Actim

AV block, heart failure (avoid if un-controlled), peripheral arterial circulatory disorders (avoid if severe), Prinzmetals angina, myasthenia gravis, Ischaemic heart disease, withdraw gradually, history of bronchospasm, diabetes, hyperthyroidism, renal or hepatic impairment, psoriasis, elderly, consider withdrawal before elective surgery, anaphylaxis risk due to increased sensitivity to allergens, Always withdraw gradually over period of 1-2 weeks IV administration requires cardiac and blood pressure monitoring

Dose adjustment in renal impairment: with oral use max 50mg daily if eGFR15-35 ml/minute/1

max 25mg daily or 50 mg on alternate days if eGFR less than 15 ml/minute/1

With intravenous use max 10 mg on alternate days if eGFR15-35 ml/minute/1

10 mg every 4 days if eGFR less than 15 ml/minute/1