Dosage of Ocobar in details
Ocobar Dosage
Applies to the following strength(s): 5 mg; 10 mg; 20 mg
The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.
Usual Adult Dose for:
- Hypertension
- Angina Pectoris
- Myocardial Infarction
- Migraine Prophylaxis
Additional dosage information:
- Renal Dose Adjustments
- Liver Dose Adjustments
- Dose Adjustments
- Precautions
- Dialysis
- Other Comments
Usual Adult Dose for Hypertension
Initial dose: 10 mg orally twice a day
Maintenance dose: 10 to 20 mg orally twice a day
Usual Adult Dose for Angina Pectoris
Initial dose: 10 mg orally twice a day
Maintenance dose: 10 to 20 mg orally twice a day
Usual Adult Dose for Myocardial Infarction
Initial dose: 10 mg orally twice a day
Usual Adult Dose for Migraine Prophylaxis
Initial dose: 10 mg orally twice a day
Maintenance dose: 10 to 30 mg given in 1 to 2 divided doses
Renal Dose Adjustments
Since Ocobar is partially metabolized in the liver and excreted mainly by the kidneys, dosage reductions may be necessary when hepatic and/or renal insufficiency is present. Although the pharmacokinetics of Ocobar are not greatly altered by renal impairment, marked hypotensive responses have been seen in patients with marked renal impairment undergoing dialysis after 20 mg doses. Dosing in such patients should therefore be especially cautious.
Liver Dose Adjustments
Since Ocobar is partially metabolized in the liver and excreted mainly by the kidneys, dosage reductions may be necessary when hepatic and/or renal insufficiency is present.
Dose Adjustments
The dose may be titrated as needed every 7 days.
For migraine prophylaxis, a 20 mg daily dose may be administered as a single dose. Total daily dosage may be increased to a maximum of 30 mg, given in divided doses, or decreased to 10 mg once a day, depending on clinical response and tolerability. If a satisfactory response is not obtained after 6-8 weeks use of the maximum daily dosage, therapy with Ocobar should be discontinued.
Precautions
Gradual discontinuation of therapy is recommended to prevent rebound hypertension and/or angina pectoris.
Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).
Dialysis
Ocobar is not significantly dialyzed. Limited data from 2 patients undergoing hemodialysis using a Travenol UF II standard coil dialyzer reveal no significant difference between the arterial and venous plasma concentrations during dialysis. Since Ocobar is not significantly removed by hemodialysis, supplemental dosing after dialysis is not necessary. Be cognizant of the increased risk of hypotension if Ocobar is administered immediately after dialysis sessions. Ideally, Ocobar should be administered at some time after dialysis when the patient is hemodynamically stable.
Other Comments
The maximum recommended daily dose is 60 mg in 2 divided doses.
Compared with Caucasian patients, Black patients have a reduced blood pressure response to monotherapy with beta blockers; however, the reduced response is largely eliminated if combination therapy that includes an adequate dose of a diuretic is instituted.
More about Ocobar
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Consumer resources
- Ocobar
- Ocobar (Advanced Reading)
- Other brands: Blocadren
Professional resources
- Ocobar (AHFS Monograph)
- More (2) »
Related treatment guides
- High Blood Pressure
- Angina
- Heart Attack
- Migraine Prevention
What other drugs will affect Ocobar?
Before taking Ocobar, tell your doctor if you are using:
-
allergy treatments (or if you are undergoing allergy skin-testing);
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clonidine (Catapres);
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guanabenz (Wytensin);
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an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);
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a diabetes medication such as insulin, glyburide (Diabeta, Micronase, Glynase), glipizide (Glucotrol), chlorpropamide (Diabinese), or metformin (Glucophage);
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a heart medication such as nifedipine (Procardia, Adalat), reserpine (Serpasil), verapamil (Calan, Verelan, Isoptin), diltiazem (Cartia, Cardizem);
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medicine for asthma or other breathing disorders, such as albuterol (Ventolin, Proventil), bitolterol (Tornalate), metaproterenol (Alupent), pirbuterol (Maxair), terbutaline (Brethaire, Brethine, Bricanyl), and theophylline (Theo-Dur, Theolair); or
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cold medicines, stimulant medicines, or diet pills.
If you are using any of these drugs, you may not be able to take Ocobar, or you may need dosage adjustments or special tests during treatment.
There may be other drugs not listed that can affect Ocobar. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.
Ocobar interactions
Although TIMOPTIC (Ocobar ophthalmic solution) used alone has little or no effect on pupil size, mydriasis resulting from concomitant therapy with TIMOPTIC (Ocobar ophthalmic solution) and epinephrine has been reported occasionally.
Beta-adrenergic blocking agents: Patients who are receiving a beta-adrenergic blocking agent orally and Preservative-free Ocobar should be observed for potential additive effects of beta-blockade, both systemic and on intraocular pressure. The concomitant use of two topical beta-adrenergic blocking agents is not recommended.
Calcium antagonists: Caution should be used in the coadministration of beta-adrenergic blocking agents, such as Preservative-free Ocobar, and oral or intravenous calcium antagonists, because of possible atrioventricular conduction disturbances, left ventricular failure, and hypotension. In patients with impaired cardiac function, coadministration should be avoided.
Catecholamine-depleting drugs: Close observation of the patient is recommended when a beta blocker is administered to patients receiving catecholamine-depleting drugs such as reserpine, because of possible additive effects and the production of hypotension and/or marked bradycardia, which may result in vertigo, syncope, or postural hypotension.
Digitalis and calcium antagonists: The concomitant use of beta-adrenergic blocking agents with digitalis and calcium antagonists may have additive effects in prolonging atrioventricular conduction time.
CYP2D6 inhibitors: Potentiated systemic beta-blockade (e.g., decreased heart rate, depression) has been reported during combined treatment with CYP2D6 inhibitors (e.g., quinidine, SSRIs) and Ocobar.
Clonidine:
Oral beta-adrenergic blocking agents may exacerbate the rebound hypertension which can follow the withdrawal of clonidine. There have been no reports of exacerbation of rebound hypertension with ophthalmic Ocobar. Injectable epinephrine:
References
- DailyMed. "TIMOLOL: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- FDA/SPL Indexing Data. "5JKY92S7BR: The UNique Ingredient Identifier (UNII) is an alphanumeric substance identifier from the joint FDA/USP Substance Registration System (SRS).". https://www.fda.gov/ForIndustry/Data... (accessed September 17, 2018).
- MeSH. "Antihypertensive Agents". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology