility through different mechanisms. Therefore, clinical signs and electrocardiogram should be carefully monitored during the treatment with this combination particularly when initiating therapy. Floctafenine: In case of shock or hypotension due to floctafenine, beta-blockers make the drugs used for compensating these symptoms less effective. Monoamineoxidase inhibitors (exception MOA-B inhibitors): co-administration of beta blockers with MAOI is not recommended. Associations to be used with caution: Class I antiarrhythmic agents (disopyramide, quinidine): risk of disturbances in rhythm and conduction. Therefore, clinical and ECG monitoring must be performed. Calcium antagonists: diltiazem, bepridil, as they depress the myocardial contractibility and slow the A.V. conduction. Insulin and oral antidiabetic drugs: beta-adrenergic blockade may prevent the appearance of signs of hypoglycemia, such as tachycardia. In diabetics treated by sulfonylureas, efficacy of the treatment may be increased and drug adjustment may be required. Anesthetic drugs: celiprolol therapy must be reported to the anesthetist prior to general anesthesia. (See also section 6. Anesthesia) Celiprolol, as other ? blockers, attenuates the reflex tachycardia and increases the risk of hypotension. Associations to be taken into account: Prostaglandin synthetase inhibiting drugs; may decrease the hypotensive effects of beta-blockers. Tricyclic antidepressants and phenothiazines: concomitant administration may increase the anti-hypertensive effect of beta blockers and the risk of orthostatic hypotension. Mefloquine: risk of bradycardia.


Sudden withdrawal of ?eta adrenoceptor blocking agents in patients with ischaemic heart disease may result in the appearance of anginal attacks of increased frequency or severity or deterioration in cardiac state. Discontinuation of therapy should be gradual. The ?eta-blocker should only be used with caution in patients with controlled congestive cardiac failure or with a history of asthma. Evidence of recrudescence of either condition should be regarded as a signal to discontinue therapy. Celiprolol may be used in patients with obstructive respiratory disorders provided that adequate supervision is maintained to permit any necessary adjustment of dosage of the bronchodilator employed. The initial treatment of severe malignant hypertension should be so designed as to avoid reduction in diastolic blood pressure with impairment of autoregulatory mechanisms. Patients with hepatic or renal insufficiency should be carefully monitored after treatment has commenced. Cardiac Failure: in patients with well-controlled cardiac insufficiency, celiprolol requires strict medical surveillance. Symptoms of cardiac decompensation should be regarded as a signal to discontinue therapy. First degree heart block: celiprolol should be given with caution in patients with first degree heart block. Prinzmetal’s angina: beta-blockers may increase the number and the duration of anginal attacks in patients with Prinzmetal’s angina. Peripheral circulatory disorders: due to its vasodilating activity, celiprolol may be used in patients with peripheral circulatory disorders (Raynauds disease or syndrome, intermittent claudication). Nevertheless, close monitoring of such patients is advisable. Asthma and bronchospastic diseases: due to its beta 1 selective blocking and beta 2 agonist properties, celiprolol may be used with caution in controlled asthmatics and in patients with compensated chronic obstructive pulmonary disease. Impaired Renal Function: see dosage and method of administration. Treated pheochromocytoma: close blood pressure monitoring should be exercised. Diabetes Mellitus: although celiprolol dose not interfere with the metabolism of carbohydrates, celiprolol as other beta blockers may mask the symptoms of hypoglycaemia. (see also section 4.5). Allergic reactions have been observed with celiprolol which may increase both the sensitivity towards allergens and the seriousness of anaphylactic reactions induced by other drugs. Drug-screening tests: celiprolol which may induce a positive reaction when drug-screening tests are conducted and patients should be informed about such a possibility. Discontinuation of therapy should be gradual i.e. over 1-2 weeks



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