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Common Oral Antihypertensive Agents

Obat-Obat Anti Hipertensi

Table below lists the available antihypertensive medications. Although all of these classes of agents have been shown to be roughly equal in their ability to lower blood pressure in large population studies, they are not equally effective in all demographic groups or in preventing all complications. The initial choice for a given patient should take age, race, metabolic side effects, other cardiac risk factors and, most importantly, concomitant diseases into consideration.

The report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure recommends monotherapy with diuretics or Beta-blockers as initial therapy. Calcium channel blockers, ACEIs, and ARBs, are alternative first-line agents. The report does recognize special populations, such as diabetic patients and patients with coronary disease, which need special consideration.

Drug Total Daily Dose1 (mg) Frequency Drug Total Daily Dose1 (mg) Frequency
Adrenergic inhibitors   Calcium channel blockers  
 Alfa -Blockers    Diltiazem (SR) 120–160 Twice daily
    Doxasosin 1–16 Once daily     (CD, XR) 120–160 Once daily
     Prazosin 1–20 Two or three times daily    Verapamil 80–480 Two or three times daily
     Terazosin 1–20 Once daily     (long-acting) 120–480 Once or twice daily
  Beta-Blockers   Dihydropyridines
     Atenolol 25–100 Once daily      Amlodipine 2.5–10 Once daily
     Betaxolol 5–40 Once daily      Felodipine 5–20 Once daily
     Bisoprolol 5–20 Once daily      Isradipine 2.5–10 Twice daily
     Carvedilol 3.125–25 Twice daily      Nifedipine (GITS) 30–120 Once daily
     Metoprolol 25–200 Twice daily
     Nadolol 20–240 Twice daily Diuretics  
     Propranolol (long-acting) 60–240 Once daily   Thiazide–type
    Bendroflumethiazide 2.5–5 Once daily
     Timolol 20–40 Once daily     Benzthiazide 12.5–50 Once daily
  Beta-Blockers with ISA      Chlorthalidone 12.5–50 Once daily
     Acebutolol 200–1200 Once daily     Chlorthiazide 12.5–50 Once daily
     Carteolol 2.5–10 Once daily     Hydroclorthiazide 12.5–50 Once daily
     Penbutolol 20–80 Once daily      Indapamide 2.5–5 Once daily
     Pindolol 10–60 Twice daily      Metolazone 1.25–5 Once daily
  Alfa-Beta-Blockers      Methyclothiazide 2.5–5 Once daily
     Labetalol 200–1200 Once or twice daily     Polythiazide 1.0–4 Once daily
ACE inhibitors       Trichlormethiazide 1.0–4 Once daily
     Benazepril 10–40 Once or twice daily   Loop diuretics
     Captopril 25–50 Three times daily      Bumetanide 0.5–5 Twice daily
     Enalapril 10–40 Once or twice daily      Furosemide 10–300 Twice daily
     Fosinopril 10–40 Once or twice daily      Torsemide 2.5–10 Once daily
     Lisinopril 10–40 Once or twice daily   Potassium-sparing agents
     Moexipril 7.5–30 Once or twice daily      Amiloride 5–10 Once or twice daily
    Perindopril 4–16 Once daily      Spironolactone 25–100 Two or three times daily
     Quinapril 10–80 Once or twice daily      Triamterene 50–150 Once or twice daily
     Ramipril 2.5–20 Once or twice daily
     Trandolapril 1–8 Once daily Centrally acting agents  
   Clonidine 0.1–1.2 Once or twice daily
Angiotensin receptor blockers       Transdermal 0.1–0.3 Once a week
   Candesartan 2–32 Once daily    Guanabenz 4–64 Twice daily
   Eprosartan 600–800 Once or twice daily    Methyldopa 250–2000 Twice daily
   Irbesartan 75–300 Once daily
   Losartan 25–100 Once or twice daily Peripheral vasodilators  
   Telmisartan 20–80 Once daily    Hydralazine 50–200 Once or twice daily
   Valsartan 80–320 Once daily    Minoxidil 2.5–80 Once or twice daily

1The total daily dose should be given in divided doses at the frequency specified. The initial dose should be the smallest listed.

ISA: intrinsic sympathomimetic activity 

Current Diagnosis & Treatment Cardiology 3rd Edition (McGraw-Hill) 2009

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